HomeMy WebLinkAboutBLD2011-00212 - RE ROOF UILDING PERMIT APPLICAT!N BLD11-00212
Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT#: BLD11-00212 Received Date: 8/2/2011
SITE ADDRESS: 1891 S JACOB MILLER RD
PORT TOWNSEND, 98368
OWNER: MADELEINE C HOUSTON PHONE: 360-385-1489
PO BOX 751
PORT TOWNSEND WA 98368-0751
IRVING PARK ADDITION
SUBDIVISION: Block: 13 Lot: 1-10
PARCEL NUMBER: 963301301 Section: 16 Township: 30 N Range: 01 W
CONTRACTOR: INTERLOCK INDUSTRIES INC PHONE: 425-438-8585
1420 80TH ST SW
SUITE E
EVERETT WA 98203
Contractor's License INTERII020LC Expires 2/6/2013
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOI RE-ROOF SFR
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION 44,140.00 ADD'L: HEAT TYPE:
CODE EDITION: 2009 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY: 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: <'
8 z[ 1
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $593.25 LYK 08/02/11 127969 APPf \j Plan Check $385.61 LYK 08/02/11 127969
State Building Code $4.50 LYK 08/02/11 127969 AL'S 3 21111
Total: $983.36
Jefferson County Planning
&Building Department
S .
i' CsN JEFFERSON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
1 621 Sheridan Street• Port Townsend •Washington 98368
360/379-4450 • 360/379-4451 Fax
�'° (' www.co.jefferson.wa.us/commdevelopment
vl, r
Master Permit Application MLA: IN- ) MLA e€
Project Description(include separate sheets as necessary): HD M E
Tear off existing Comp/Cedar roofing,replace all plywood&Reroof to New Interlock Aluminum Shingles in our Slate design
Tax Parcel ���� Property
Number: q(0,5--L ) I Size: (acres/square feet)
Site Address and/or Directions to Property: 1891 South Jacob Miller Road, Port Townsend, WA 98368
Property Owner(s)of Record: Madeleine Houston&Daniel Hauptman
Telephone:360-385-1489&/or 503-507-3571 Fax: email:
Mailing Address: P.O.Box 751,Port Townsend,WA 98368
Applicant/Agent(if different from owner): Interlock Industries,Inc.
Telephone:425-438-8585 Fax: 425-438-8577 email: RBLAOK@ALROOF.COM
Mailing Address: 1420 80th Street SW Suite E,Everett,WA 98203
Whit t kind of Permit?(Check each box that applies
uilding ❑Variance(Minor, Major or Reasonable Economic Use)
Demolition Permit ❑Conditional Use[C(a),C(d), or C]**
❑Single Family ❑Garage Attached/Detached ❑Discretionary"D"or Unnamed Use Classification
❑ Manufactured Home ❑ Modular ❑Special Use(Essential Public Facilities)**
❑ Commercial* ❑ Boundary Line Adjustment
❑ Change of Use ❑Short Plat**
❑ Address ❑Road Approach ❑Binding Site Plan**
❑ Home Business ❑Cottagelndustry ❑Long Plat**
❑ Propane ❑Planned Rural Residential Development(PRRD)/Amendments**
❑Sign ❑Plat Vacation/Alteration**
❑Allowed"Yes"Use Consistency Analysis ❑Shoreline Master Program Exemption/Permit Revisions**
❑Stormwater Management ❑Shoreline Management Substantial Development**
❑Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Variance
❑Temporary Use ❑Comprehensive Plan/U I -•• - - • as• ,•• e t
❑Wireless Telecommunication* ❑Jefferson County S n a�tvfe is t
❑ Forest Practices Act/Release of Six-Year Moratorium ❑Tree Vegetaion Re,i V
*May require a Pre—Application Conference **Re•uires a P -`' •. ibation Conference
Please identify any other local,state or federal permits required for this pr• •o, �l, if known: 2 2011 I
DESIG'A 'N OF 'GENT ! Ii U
hereby designate Interlock Industries,Inc. to • as t agent in mattes relat •• - -'- - •-•••2=i or permit(s).
