HomeMy WebLinkAboutBLD2012-00086 CERTIFICATE OF OCCUPANCY
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
Carl Smith, Director/Building Official
PERMIT #: BLD12-00086
SITE ADDRESS: 270 JANSEN RD Issue Date: 08/9/2012
NORDLAND, 98358 Final Date: 8/9/2013
APPLICANT: KAREN KIEST PHONE: 206-281-8106
3229 24TH AVE W
SEATTLE WA 981992807
SUBDIVISION: OLSON & HAMBLETON'S Block: Lot:
PARCEL NUMBER: 977700004 Section: 4 Township: 29 N Range: 01 E
PROJECT DESCRIPTION: RE-LOCATE EXISTING SHACK - UNHTD, NO PLMB
THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2009
EDITION.
OCCUPANCY GROUP:
TYPE OF CONSTRUCTION:
SPRINKLER SYSTEM yes (9)n
THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 8/9/2013
\\tidemark\data\forms\F_BLD_Occupancy.rpt 9/12/2013
• BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT#: BLD12-00086 Received Date: 3/19/2012
SITE ADDRESS: 270 JANSEN RD Issue Date 8/9/2012
NORDLAND, 98358 Expiration Date 8/9/2013
OWNER: KAREN KIEST PHONE: 206-281-8106
3229 24TH AVE W
SEATTLE WA 981992807
OLSON & HAMBLETON'S
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 977700004 Section: 4 Township: 29 N Range: 01 E
CONTRACTOR: METHOD CONTRACTING LLC PHONE: 206-789-5553
31803 SE 48TH ST
FALL CITY WA 98024
Contractor's License METHOCL910MS Expires 8/24/2013
PROJECT DESCRIPTION: RE-LOCATE EXSITING SHACK - UNHTD, NO PLMB
TYPE OF WORK GAR SQUARE FOOTAGE:
TYPE OF IMP ALT MAIN: 300
VALUATION 2,500.00 ADD'L: HEAT TYPE UH
CODE EDITION: 2009 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY:
OTHER:
CONST TYPE: GARAGE: SHORELINE:
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: ALT
WATER SYSTEM: 05783 Type Amount Paid By: Date: Receipt:
BEDROOMS: BATHROOMS: Permit $83.25 LYK 03/19/12 131553
Exist: 0 Exist: 0 Plan Check $54.11 LYK 03/19/12 131553
Prop: 0 Prop: 0 State Building Code $4.50 LYK 03/19/12 131553
Total: 0 Total: 0 Total: $141.86
Directions to Site:
HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED PRIOR TO FINAL INSPECTION
THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED
BUILDING INSPECTION HOT-LINE 379-4455.
Request must be received by 7 am the day the inspection is needed.
Office Hours 9:00 am -4:30 pm MONDAY - THURSDAY
HOT LINE AVAILABLE 24 HOURS A DAY
SPECIAL CONDITIONS APPLY-SEE ATTATCHED
Jefferson County Bui!ding Divi ion Permit Numb BLD12-00086
Applicant: KIEST
LUILDING PERMIT INSPECTION APPROVALS Applicable Code: 2009 International Building Codes
To schedule inspections, call (360)379-4455 no later than 7:00 AM the day of the inspection.
Requests received after 7:00 AM will not be scheduled for that day's inspections.
ELECTRICAL PERMITS are issued by the Washington State Department of Labor& Industries.
The electrical permit must be signed off by the State Inspector prior to the County's Framing Inspection
Inspection Item Date Approval Signature Notes
Foundation Footing ‘ (vim diamond piers
Straps(hold downs) g/�,/j3 L� '/ 2 rriJE eN c INN Di
Framing �a// r' OK c t�'> Gr' 1.463✓
8/9/41:). , ffe41-tcjin--/k eftid PtAZ
FINAL INSPECTION *45
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
• •
CONDITIONS for Building Permit# :BLD12-00086
1.) See BLD12-00087 for conditions that apply to this permit, project and property.
