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HomeMy WebLinkAboutBLD2013-00189 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 #: BLD13-00189 SITE ADDRESS: 1770A SWANSONVILLE RD Issue Date: 06/26/2013 PORT LUDLOW, 98365 Final Date: 10/3/2013 APPLICANT: DONALD TRUMBLE PHONE: 360-857-3803 SANDRA M TRUMBLE 1770 SWANSONVILLE RD PORT LUDLOW WA 98365-9779 SUBDIVISION: Block: Lot: PARCEL NUMBER: 821053005 Section: 5 Township: 28 N Range: 01 E PROJECT DESCRIPTION: INTERIOR REPAIR OF FIRE DAMAGED HOUSE - INSIDE EXISTING FOOTPRINT, SAME STRUCTURE 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 10/3/2013 \\tidemark\data\forms\F_BLD_Occupancy.rpt 10/8/2013 • • BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD13-00189 Received Date: 6/20/2013 SITE ADDRESS: 1770A SWANSONVILLE RD Issue Date 6/26/2013 PORT LUDLOW, 98365 Expiration Date 6/26/2014 OWNER: DONALD TRUMBLE PHONE: 360-857-3803 SANDRA M TRUMBLE 1770 SWANSONVILLE RD PORT LUDLOW WA 98365-9779 SUBDIVISION: Block: Lot: PARCEL NUMBER: 821053005 Section: 5 Township: 28 N Range: 01 E CONTRACTOR: HERITAGE RESTORATION PHONE: 360-345-1015 DANNY ANDERTON 1581 N NATIONAL AVE CHEHALIS WA 98532 PROJECT DESCRIPTION: INTERIOR REPAIR OF FIRE DAMAGED HOUSE - INSIDE EXISTING FOOTPRINT, SAME STRUCTURE TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP REP MAIN: VALUATION 101,165.00 ADD'L: HEAT TYPE: CODE EDITION: 2009 HEAT BASE: HEAT TYPE: OCCUPANCY: OCCUPANCY: UNHEATED: #OF STORIES: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: OSS WATER SYSTEM: 1 PWELL Type Amount Paid By: Date: Receipt: BEDROOMS: BATHROOMS: Permit $1,004.95 MEB 06/20/13 142198 Exist: 2 Exist: 2 Plan Check $653.22 MEB 06/20/13 142198 Prop: Prop: State Building Code $4.50 MEB 06/20/13 142198 Total: 2 Total: 2 Total: $1,662.67 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 3pm the day before the inspection is needed. Office Hours 9:00 am -4:30 pm MONDAY - THURSDAY HOT LINE AVAILABLE 24 HOURS A DAY • Jefferson County Building Division Permit Nu'er: BLD13-00189 Applicant: TRUMBLE BUILDING PERMIT INSPECTION APPROVALS Applicable Code: 2009 International Building Codes To schedule inspections, call (360)379-4455 no later than 3:00PM the day before the inspection is needed. Requests received after 3:00 PM will not be scheduled for the next 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 Under Floor Framing Rough-in Plumbing 814.113 /; Framing 3 /4/� f11' ftInsulation: Walls ,frfr l3 Insulation: Floors Insulation: Ceiling '_k,fi, 94/ Mechanical Systems Smoke&CO2 FINAL INSPECTION ,©_)__t� FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR T. en J w to a M O N 1 .2.y► I .y.Ol ,i. .6.►t ...).- .0.B1 L ,_.,s_l '.7 1 !.. F—,f.► En.[ E„,j j Z:. •.1.►-�1 I .9-1. 4 s.z� �.O1./1 .9.11—�- 1 .rZ I,- = p D..6.ot T �.11.Q ...1 q � .a.yl t' .t—s—It.Z,► k F..O7 � 9 { I ,y 1 .bv 6. I 1. 