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Home My WebLink AboutBLD2012-00239 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#: BLD12-00239 SITE ADDRESS: 313786 HWY 101 Issue Date: 08/6/2012 BRINNON, 98320 Final Date: 6/20/2013 APPLICANT: VICTORIA M DADI PHONE: 425-445-0591 ANDREW DADI 313786 US HIGHWAY 101 BRINNON WA 98320-9713 SUBDIVISION: Block: Lot: T 61+ PARCEL NUMBER: 502311013 Section: 31 Township: 25 N Range: 02 W PROJECT DESCRIPTION: BATHROOM REMODEL 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 C i THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 6/20/2013 \\tidemark\data\forms\F_BLD_Occupancy.rpt 7/12/2013 Jefferson County Building Division Permit Numb. BLD12-00239 Applicant: DADI 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 Rough-in Plumbing , a(1., /)_ 3 /G-7.�Framing / � (�— �-/Z- / v FINAL INSPECTION FINAL INSPECTIO MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR IPUILDING PERMIT APPLICAN BLD12-00239 Jefferson County Department of Community Development Review Type: 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD12-00239 Received Date: 8/2/2012 SITE ADDRESS: 313786 HWY 101 BRINNON, 98320 OWNER: VICTORIA M DADI PHONE: 425-445-0591 ANDREW DADI 313786 US HIGHWAY 101 BRINNON WA 98320-9713 SUBDIVISION: Block: Lot: T 61+ PARCEL NUMBER: 502311013 Section: 31 Township: 25 N Range: 02 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE PROJECT DESCRIPTIOt BATHROOM REMODEL TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ALT VALUATION 5,000.00 MAIN: ADD'L: HEAT TYPE: EEE CODE EDITION: 2009 HEAT BASE: HEAT TYPE: OCCUPANCY: R_3 OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: 5N OTHER: CONST TYPE: GARAGE: SHORELINE: DECK: SETBACK: SEWAGE DISPOSAL: CON BANK HEIGHT: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: 2 Exist: 2 Prop: 0 Prop: 0 Total: 2 To : Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $111.25 LYK 08/02/12 135071 Plan Check $72.31 LYK 08/02/12 135071 APPROVEr State Building Code $4.50 LYK 08/02/12 135071 Total: $188.06 AUG to 202 Jefferson County Planninr & Building Department \\4irlomorle\r4o4o\fnrme\C RI n Ann Rlrl rnt Q/1/1/111 • BUILDING PERMIT • Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD12-00239 Received Date: 8/2/2012 SITE ADDRESS: 313786 HWY 101 Issue Date 8/6/2012 BRINNON, 98320 Expiration Date 8/6/2013 OWNER: VICTORIA M DADI PHONE: 425-445-0591 ANDREW DADI 313786 US HIGHWAY 101 BRINNON WA 98320-9713 SUBDIVISION: Block: Lot: T 61+ PARCEL NUMBER: 502311013 Section: 31 Township: 25 N Range: 02 W CONTRACTOR: OWNER/BUILDER PHONE: PROJECT DESCRIPTION: BATHROOM REMODEL TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ALT MAIN: VALUATION 5,000.00 ADD'L: HEAT TYPE: EEE CODE EDITION: 2009 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: Type Amount Paid By: Date: Receipt: BEDROOMS: BATHROOMS: Permit $111.25 LYK 08/02/12 135071 Exist: 2 Exist: 2 Plan Check $72.31 LYK 08/02/12 135071 Prop: 0 Prop: 0 State Building Code $4.50 LYK 08/02/12 135071 Total. 2 Total: 2 Total: $188.06 Directions to Site: HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUIRED PRIOR TO FINAL INSPECTION THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED BUILDING INSPECTION HOT-LINE 379-4455. Request must be received by 7 am the day the inspection is needed. Office Hours 9:00 am -4:30 pm MONDAY - THURSDAY HOT LINE AVAILABLE 24 HOURS A DAY ��,gN CO JEFFERSON COUNTY • 4 / COVE oi‘it621 SheridanDEPARTMENT StreetOF • Port TownsendMMUNITYDE E. LOPMENTWashington 98368 360/379-4450 • 360/379-4451 Fax qG„SO$ www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: no 'f 1C- Proje Description(include s pa to sheets as neces ary): ( 1 tXY'J. Ce. — See. �CJu.� Tax Parcel Number: 502 3 %t 0 t"5 , Pr (acres/square feet) Site Address and/or Directions to Property: C , u V L 313'i-E C OS G--t t,�.s l O t 1 C�c wwt o� M Property Owner(s)of Record: AtActie 1 pc-AAA I v J d'I•n( Telephone:42-S". 