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4,* ON c0�, JEFFERSON�UNTY
' ` V.)..‘4. DEPARTMENT OF COMMUNITY DEVELOPMENT S
"' '' ' 621 Sheridan Street • Port Townsend • Washington 98368
loo
360/379-4450 • 360/379-4451 Fax
.q� Na�p www.co.jefferson.wa.us/commdevelopment
Master Permit Application MLA: o -a L
Project escription include separate sheets as necessary):
4000. = -E-PC.I Si-I SV cJ
•
Tax Parcel Number: ODUO V
�� �-- Property Size: /2.:j/ q (4. (acres/square feet)
Site Address and/or Directions to Property: i
2O ` avi Pc -.4 / N 5`6{(akl a W ii- q8 ”
Property Owner(s)of Record: l<l'e41 (/G St—
Telephone: -06-201• gf b6(4) yot:tAik 246' 323• C,O332-- email: (c-1G4 i-,k-(4,6.00,„
Mailing Address: 322c.f 244'1 C{VEm(•if f., weSrt. 1/1/A- q / ''
Applicant/Agent(if different from owner): re,t'1 /4 list /4o1 Acid /---frryk1e,5
Telephone: '2.-0.6, • 640.367,--Z Fax: email: ggrofrtQ/Y1C' afIl yesy
Mailing Address:fTh1Zwet t of 2. 2-t -04Sf"la k(.7 Lrn,G, EA.sf• 5 -(f�p W4 1 --1 02
What kind of Permit? (Check each box that applies
:uilding ($'Critical Areas Stewardship Plan
I Demolition Permit 0 Variance(Minor, Major or Reasonable Economic Use)
'Single Family 0 Garage Attached/Detached 0 Conditional Use[C(a), C(d),or C]**
❑ Manufactured Home ,81 Modular 0 Discretionary"D"or Unnamed Use Classification
❑ Commercial* 0 Special Use(Essential Public Facilities)**
❑ Change of Use 0 Boundary Line Adjustment
❑ Address 0 Road Approach 0 Short Plat**
❑ Home Business 0 Cottage Industry 0 Binding Site Plan*(`-
❑ Propane 0 Long Plat** \ ' .> . ,_ I --
❑Sign 0 Planned Rural Residential-Development **
❑Allowed"Yes" Use Consistency Analysis 0 Plat Vacation/Alteration** ;; '
O'Stormwater Management ? Shoreline Master Proglram Exemption/Permit Revisio0s I**
❑Site Plan Approval Advance Determination (SPAAD)* 0 Shoreline Management Substantial Development**I i I
❑Temporary Use 0 Shoreline ManageM_en�uariance !L-J •
❑Wireless Telecommunication* 0 Comprehensive Plan/UDGlL-and-Use-District-Map-Amendment
❑Forest Practices Act/Release of Six-Year Moratorium ❑Jefferson County 4horeline Malster'p[ogr'afr't�(mendment j
*May require a Pre-Application Conference 0 Tree Vegetation R quest' -I't •'i• I• r_ .•,1 1
**Requires a Pre-Application Conference
Please identify any other local, state or federal permits required for this proposal, if known:
~ • DESIGNATION OF AGENT
I hereby designate O✓ 0( o act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE Date: I�'�(({�i� 1' OI7/
By signing this application fo ,the owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of
his,her or its knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet
may result in this permit being null and void.
I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorney's fees and
expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit.
I further agree to pr vo tde,acces�s right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application
review and an required at ' specttons. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the ap lication that or she nts prior notice.
Signature: Date: " W 41 /?'I ' 0/2.-
The action or actions Applicant will undertake as a result of the issuance of this permit may negatively impact upon one or more threatened or
endangered species and could lead to a potential"take"of an endangered species as those terms are defined in the federal law known as the
"Endangered Species Act"o " SA."Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this
permit has been issue• ill of v late the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your
action(s)even if you are."compli ce with the Jefferson County development code.The Applicant acknowledges that he, she or it holds individual
and non-tran ferable re3'+7l sibi" r adhering to and complying with the ESA. The Applicant has read this di taiimer a d signs and dates it below.
Signature: / Date: ( a /3- 2.-01 Z
t
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• •
BUILDER STATEMENT
The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that
they will be assuming the responsibility of the General Contractor for the proposed project.
Signature: Date:
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
RE-1?-!o /10 L. a�6) 7
�-5 ) G. (z5--q.scs3 (zo6) 7E-9-5'fs y
MAILING ADDRESS: -z Y / gAsI/4ke, QrAt i-, EMAIL.: .4pr' e kt,A014h^Gli/L4..�
CONTRACTOR'S LICENSE WAINS
NUMBER: me T,/d C e.- el/t) 4'75 NUMBER
ARCHITECT/ENGINEER: 1//.<1 PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
New tAcWood Existing: 1 Sewer
C Addition Steel Proposed: Bank 1, Community System
2--Alteration/Remodel E Concrete Total: — Height: C Individual System
C Repair E. Masonry SEP Permit#
—
C Demolition JOther: Bedrooms: Water Supply:
Existing: - Setback: - Private well Two Party
TynJiea Proposed: Public
y�R� Total: Name System:
If this is a Commercial Project you must answer the following:
Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces:
Number of occupants (includes owners,tenants, employees, etc) Current Proposed
• IBC Occupancy: IBC Type of construction: L -�II;y_qu aae�E J I(fez Y /I No
If this is a Propane Tank and/or Appliance Installation permit, mark all itpms`,b��pol- " I i-,-,
i Underground Tank i Above ground Tank Size of Propane Tank: I I I
i Heat Stove i Cook Stove i Woodstove i Fireplace Insert i Hot Water Tank i•Pellet Stove i Othei ) _
Is this appliance being installed in a Manufactured/Mobile Home? Yes'/ No: ii�14
When applying for a permit to install a propane tank you must also submit a'sjte plan showing all of th i t ilcings,all property
lines, tank location and size,distances from the propane tank to all property lines,bt(ifyiagscvj septic system components,
including the reserve area.
prn7 pr c,cri,tijr.im.orvrl noM NT
Square Footage Current Proposed For Office Use Only - Amount . Revision
Main Floor Heated EH Bld App Review: .
s F2 _
2":`Floor Heated Consistency Review:
Other Heated Base fee: W I
S3.2S
Mezzanine Additional Section:
Heated Basement Plan Check fee:
Unheated Basement State Surcharge fee: 50
Other Unhea d. -- ._ — ---- / — —
_ 0� Pot Water Review fee: ---
Garage/Carport SUBTOTAL
Decks 911/Rd Approach fee: _
Other •
•
TOTAL: $ L _ g(4,
Receipt Number:
Cash/Check Number:
ESTIMATED COST(REQUIREQ Date: ��
• arrm`ar ue o a materials foundation to finish — ` 42 -,
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NEIV ELECTRIC LINE FROM EX. SERVICE
JANSEN ROAD 60' R.O.W. (UNIMPROVED
��, KAREN KIEST
0 0 ,,, landscape architects
ZIII west john street, suite 305
Seattle washington 98119
t e I: 206. 323. 6032
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OJANSEN ROAD \ / fax. 206.281.9336
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