1 1 - -1 .1.LS 1 M N O al w Ii)P. a w ItUILDING PERMIT APPLICA•ON BLD13-00189 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD13-00189 Received Date: 6/20/2013 SITE ADDRESS: 1770A SWANSONVILLE RD PORT LUDLOW, 98365 OWNER: DONALD TRUMBLE PHONE: 360-857-3803 SANDRA M TRUMBLE 1770 SWANSONVILLE RD PORT LUDLOW WA 98365-9779 SUBDIVISION: Block: Lot: PARCEL NUMBER: 821053005 Section: 5 Township: 28 N Range: 01 E CONTRACTOR: HERITAGE RESTORATION PHONE: 360-345-1015 DANNY ANDERTON 1581 N NATIONAL AVE CHEHALIS WA 98532 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI INTERIOR REPAIR OF FIRE DAMAGED HOUSE - INSIDE EXISTING FOOTPRINT, SAME STRUCTURE TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP REP MAIN: VALUATION 101,165.00 ADD'L: HEAT TYPE: CODE EDITION: 2009 HEAT BASE: HEAT TYPE: OCCUPANCY: OCCUPANCY: UNHEATED: #OF STORIES: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: OSS WATER SYSTEM: 1PWELL BEDROOMS: BATHROOMS: Exist: 2 Exist: 2 Prop: Prop: Total: 2 Total: 2 Routing Date: Lc 1411 Type Amount Paid Bv: Date: Receipt: Approved/Date Permit $1,004.95 MEB 06/20/13 142198 Plan Check $653.22 MEB 06/20/13 142198 APPROVED State Building Code $4.50 MEB 06/20/13 142198 JUN 2 6 2013 Total: $1,662.67 Jefferson County DCD \\+irtcm rlo+o\fnrmc\G RI fl Ann PIA rn+ ailnnn1z _ • s i.,01 3 -k r-- �w 'SoN co lr JEFFERSC.OUNTY ' ` j DEPARTMENT OF COMMUNITY DEVELOPMENT _ "' ` ''.4 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax �� p$ www.co.jefferson.wa.us/commdevelopment FIIN Master Permit Application MLA: Project Descriptionr (inclu a separate sheets as necessary): • / ` I.e re t 21 r•) / w%O le...._ ,2 -♦t 0 r vt-I-er►o r— a 1 Y,0,1".. .-—Ory b,�a.I I, P).ir.,�j,'i i„c-r.�..t Tax Parcel Number: Sol I OS 3 oo--• Property Size: 6 cam k,es (acres/square feet) Site Address and/orn► Directions� to Property: I 11 i►O 4 -w a Nei $o r� U t 1 1 Y J IQ J . "P r 4. L µ c!fl o_ Property Owner(s)of Record: -1)0,., f-• Sa_ re__ Tru.w.tjt.e__ Telephone: C 60 43 7- s i s Fax: email: Mailing Address:_)1 Teo Swa.,ns/,B. Rc.1 I./44Jot , (,c . 9i 36,S ,t� Applicant/A ent(if different from owner): Vert-ta o _ i e.s,4.t -�o-ic trine . "barn >I-1 r r-La el Telephone: 3VV) 345-i 0/j Fax: (3foa, 34 S-toi $ email:41as,ok 1 P,r41.4 4Eis4v, dv_c_s.•L. Mailing Address: t Sei 1k1. Nide -,o"ft( Aoe CA,cL .11s l,O= . 18S32.... What kind of Permit?(Check each box that applies 0 Lot or Road Segregation ❑Building 0 Critical Areas Stewardship Plan - � L� 0 Demolition Permit 0 Variance(Minor, Major or Reasons i F��Single Family 0 Garage Attached/Detached 0 Conditional Use[C(a), C(d),or CI*"; ❑ Manufactured Home .0 Modular 0 Discretionary"D"or Unnamed Lie Classification ❑ Commercial* 0 Special Use(Essential Public Facilities)** 0 Change of Use , 0 Boundary Line Adjustment i ; ;❑ Address ❑ Road Approach ❑Short Plat** , J UJ [...-.2) ❑ Home Business ❑ Cottage Industry 0 Binding Site Plan** JEFFERSON COUNTY 0 Propane 0 Long Plat** f nt PT OF ,I F‘ ur • 0 Ciyn 0 Planned Rural Residential Deveropme ❑Allowed"Yes" Use Consistency Analysis 0 Plat Vacation/Alteration** ❑ Stormwater Management 0 Shoreline Master Program Exemption/Permit Revisions** O Site Plan Approval Advance Determination (SPAAD)* 0 Shoreline Management Substantial Development** ❑Temporary Use 0 Shoreline Management Variance 0 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 **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 49 rr+a1 0._1?.4 sa- o A to act as my agent in matters relating to this application for permit(s). OWNER SIGNA Date: O 6.