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Home My WebLink AboutBLD2012-00413 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#: BLD12-00413 SITE ADDRESS: 831 WALKER WAY Issue Date: 12/26/2012 PORT LUDLOW, 98365 Final Date: 3/25/2013 APPLICANT: BEVERLY SMITH PHONE: 360-301-4501 NANETTE &A STEVEN AURDAL PO BOX 266 CHIMACUM WA 98325-0266 SUBDIVISION: PORT LUDLOW NO. 4 Block: Lot: 78 PARCEL NUMBER: 990500078 Section: 8 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 3/25/2013 \\tidemark\data\forms\F_BLD_Occu pancy.rpt 3/27/2013 • • MECHANICAL AND DEMOLITION PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD12-00413 Received Date 12/26/2012 SITE ADDRESS: 831 WALKER WAY Issue Date 12/26/2012 PORT LUDLOW, 98365 APPLICANT: BEVERLY SMITH PHONE: 360-301-4501 NANETTE &A STEVEN AURDAL PO BOX 266 CHIMACUM WA 98325-0266 78 SUBDIVISION: PORT LUDLOW NO. 4 Block: Lot: PARCEL NUMBER: 990500078 Section: 8 Township: 28N 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 OWNER, BEVERLY SMITH PHONE: 360-301-4501 if different: NANETTE &A STEVEN AURDAL PO BOX 266 CHIMACUM WA 98325-0266 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 12/26/2013. REQUIRED INSPECTIONS: Tank/Line/Appliance: FinalApproval: ) 3/7 C//3 BUILDING INSPECTION HOT-LINE 379-4455. REQUESTS MUST BE RECEIVED BY 3 PM THE DAY BEFORE THE INSPECTION IS NEEDED. Office Hours 9:00 a.m. -4:30 p.m. Monday-Thursday HOT LINE AVAILABLE 24 HOURS A DAY \\tidemark\data\forms\F_BLD_Permit_Propane.rpt 12/26/2012 BUILDING PERMIT APPLICA ION T BLD12-00413 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD12-00413 Received Date: 12/26/2012 SITE ADDRESS: 831 WALKER WAY PORT LUDLOW, 98365 OWNER: BEVERLY SMITH PHONE: 360-301-4501 NANETTE &A STEVEN AURDAL PO BOX 266 CHIMACUM WA 98325-0266 PORT LUDLOW NO. 4 SUBDIVISION: Block: Lot: 78 PARCEL NUMBER: 990500078 Section: 8 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 MAIN: CODE EDITION: 2009 ADD'L: HEAT TYPE: OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $222.00 LYK 12/26/12 139845 AP P ® ,/ 1" Total: $222.00 �J DEC2f,0 2012 Jefferson County Planninc & Building Department \\firlem.arIArlofo\fnrrne PI n Ann PIA rnf 11/1A/7/11') ,)4 q i (": c% JEFFERSON COUNTY \ •4 DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street• Port Townsend •Washing*.o i 98368 a . 360/379-4450 • 360/3 79-4451 Fax 4,c,�NasO www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: No nnL Iroject Rescription(include se rate sheets a;; ecess ): ns i� 0..) c �t s � c r Tax Parcel NumbergO D A--)mo Property Size: (acres/square feet) Site Address and/or Directions to Property: Property Owner(s)of Record: T t 5r _ik Telephone: aD D • k - `j c: \ ax: __ email: Mailing Address: ,— Applicant/A ent(if different from owner): (t � -- Telephone:'‘).U�o `a y A'IA fR Fax: f� D.• • ie JI to. . . 1 t '�7�, r:t. Mailing Address: L t� �` '1^ V L 2p —� t. S ---- ' P.'.i- • . 1 L' yl'1 What kind of Permit?(Check each box that applies / ❑Building El Critical Areas Stewardship Plan I ❑ Demolition Permit 0 Variance(Minor,Major or Reasonable Economic Us= .Single Family 0 Garage Attached/Detached 0 Conditional Use[C(a),C ** ❑ Manufactured Home 0 Modular ❑Discretionary"D"or Unnamec��t;iwO� *� lon ❑ Commercial* ❑Special Use(Essential Pub ❑ Change of Use � � FF"�I npP^FNT g 0 Boundary Line Adjustmerif --------- ' ❑ Address ❑ Road Approach ❑Short Plat** ❑ Home Business 0 Cottage Industry 0 Binding Site Plan** ❑Propane ❑Long Plat** ❑Sign 0 Planned Rural Residential Development(PRRD)/Amendments** ❑Allowed"Yes'Use Consistency Analysis ❑Plat Vacation/Alteration** ❑Stormwater Management ❑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 Moratorium 0 Jefferson County Shoreline Master Program Amendment *May require a Pre—Application Conference 0 Tree Vegetation Request **Req Tres a Pre-Application Conference Please identify any other local,state or federal permits required for this proposal, if known: DES GNATION OF AGENT I hereby designate o 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 pro ided herein,and in anyattachments,is true and correct ect 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. Signature: Date. 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 the se terms are defined in the federal law known as the "Endangered Species Act"or"ESA."Jefferson County makes no assurances to the appiir;ar+t 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'awsuit 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:\PennitCenter\###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 OR ANUFACTURED HOME INSTALLER: PHONE: FAX: 't A'\.v\..cl—n L (.-- z (� I } y 1 cc calm, (l' 3 (')._ryt LING ADDRESS: 3 \ (�' ` -t J �' ,_. y�Y\ i '� EMAIL: 1Lt ;YYi.t� t� t{ h /✓�.iLYI [2.: , Y�( . CONTRACTOR'S LICENSE '7`�( e x.\.Y\�,�,..-(\ ( _i\ +` ,'I,;V IINS NUMBER. NUMBER C-c:s Yl ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: Li New ii Wood Existing: _ Sewer ❑ Addition C1 Steel Proposed: Bank ❑ Community System c Alteration/Remodel Li Concrete Total: Height: ❑ Individual System LI Repair ❑ Masonry SEP Permit# Li Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well ❑ Two Party Type o Heat: Proposed: Li Public t" CC-- Total: -- Name of System: If this is a Commercial Proiect 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: I Underground Tank 1 Above ground Tank Size of Propane Tank: I Heat Stove I Cook Stove I Woodstove I Fireplace Insert I Hot Water lank I Pellet Stove i 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 pa n-<' ''�l t • r }s� , — p Fo 9 ti'' 2&Q nl ,; Amount_. ,Revision Main Floor Heated ,$ -; EH Bld App Review: 2�Floor Heated x i> � } „� Consistency Review: Other Heated/ h � Base fee: Mezzanine 4'_. . Additional Section: Heated Basement '� Plan Check fee: Unheated Basement • , State Surcharge fee: Other Unheated Pot Water Review feP"I �' /7 -� I Garage/CarportI I SUBTOTAIt0 (� �I i' , . Decks 911/Rd Approach fee:,fl l ;12 Other — V 'MIA:: $, JEFFERSON COLNTY '~ q;;. Receipt Number: '"PT.OF COMMUNITY DE"IEI.OPMENT ' "'' Cash/Check Number: ESTIMATED COST(REQUIRED) LDate: .Fair market value of all labor and materials foundation to finish Initials: G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc