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Home My WebLink AboutBLD2012-00322 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 #: BLD12-00322 SITE ADDRESS: 181 QUARRY RD# Issue Date: 10/11/2012 PORT LUDLOW, 98365 Final Date: 9/25/2013 APPLICANT: JAMES K HATTRICK PHONE: 360-620-1288 SARAH F BLOSSOM 181 QUARRY RD PORT LUDLOW WA 98365-9418 SUBDIVISION: BASALT BEACH Block: 2 Lot: 8+ PARCEL NUMBER: 931500207 Section: 4 Township: 28 N Range: 01 E PROJECT DESCRIPTION: DUCTLESS HEAT PUMP THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2009 EDITION. OCCUPANCY GROUP: TYPE OF CONSTRUCTION: SPRINKLER SYSTEM yes no THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 9/25/2013 \\tidemark\data\forms\F_BLD_Occupancy.rpt 10/8/2013 • PROPANE/PELLET/WOOD STOVE & TANK INSTALLATION PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD12-00322 Received Date 10/11/2012 SITE ADDRESS: 181 QUARRY RD Issue Date 10/11/2012 PORT LUDLOW, 98365 APPLICANT: JAMES K HATTRICK PHONE 360-620-1288 SARAH F BLOSSOM 181 QUARRY RD PORT LUDLOW WA 98365-9418 8+ SUBDIVISION: BASALT BEACH Block: 2 Lot: PARCEL NUMBER: 931500207 Section: 4 Township: 28N Ranqe: 01 E CONTRACTOR: BRENNAN HTG &A/C LLC PHONE: 206-248-7900 4601 S 134TH PL SEATTLE WA 98168 Contractor's License BRENNHA971R9 Expires 12/29/2013 OWNER, JAMES K HATTRICK PHONE: 360-620-1288 if different: SARAH F BLOSSOM 181 QUARRY RD PORT LUDLOW WA 98365-9418 PROJECT DESCRIPTION: DUCTLESS HEAT PUMP Directions To Site: THIS PERMIT IS VALID FOR ONE YEAR AND IS NOT RENEWABLE. THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WITHIN THAT YEAR. THE EXPIRATION DATE IS 10/11/2013. REQUIRED INSPECTIONS: Tank/Line/Appliance: 014.. J 44010 '05 FinalApproval: g/e -\ crL- 9' ZS/,3 BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS. Office Hours 9:00 a.m. -4:30 p.m. HOT LINE AVAILABLE 24 HOURS A DAY \\tidemark\data\forms\F_B LD_Permit_Propa ne.rpt 10/11/2012 0 UILDING BLD12-00322 PERMIT APPLICATION Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD12-00322 Received Date: 10/11/2012 SITE ADDRESS: 181 QUARRY RD PORT LUDLOW, 98365 OWNER: JAMES K HATTRICK PHONE 360-620-1288 SARAH F BLOSSOM 181 QUARRY RD PORT LUDLOW WA 98365-9418 BASALT BEACH SUBDIVISION: Block: 2 Lot: 8+ PARCEL NUMBER: 931500207 Section: 4 Township: 28 N Range: 01 E CONTRACTOR: BRENNAN HTG &A/C LLC PHONE: 206-248-7900 4601 S 134TH PL SEATTLE WA 98168 Contractor's License BRENNHA971R9 Expires 12/29/2013 REPRESENTATIVE: PHONE PROJECT DESCRIPTION DUCTLESS HEAT PUMP TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC VALUATION 2,500.00 MAIN: CODE EDITION: 2009 ADD'L: HEAT TYPE: OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: GARAGE: SHORELINE: CONST TYPE: SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routinq Date: Type Amount Paid Bv: Date: Receipt: Approved/Date Permit $83.25 LYK 10/11/12 135289 APPROVFr Plan Check $54.11 LYK 10/11/12 135289 State Building Code $4.50 LYK 10/11/12 135289 Total: $141.86 OC` I /_c,4' Jefferson County Nonni!), & Building Deoartmen- \\firlcmor4\r4n+n\forme\C PI r1 4nn PIArnf 1!1/11/7/119 r • ' 44("::-.:ON'sc.> • 0'46 JEFFERSON COUNTY di \ '-() 14 1 DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax �gS�NO,sp� www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: L rn(A r ect escri tion clude s parate shee s s ne sary): yvv.k.) Tax Parcel Number: cL T� Property L� C IF n V Ea s uare feet) Site Address and/or Directions t P operty: I CIA a\.;cat t V- Sofa- Lv c� of v 24,2 Property Owner(s)of Rec` d: Q.� 'R1 t�,%..%o (1 i 1i Telephone: 0 t> ' wino• 1 6 8 Fax: Mailing Address: gob /� JEFFERSON COUNTY Applicant/A ent(if different from owner): 7t! Ai AIL �A �� RIg — UNRY DEVEIO Telephone:: kAo . 121) 4 ()VD a ax:... b . lb 3 email:,, \;t.�.(Y [i/lAki,f1 Mailing Address: ' i b S 'AVM!I._ `.MP-. •i! i(lD(1) a11VA �� What kind of Permit?