HomeMy WebLinkAboutBLD2012-00102 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#: BLD12-00102
SITE ADDRESS: 1740 SWANSONVILLE RD Issue Date: 06/13/2012
PORT LUDLOW, 98365 Final Date: 10/22/2013
APPLICANT: MARK D KURRUS PHONE: 360-437-0247
LISA L KIRSCH KURRUS
1740 SWANSONVILLE RD
PORT LUDLOW WA 983659779
SUBDIVISION: Block: Lot: +
PARCEL NUMBER: 821053012 Section: 5 Township: 28 N Range: 01 E
PROJECT DESCRIPTION: CONVERT 238 SF TO HTD REC ROOM IN EXISTING ATTACHED GARAGE
THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2009
EDITION.
OCCUPANCY GROUP: R-3
TYPE OF CONSTRUCTION: 5N
SPRINKLER SYSTEM yes no
THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 10/22/2013
\\tidemark\data\forms\F_BLD_Occupancy.rpt 10/28/2013
GILDING PERMIT APPLICATION BLD12-00102
Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD12-00102 Received Date: 3/28/2012
SITE ADDRESS: 1740 SWANSONVILLE RD
PORT LUDLOW, 98365
OWNER: MARK D KURRUS PHONE: 360-437-0247
LISA L KIRSCH KURRUS
1740 SWANSONVILLE RD
PORT LUDLOW WA 983659779
SUBDIVISION: Block: Lot: +
PARCEL NUMBER: 821053012 Section: 5 Township: 28 N Range: 01 E
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOF CONVERT 238 SF TO HTD REC ROOM IN EXISTING ATTACHED
GARAGE
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP ALT MAIN: 238
VALUATION 24,733.00 ADD'L: HEAT TYPE: HTP
CODE EDITION: 2009 HEAT BASE: HEAT TYPE:
OCCUPANCY: R-3
OCCUPANCY: UNHEATED: #OF STORIES:
CONST TYPE: 5N OTHER: SHORELINE:
CONST TYPE: GARAGE: SETBACK:
DECK: BANK HEIGHT:
SEWAGE DISPOSAL: ALT
WATER SYSTEM: 1PWELL
BEDROOMS: BATHROOMS:
Exist: 3 Exist: 2
Prop: 0 Prop: 0
Total: 3 Total:_ 2
Routing Date
3-Zs -12
Type Amount-Frail Bv: Date: Receipt: Approved/Date
Permit $391.25 LYK 03/28/12 131584 APPROVE'
Plan Check $254.31 LYK 03/28/12 131584
State Building Code $4.50 LYK 03/28/12 131584 JUN
Total: $650.06 Jefferson County Plannin
& Building Department
Jefferson County Building Dion Permit Num BLD12-00102
Applicant: KURRUS
BUILDING 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
Framing 7/f / /
Airseal ���� .�.�17
Insulation:Walls -11 7-5-i7,3Insulation: Floors
Insulation: Ceiling42-4 3
/h
Wallboard Nailing
—13 -'J A00 t s .4,-,2,.•e
FINAL INSPECTION - 1 l 14-)
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
•
CONDITIONS for Building Permit# :BLD12-00102
1.) No plumbing has been reviewed or approved for this project by Jefferson County Public
Health. Additional requirements may apply if plumbing is proposed.
�05ox cod
JEFFERSON A
NTY 0 1
rr ' �. DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street • Port Townsend •Washington 98368
0' 360/379-4450 • 360/379-4451 Fax
,� dr. www.co.jefferson.wa.us/commdevelopment
Master Permit Application MLA: t0 (YlLA- e--Q 11
Project Description(include separate sheets as necessary): n
._!- n-1,Pfec,;' R :rlcc e ( - 1i d- 093Ssr,C)S V .Q 4-0 01 LC. lJ
Tax Parcel Number:. ) 05 3 0 i 01 Property SYze: . (0 cic rP acre square feet)
Site Address and/or Directions to Property:
.7HC 5.J-Nanson.:i \ \e Rek Port L..4 cl/0..v eve `tS 3(aS
Property Owner(s)of Record: M car K n nc.l L r 5 CA k u R P 4
Telephone: _j 3(cO c.1 7- C:9 -17 Fax: f email:
Mailing Address: \-Z'-jo 5..kici ry5 on.,, 1IP race Port LucAIow LU . cte3(s
Applicant/Agent(if different from owner):
Telephone: Fax: email:
Mailing Address:
Wibat kind of Permit?(Check each box that applies 0 Lot or Road Segregation
Building 0 Critical Areas Stewardship Plan
❑ Demolition Permit 0 Variance(Minor, Major or Reasonable Economic Use)
❑Single Family 0 Garage Attached/Detached ❑Conditional Use[C(Ery,. or
❑ Manufactured Home .0 Modular - • - 0 Discretionary"D"or Un lri •
c sJc t�n`�
❑ Commercial* ❑Special Use(Essential
❑ Change of Use ❑ Boundary Line Adjm''nt
❑ Address 0 Road Approach 0 Short Plat** im� i
❑ Home Business 0 Cottage Industry 0 Binding Site Plan ; I MAR 2 $ 202
❑ Propane ❑Long Plat** \I L.
❑ Sign -. ❑Planned Rural Res(dentia ndm is**
❑Allowed"Yes"Use Consistency Analysis ❑Plat Vacation/Alter4tion** 1E1 ERSOid OUNTY
^P n I . r
El Prow-A--
0
inr
Stormwater Management ❑Shoreline Master
❑ Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Substantial Development**
❑Temporary Use ❑Shoreline Management Variance
❑Wireless Telecommunication* ❑Comprehensive Plan/UDC/Land Use District Map Amendment
❑ Forest Practices Act/Release of Six-Year Moratorium 0 Jefferson County Shoreline Master Program Amendment
*May require a Pre—Application Conference 0 Tree Vegetation Request
_^ **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 to act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE Date: �-
By signing this application form,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 provide access and right of entry to Jefferson County and its employees,representatives or agents for the sole purpose of application
review and any required later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the plica ion that he or he wants prior notice.
Signature: Date: 3 Q 7
The action a ' ns Applicant will undertake as a result of the issuance of this permit may negatively impact upon one or more threatened or
endangered s ecies 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"or"ESA."Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this
permit has been issued will not violate 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 in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual
and non-transfera le response •ity for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: / .., 1,t�"..� Date: 3)c�7 j (a-
G:\PemmitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc
r •
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 response ility of the General Contractor for the proposed project.
Signature: } )4. -' k.jy ..7
. --' Date: 3I,a- la
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
f`lctvk eLA.1ik.,S ( ' 11 L( 37-0—)LI —) ( )
MAILING ADDRESS: EMAIL.:
CONTRACTOR'S LICENSE WAINS
NUMBER: NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
❑ New Wood Existing: __ 0 Sewer
❑ Addition ❑ Steel Proposed: — Bank ❑ Community System
.(S1,'Alteration/Remodel 0 Concrete Total: _ Height: 1!'Individual System
❑ Repair ❑ Masonry SEP Permit# 0,?- 0oo-3.5
❑ Demolition ❑ Other: Bedrooms: '7 Water Supply:
Setback:Existing: N' Private well 0 Two Party
Type of at: Proposed: ❑ Public
l-k-420047 n Total: 3 Name of 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: Will you have Food Service? Yes / No
If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply: ,t,`//I-
i Underground Tank i Above ---.---'T.._'. Size of Propane Tank:
i Heat Stove i Cook Stove , vvrx,c-;�:-,;;, i Fireplace Insert i Hot Water Tank i Pellet Stove i Other
Is this appliance being installed m a ma.iufactured/Mobile Home? Yes / No A//.:}
When applying for a permit to install a propane tank you must also submit a site plan showing all of the buildings,all property
lines, tank location and size, distances from the propane tank to all property lines,buildings and septic system components,
including the reserve area.