-,1a -le,/3 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 -:,lication that - •.,/.he 1=nts prior notice. Signature. �.�i /'' Date: t9‘- 420 L0/3 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-transferable respo i ..ty f dhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature AD• Date: 46 - :10/3 G:\PermitCenter\###FORMS###\DRD FORMS\Current 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 MANUFACTURED HOME INSTALLER: PHONE: FAX: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTORS LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: r New it_Wood Existing: v Sewer C Addition ❑ Steel Proposed: 0 Bank ❑ Community System ❑ Alteration/Remodel 0 Concrete Total: ?i Height: Er-Individual System Repair ❑ Masonry _ SEP Permit# _ C' Demolition 0 Other: Bedrooms: Water Supply: Existing: y Setback: a/Private well ❑ Two Party Type of Heat: Proposed: r? 0 Public Total: 7/ .8'— 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: 1 Underground Tank 1 Above ground Tank Size of Propane Tank: 1 Heat Stove 1 Cook Stove 1 Woodstove 1 Fireplace Insert 1 Hot Water Tank 1 Pellet Stove 1 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. )a`FL Square Footage Current Proposed For Office Use Only Amount Revision Main Floor Heated EH Bld App Review: 2nd Floor Heated Consistency Review: �-. Other Heated Base fee: \ (J/`O1i Q c Mezzanine Additional Section: Heated Basement Plan Check fee: 5-- � 3. 22 Unheated Basement State Surcharge fee: 11' 5 Q Other Unheated' Pot Water Review fee: _ Garage/Carport SUBTOTAL Decks 911/Rd Approach fee: Other TOTAL: $ � 2^ 6 Receipt Number: `14 2_ICkS Cash/Check Number: ZZs-1O4 ESTIMATED COST(REQUIRED) Date: O •Fair market value f all labor and materials foundation to finish I t, 0,,/D; /6.c 9 Initials: G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc • •;:-'. , . • e;t4D,,,,;(x, - ,,-5 5 Lsc, ol ��- • • s-egl 1 - a1.EU 1,, 1 )I • --'�� � 2007 � [\'- RECEIVED • 4 :`rlaY 17 2007 • .ii1 �i5U 6UU ' 1111,1 Jefferson County • Environmental Health , u S° \• • V>. -4-1 - ,t) r>9 f0 , \,... .— • 7/ AY \- - , , N,,, \ .-i 44-1. _,N `/ \ /)\\......\ .• • •�y r \ • • ki . mod... ,,� A. ' �� • j L . F .;4 x X v' 5( . lik.,,,,v- ,..1-szay4 1 ,. tcz. iv ,- ,o.. ' $1 liA: .• NA.- . " 0 .. • R to �- � � . � •. •• a , t3 wi704 n k' pw \` ! / . sa i ""- 4c SITE PLAN a ii 1 I o ,y-1 w o: J U N - 8 2007 , x Q i P19 � �� 'Tr ei i I.I / JEFFERSON COLM -- SIGNATRCOMMUN &, ' .• 0 7 —• 0 1 i' • ry . --,..4,40L 9. . ,) J 44915r;e- SON c1 lfi r - c . fZ✓/fl Stormwat r BMP's • '4 Required mom-- s oq ✓p//t' Avi/ 'I- ehi,a,e,"% . • -72 82 / d3 PvyALLUPJ WA ?837Z /'774,E Su' N ✓�I�Er F2.�? I(I C � ( ( -.6'3 -23�. Ii� 02T Lt•P 1 •. I. JUN 2 L _013 ( JEFFERSON COUNTY • DEPT OF COMMUNITY DEVELOPMENT