(Check each box that applies '�-"" m ❑Building 0 Critical Areas Stewardship Plan ❑ Demolition Permit 0 Variance(Minor,Major or Reasonable Economic Use) •,,t=Single Family 0 Garage Attached/Detached 0 Conditional Use[C(a),C(d),or C]** ❑ Manufactured Home 0 Modular 0 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 Ste Plan** ❑Propane ❑Long Plat** ❑Sign ❑Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis 0 Plat Vaca:ion/Alteration** ❑Stormwater Management 0 Shoreline Master Program Exemption/Permit Revisions** ❑Site Plan Approval Advance Determination(SPAAD)* 0 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 Moratonum 0 Jefferson C'aunty Shoreline Master Program Amendment *May require a Pre-Application Conference 0 Tree Vegetation Request **Req_t res a Pre-Application Conference Please identify any other local,state or federal permits required for this proposal, if known: DESIGNATION OF AGEI T I hereby designate �-�nn n/� I /� to acJas my agent in matters relating to this application for permit(s). OWNER SIGNATURE :J1 Q Q- l l li.c �_ ..ti c,X . nt . C\2I 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 application that he or she wants prior notice. time 11`O.-L. K %�3�k 1� t` ( k• c t- Date. 1 L' .. I 1 - ZC i -1-- The action or actions Applicant will undertake as a result of the issuance of this permit nay 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 app icant 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-transferable responsibility for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: _..— Date. G:\PernntCenter\###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 assuming the responsibility of the General Contractor for the proposed project. Signature: Date: GENERAL CONTRACTOR ORMANUFACTURED HOME INSTALLER: PHONE: FAX: •-t ;i1,,n 0-4r\ \ £. ( l l� (' )�141 _1t �� , (mil oux Cl'3 3 e, MAILING 4 ADDRESS:y�ih\ 3 ; ' \ EMAII: i 4_1 '�.- �{l,i�'Y�a� L:�(LiLrx V 10 0 Y\Cr' CONTRACTOR'S LICENSE \- .Q ,v�,� `--.t, vA L'Y INS et ''YZ NUMBER. NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: Li New [1 Wood Existing: !l Sewer ❑ Addition 11 Steel Proposed: —. Bank El Community System El Alteration/Remodel ❑ Concrete Total: _. Height: ❑ Individual System [.I Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: _ Setback: ❑ Private well El Two Party Type of.Heat: Proposed: 0 Public L—1 LC_ Total: -- 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 Pro IBC Occupancy: IBC Type of construction: Will you have Food 5er1 /-N If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply: i I Underground Tank I Above ground Tank Size of Propane Tank: I I Heat Stove I Cook Stove I Woodstove I Fireplace Insert 1 Hot Water Tank I Pellet Stove I Other , ^ d Is this appliance being installed in a Manufactured/Mobile Home? Yes / No I!_o When applying for a permit to install a propane tank you must also submit a site plan showing all-ef he-buildings,aN-pi ope lines,tank location and size,distances from the propane tank to all property lines,buildings and septic system components, including the reserve area. T tiltniZ:A it W fla+ 4 11 F 4�'' r 't- ?; Square Footage Current Proposed .F4G 3��,',�,y, �� i>, s j� - Main Floor Heated � ±t Y o•, EH Bld App Review: • s `S f 4A 2n°Floor Heated Consistency Review: Other Heated x i�* ',�' Base fee: .25 Mezzanine ',... "' Additional Section: Heated Basement Plan Check fee: I r Unheated Basement State Surcharge fee: -- Other Unheated Pot Water Review fee: Garage/Carport • SUBTOTAL Decks 911/Rd Approach fee: -- Other !;,:t; ' TOTAL: $ 0 _ 9 ', ; Receipt Nunt,er: 352 M ry ` Cash/Checl.t'Iumber: ^, r, �j Y�eC�.•4�H 1 ESTIMATED COST(REQUIRED) L(0( Date: .Fair market value of all labor and materials foundation to finish I d (� Z Initials: I________— G:\FermitCenter\###FORMS###\DRI)FORMS\Master Permit Application 5-29-08.doc