Square Footage Current Proposed For Office Use Only Amount Revision
Main Floor Heated EH Bld App Review:
22 Floor Heated Consistency Review:
Other Heated Base fee: 3n, I ✓Q"
Mezzanine Additional Section: "�
Heated Basement Plan Check fee: c3 5 31
Unheated Basement State Surcharge fee: SC)
Other Unheated Pot Water Review fee:
Garage/Carport SUBTOTAL r7
Decks 911/Rd Approach fee:
Other TOTAL: $12.1Q ,Ob
Receipt Number: i 315
Cash/Check Number: ( 0
ESTIMATED COST(REQUIRED) Date: ,� 1.Fair market value of all labor and materials foundation to finish
--_ 6)( 00 Initials:
G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc
LEGEND Revised Record Drawing '!
� Ni
V/ 10' No Build SCALE: 1"=50'
r Soil Log \\- THIS IS NOT A SURV Y
\,,, 327"
———— Building Envelope
Setback
— Existing Componet `_,``
"•:
zas
�`� i� 5
t� Tree �1V �,--,
• O, Property Corner - ----------
and/or Elevation \
(A) Clean Out �/,7 _ I
(B) Septic Tank SO/..1
1 `
(C) Filter Sock\ V� 1
I (D) Pump Tank //
(E) Hydrotech Valve 1 L\\ 1 N\
(F) Splitter 1
Fence Line
- \ t..
\ I
J '\
,� ,N. N
-' �
v
c , ' N.
`N
o , Existing Dug Well , N.,N. ,
,.r
100' , '
I I Workshop-----•--
1
\ Driv wriy
t N� \
L ''l / 1I
v .
II
__,, {.1:_ r - 4 ,
s 1 . • ,,,, 1
s _. a i
i. 40� i i
It.
Woad Shed��l�� Shed 1' 100 • `�' �, 1
,
ID LtnYIE cl
100%Reserve Area W She '�_ _it g
V W
�
11 36' 1 8' eptic Tank#1 Chamber o r s, s
, / o0
' eptic Tank#2 Chamber `° I /
2 42' 12 p ''wage xj.tin Wells
•3 35' 21 ' Pump Tank I the-di
4 1 10' 72' or,or, A , ,� _
5 125' 93' Inspection Port
•
6 121' 89' 1 ",
7123' 87' „ SFI
. /----. '
8 170' 144' Clean Out " ' 3 bedroom
9 173' 142' 102/
10174' 139' r, �,,
\,
1 1 1 14' 72' Inspection Port ,
12 113' 71' ,,
'13 111 ' 68' "
14162' 125' Clean Out I II41
15160' 123' "
16157' 117' r,
o--, i
____,... i ,<ti.,,./. ';',.(,,132,•,t,t,
j i/,
i il I,i, A� 'h ,- , ire� q�� 'P� ��Itj ,O-T. c ',-,T,
`\. NAiHANCIEAViR i";'
Y-', LlNSD[EG CR
rXrIRFS� / / l 6
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7-E— SON COUNTY I 2t�p' Nathan Cleaver Septic Design, Inc.
�f f r'' ,ITy�rlr�lpl,� I Phone: (360) 598-6546, Fax: 360-598-6548
NT CUSTOMER: Mark Kurrus& Lisa Kirsch-K us
- -. u r
/ TAX ID #: 821-053-01 2
330' /
LOCATION: 1740 Swansonville Rd
DRAWN BY: NNC I
DESIGN BY: NATHAN CLEAVER
DATE: Original Record Drawing 8/10/2008
Revised Record Drawing 1 2/7/09
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o °' 4 1z PLAN PORT LUDLOW,WA 98365 0 M E s
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(360)437 0247 www.HiLine Homes.com
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