JEFFE'•�( �r
v,
OWNER SIGNATURE A I i-
-%.I:. ." _,tip A.1'14 �b.! .�.y .. ate: D . '+ !I' M'll a), DEVELOPMENT
By signing this application form,the owner•gent attests that the information pr. •.d herein,and in any attachment,is true and correct to the best of
his,her or it's knowledge. Any material falsehood or any omission of a material - ade 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 Jeffers.• Coun and its employees,representatives or agents for the sole purpose of application
review and any required later inspections. St="'s access a d right.f:ntry will be assumed unless the applicant informs the County in writing at the
time of the appli ion a i e or sh- ants , for • 'ce. n
Signature: t i-.�l_!_ f,l(�i. .•fat. ` '_ `,>( 4_.,t Date: oL 2.011
The action or actions Applicant will u dertake as a result of the issuance of thi- •e it may negatively impact upon one or more threatened or
endangered species and could lead to a potential"take"of an endangered specs= s 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 r agency can file a lawsuit on behalf of an endangered species regarding your
action(s)even if you are in compliance with the Jefferson Cou de I ment c•.l-.The Applicant acknowledges that he,she or it holds individual
and non-trans'e able re o sibility f r adh ring nd complyi g it th ESA. I e Applicant has read this discla' er and signs and dates it below.
Signature: a \ �� L li to-- Date: ��
C:\Documents and Settings\caral\Local Settings\Temporary Internet Files\OLK86\Master Permit Application 12-19-2006.doc
•
• BUILDER STATEMENT
The signer of this statement does hereby certify that t -y,r-th. • ners of the parcel referenced herein,that they are not licensed contractors and that
they will be assuming the responsibility of - enera Co ,eta t r the proposed proje .
Signature: it A . I.1 If. '�.r A.IT t c:.. .J._ _ _I ��',__ ,mate:
GENERAL CONTRACTOR OR MAVUFACTURED HOME INSTALLEI PHONE: FM:
Interlock Industries,Inc. ii ( 425)438-8585 (425 )438-y5-11
MAILING ADDRESS: ft�••Both Si 3ytr ,�+, e l IN1E q8 3 EMAIL: ° le eAL Roo F. Co�y1
CONTRACTOR'S LICENSE WAINS �t
NUMBER: UBI:601 828 920 NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAx:( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
❑ New ❑ Wood Existing: ❑ Sewer
❑ Addition ❑ Steel Proposed: Bank ❑ Community System
4/ Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System
❑ Repair ❑ Masonry SEP Permit#
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: ❑ Private well ❑ Two Party
Type of Heat: Proposed: ❑ Public
Total: Name of System:
If this is a Commercial Proiect you must answer the following:
Number of Parking Spaces: Current: Proposed:
Number of occupants(includes owners,tenants,employees,etc) Current ,■, t-' . e•
IBC Occupancy: IBC Type of construction: RR ave Food Service? Yes / o
If this is a Pro•ane Tank and/or A. •Hance Installation •ermit mark all items . hat . ! '0, : 2 2011
in Underground Tank °Above ground Tank Size of Propane Ta I 1
❑Heat Stove ❑Cook Stove ❑Woodstove ❑ Fireplace Insert ❑Hot Water Tan ';jC pellet Stove ❑Other,
Is this appliance being installed in a Manufactured/Mobile Home? Yes / No JEFFERSON COUNTY
When applying for a permit to install a propane tank you must also submit a 'e plan sh r, 1, .,∎I. ',- •1.>j_ T. , . property
lines,tank location and size,distances from the propane tank to all property I - , •rI •rags and septic system components,
including the reserve area.
Square Footage Current Proposed For Office Useb ..".,.
nly . ', ,;' Amount a Revision
Main Floor Heated y EH Bld App Review:
2 n a Floor Heated - Consistency Review:
Other Heated . Base fee: 1--5C)3 9j
Mezzanine Additional Section:
Heated Basement Plan Check fee: 3a3. u 1
Unheated Basement , State Surcharge fee:
Other Unheated ' '" ; Pot Water Review fee:
Garage/Carport SUBTOTAL
Decks 911/Rd Approach fee:
Other TOTAL: sC
Receipt Number: !7-C _t�'
Cash/Check Number: i 24��
1
,
ESTIMATED COST(REQUIRED) Date: ��'�
.Fair market value of 1l labor and materials foundation to finish
yy of Initials:
C:\Documents and Settings\caral\Local Settings\Temporary Internet Files\OLK86\Master Permit Application 12-19-2006.doc
Contractors or Tradespeople Prin.Friendly Page Page 1 of 2
•
General/Specialty Contractor
A business registered as a construction contractor with L&I to perform construction work within the scope of
its specialty.A General or Specialty construction Contractor must maintain a surety bond or assignment of
account and carry general liability insurance.