445-()S 1 Fax: i' '� jui u emal: , C J 1. Mailing Address: i C,OtM Applicant/Agent(if different from owner): I JEFFERSON COUNTY Telephone: Fax: L_ DE_PT OF COMMUN44{41 JEIOPMF NT Mailing Address: What kind of Permit?(Check each box that applies t3Building 0 Critical Areas Stewardship Plan ❑ Demolition Permit 0 Variance(Minor,Major or Reasonable Economic Use) ®'Single Family 0 Garage Attached/Detached 0 Conditional Use[C(a),C(d),or CJ** ❑ Manufactured Home 0 Modular ❑ Discretionary"D"or Unnamed Use Classification ❑ Commercial* 0 Special Use(Essential Public Facilities)** ❑ Change of Use ❑Boundary Line Adjustment ❑ Address 0 Road Approach 0 Short Plat"* ❑Home Business 0 Cottage Industry 0 Binding Site Plan** ❑Propane 0 Long Plat*" ❑Sign 0 Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis 0 Plat Vacation/Alteration** ❑Stormwater Management ❑Shoreline Master Program Exemption/Permit Revisions** ❑Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Substantial Development** ❑Temporary Use 0 Shoreline Management Variance ❑Wireless Telecommunication* 0 Comprehensive Plan/UDC/Land Use District Map Amendment ❑Forest Practices Act/Release of Six-Year Moratorium ❑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 attomey'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 application that he or wants prior notice. Signature:t o'- --� Date: ' 171 12 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"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-tran- =ble responsibi' or a hering to and complying with the ESA. The Applicant has read this discla. er an signs and dates it below. Signature: C.---`�(� Date: �13t (`2- G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc • • 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 a ming the respon .lity of the General Contractor for the proposed project. Signature: cwt.) J1C Date: 3( GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: Fax: ( ) ( ) 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: J New r Wood Existing: l . 1-( ❑ Sewer ❑ Addition ❑ Steel Proposed: t.•c.) Bank ❑ Communi S stem )4' Alteration/Remodel ❑ Concrete Total: � � SRe air ❑ Masonry I 4t?+•l 1S4 Demolition ❑ Other: Bedrooms: I�r— Water Supply. Existing: eta; Private well Two Party Type of LHeat: Proposed ❑ P �j e_leck'i c_ Total: Na;ime 1`Syst C�v J If this is a Commercial Project you must answer the following: i ` JEFFERSON COUNTY Number of Parking Spaces: Current: Proposed: Number o1` 1�#RAMkjf>g, F!_-- 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: l Underground Tank i Above ground Tank Size of Propane Tank: i Heat Stove Cook Stove Woodstove I Fireplace Insert i Hot Water Tank I Pellet Stove Other Is this appliance being installed in a Manufactured/Mobile Home? Yes / No 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: 2° Floor Heated Consistency Review: (f Other Heated Base fee: t � Mezzanine Additional Section: { I Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL Decks 911/Rd Approach fee: Other TOTAL: $ Receipt Number: I '! i 7 I Cash/Check Number: J r7 ESTIMATED COST(REQUIRED) 4 5-//th,p Date: )�L .Fair market value of all labor and materials foihdation to finish • Initials: G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc • • FILE ..COP_ V i 1 CU • t19-1S oN CA - w o N u IgA ' Z - ww0I , o Wo-- 1) N t N TZ WN ON 5o GLV W N'i ♦ r M rl � rl \_ E \\1 / '-1 r ♦ _ A_ I ,, TNO O ti N r + r J FFERSON COUNTY DCD „o,s UILDING PLAN REVIEW 0 Ti. 3 0 APPROVED AS SUBMITTED o to o = APPROVED AS NOTED o E NOTMCE: Plana are ar.,prnv�.+ ' r,- o o any errs r a Q:n';i},,;ara�+. t ', 0 REJECTED v 2 cc c pass inspection In rcinc�ryr- Q,� *� rn all applicable codes a�^:.', r_ Date 0�V��1' f° `-' .LReviewer QO Q CO m CO