Business and Licensing Information
Name INTERLOCK INDUSTRIES INC UBI No. 601828920
Phone 4254388585 Status Active
Address 1420 80Th Street Sw,Suite E License No. INTERI1020LC
Suite/Apt. License Type Construction Contractor
City Everett Effective Date 6/3/1998
State WA Expiration Date 2/6/2013
Zip 98203 Suspend Date
County Snohomish Specialty 1 General
Business Type Corporation Specialty 2 Unused
Parent Company
Other Associated Licenses
Specialty Specialty Effective Expiration
License Name Type Status
1 2 Date Date
AMERICAN EVERLAST Construction
4MERIER014JKROOFINGCO Contractor General Unused 4/12/1999 12/31/2000 Archived
INTERSR110RKINTERNATIONAL Construction SUPER ROOF LTD Contractor General ,Unused 12/12/1989 12/31/2000 Archived
Business Owner Information
Name Role Effective Date Expiration Date
WENZEL,MARK President 12/20/2004
WENZEL, IVOR Vice President 06/03/1998 01/10/2005
Bond Information
Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date
2 GENERAL INS CO OF 6119361/VM0003002009 01/15/2002 Until Cancelled $12,000.00 01/17/2002
AMERICA
Assignment of Savings Information No records found for the previous 6 year period
Insurance Information
Insurance Company Name Policy Number_Effective Date Expiration Date Cancel Date Impaired Date Amount Received Date
NATIONAL
9 UNION FIRE INS GL5836199 02/01/2010 02/01/2012 $2,000,000.0001/13/2011
OF PA
NATIONAL
8 UNION FIRE INS g15836199 02/01/2009 02/01/2010 $2,000,000.00 02/06/2009
OF PA
AMERICAN
7 HOME GL5836199 02/01/2008 02/01/2009 $2,000,000.0002/05/2009
ASSURANCE CO
AMERICAN
6 HOME RMGLA2507311 02/01/2004 02/01/2008 $1,000,000.0002/05/2007
ASSURANCE CO
Summons/Complaint Information
Cause County Complaint Judgment Status Payment Paid By
06-2-05586-1 KING Date:01/23/2007 Dismissed
Date: Date:
STEPEN 8:MELINDA SCHMEISING Amount: $0.00
https://fortress.wa.gov/lni/bbip/Print.aspx 8/2/2011
Contractors or Tradespeople Prin.Friendly Page • Page 1 of 2
General/Specialty Contractor
A business registered as a construction contractor with L&I to perform construction work within the scope of
its specialty.A General or Specialty construction Contractor must maintain a surety bond or assignment of
account and carry general liability insurance.
Business and Licensing Information
Name INTERLOCK INDUSTRIES INC UBI No. 601828920
Phone 4254388585 Status Active
Address 1420 80Th Street Sw,Suite E License No. INTERI1020LC
Suite/Apt. License Type Construction Contractor
City Everett Effective Date 6/3/1998
State WA Expiration Date 2/6/2013
Zip 98203 Suspend Date
County Snohomish Specialty 1 General
Business Type Corporation Specialty 2 Unused
Parent Company
Other Associated Licenses
Specialty Specialty Effective Expiration
License Name Type 1 2 Date Date Status
AMERIER014JKAMERICAN EVERLAST Construction General Unused 4/12/1999 12/31/2000 Archived
ROOFING CO Contractor
INTERSR110RKINTERNATIONAL Construction General Unused 12/12/1989 12/31/2000 Archived
SUPER ROOF LTD Contractor
Business Owner Information
Name Role Effective Date Expiration Date
WENZEL,MARK President 12/20/2004
WENZEL, IVOR Vice President 06/03/1998 01/10/2005
Bond Information
Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date
2 GENERAL INS CO OF 6119361/VM0003002009 01/15/2002 Until Cancelled $12,000.00 01/17/2002
AMERICA
Assignment of Savings Information No records found for the previous 6 year period
Insurance Information
Insurance Company Name Policy Number Effective Date Expiration Date Cancel Date Impaired Date Amount Received Date
NATIONAL
9 UNION FIRE INS GL5836199 02/01/2010 02/01/2012 $2,000,000.00 01/13/2011
OF PA
NATIONAL
8 UNION FIRE INS g15836199 02/01/2009 02/01/2010 $2,000,000.00 02/06/2009
OF PA
AMERICAN
7 HOME GL5836199 02/01/2008 02/01/2009 $2,000,000.00 02/05/2009
ASSURANCE CO
AMERICAN
6 HOME RMGLA2507311 02/01/2004 02/01/2008 $1,000,000.00 02/05/2007
ASSURANCE CO
Summons/Complaint Information
Cause County Complaint Judgment Status Payment Paid By
06-2-05586-1 KING Date:01/23/2007 Dismissed
Date: Date:
STEPEN Et MELINDA SCHMEISING Amount: $0.00
https://fortress.wa.gov/lni/bbip/Print.aspx 8/2/2011
1891 S Jacob Miller Rd, Port TOsend, WA 98368 • Page 1 of 2
��, Call:877-973-3346 Join Redfin or Son In VE
a,,
REDFIN
Welcome to Redfin!
Want to see all the homes for sale in
0 Off-Market Property your area?
Just click Search Listings
1891 S Jacob Miller Rd
BEDS:- STYLE:Single Family Residential
Port Townsend,WA 98368 BATHS:- YEAR BUILT:-
FINISHED SQFT:- YEAR RENOVATED:-
Source:Public Records UNFINISHED SOFT:- COUNTY:Jefferson County
TOTAL SOFT:- APN:-
FLOORS:- LAST UPDATED:March 4,2010
LOT SIZE:-
Views
lub Rd fi rt,-4 m.xa. r.
El . i A
-
4
r- ER.
i
:a �Y
Y V
'-�i.y,Ills, H , ..' '..z.
Property History Property Tax
Date Event Price Appreciation Source No data is available for this
property.
Notice:There are past MLS listings for this property which are not being shown.In order to
t,.
see these listings,please slam in.Why is this required?
What's the Market Like for Houses Near 1891 S Jacob Miller Rd?
House:$/Sq.Ft.in 98368 Median House Values
Select a place below for more pricing guidance.
List$ $/Sq.Ft. Sale/List
98368 $362,500 $195 94.3%
Jefferson County $359,000 $183 94.6%
Home Value Estimates
' ISO EUV
f; ' ',Iv, 2 2011
It
■ u JEFFERSON COUNTY
DEPT.OF COMMUNITY DEVELOPMENT
http://www.redfin.com/WA/Port-Townsend/1891-S-Jacob-Miller-Rd-98368/home/17084737 7/20/2011
BUILDING PERMIT S
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD11-00212 Received Date: 8/2/2011
SITE ADDRESS: 1891 S JACOB MILLER RD Issue Date 8/3/2011
PORT TOWNSEND, 98368 Expiration Date 8/3/2012
OWNER: MADELEINE C HOUSTON PHONE: 360-385-1489
PO BOX 751
PORT TOWNSEND WA 98368-0751
IRVING PARK ADDITION
SUBDIVISION: Block: 13 Lot: 1-10
PARCEL NUMBER: 963301301 Section: 16 Township: 30 N Range: 01 W
CONTRACTOR: INTERLOCK INDUSTRIES INC PHONE: 425-438-8585
1420 80TH ST SW
SUITE E
EVERETT WA 98203
Contractor's License INTERII020LC Expires 2/6/2013
PROJECT DESCRIPTION: RE-ROOF SFR
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION 44,140.00 ADD'L: HEAT TYPE
CODE EDITION: 2009 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY:
OTHER:
CONST TYPE: GARAGE: SHORELINE:
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL:
WATER SYSTEM: Type Amount Paid By: Date: Receipt:
BEDROOMS: BATHROOMS: Permit $593.25 LYK 08/02/11 127969
Exist: Exist: Plan Check $385.61 LYK 08/02/11 127969
Prop: Prop: State Building Code $4.50 LYK 08/02/11 127969
Total: Total: Total: $983.36
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
Jefferson County Building Division Permit Num . BLD11-00212
Applicant: HOUSTON
BUILDING PERMIT INSPECTION APPROVALS kpplicable 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
Insulation:Ceiling
FINAL INSPECTION 7_ D- /Z gip
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR