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BLD2013-00314
UILDING PERMIT APPLICN BLD13-00314 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD13-00314 Received Date: 10/7/2013 SITE ADDRESS: 979 OAK BAY RD PORT HADLOCK, 98339 OWNER: COREY J WOODLEY PHONE: 979 OAK BAY RD PORT HADLOCK WA 983399707 BAYVIEW ADDITION TO HADLOCK SUBDIVISION: Block: Lot: PARCEL NUMBER: 931800901 Section: 12 Township: 29 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTION ADDITION OF BEDROOM AND BATHROOM TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ADD MAIN: 440 VALUATION 46,568.00 ADD'L: HEAT TYPE: CODE EDITION: 2012 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: 440 #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: 154 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: OSS WATER SYSTEM: 05783 BEDROOMS: BATHROOMS: Exist: 2 Exist: 1 Prop: 1 Prop: 1 Total: 3 Total: 2 Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $550.00 MEB 10/03/13 145424 APPROVED � Plan Check $357.50 MEB 10/03/13 145424 A1" R®®VC G State Building Code $4.50 MEB 10/03/13 145424 DEC 0 2 2013 Total: $912.00 Jefferson County DCD \\+irlcmorWrlo+a\forme\G RI n Ann RL+rn+ Inrmn94 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#: BLD13-00314 APPLICANT: COREYJ WOODLEY PHONE: 360-301-2902 979 OAK BAY RD PORT HADLOCK WA 98339-9707 SITE ADDRESS: 979 OAK BAY RD Issue Date: 12/2/2013 PORT HADLOCK, 98339 Final Date: 6/9/2014 SUBDIVISION: BAYVIEW ADDITION TO HADLOCK Block: Lot: PARCEL NUMBER: 931800901 Section: 12 Township: 29 N Range: 01 W PROJECT DESCRIPTION:ADDITION OF BEDROOM AND BATHROOM THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2012 EDITION. OCCUPANCY GROUP: TYPE OF CONSTRUCTION: SPRINKLER SYSTEM yes • • THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 6/9/2014 \\tidemark\data\forms\F_BLD_Occupancy.rpt 6/16/2014 ' ip/AD s - S ( q ,�i"�'sox cOL. JEFFERSOOOUNTY - 4, , • ' 1:44 DEPARTMENT OF COMMUNITY DEVELOPMENT ` ''d 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax ' Q www.co.jefferson.wa.us/commdevelopment VErING Master Permit Application MLA: Project Description(include separate sheets as necessary): A of ,A s," . 6 es0. 0 0 - ov n A 1D n��r a ii.lec�. •Tax Parcel Number:al /O O �i 0 I 1 r , _ Property Size: �� 1 / (Q (acres/square feet) Site Address and/or Directions to Property: ■ Property ner(s)of Record: r _ o. ..1 Telephone:`3& 3 01 -.200 Fax: email: Lo _ , - 0 • rte;(. GD r^ Mailing Address:_cr7 9 0' k1 6� aid. P-',.1 1-\41.ok �J A qS'S'' Applicant/Agent(if different from owner): _ Telephone: Fax: email: _ Mailing Address: What kind of Permit?(Check each box that applies ❑ Lot or Road Segregation Building ❑Critical Areas Stewardship Plan r_ I n fI(� ' \ Demolition Permit ❑Variance(Minor, Major or Reas• . . _«•r / L. ❑ Single Family ❑Garage Attached/Detached ❑Conditional Use[C(a),C(d),or S) ❑ Manufactured Home .❑ Modular - 0 Discretionary"D"or Unnamed U:- , -:sification ❑ Commercial'` ❑Special Use(Essential Public F I'i-• ** OCT 3 2013 ❑ Change of Use ❑Boundary Line Adjustment ❑ Address ❑ Road Approach_ ❑Short Plat** ❑ Home Business ❑Cottage Industry ❑ Binding Site Plan** JEFFERSON COUNTY ❑ Propane ❑Long Plat** I, c y u Ni1YDEVELOPMENT ❑ Sign ❑ Planned Rural Residential Devel'•••_• _- . ❑Allowed"Yes"Use Consistency Analysis ❑ Plat Vacation/Alteration** ❑ Stormwater Management ❑Shoreline Master Program Exemption/Permit Revisions** ❑ Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Substantial Development** ❑Temporary Use ❑Shoreline Management Variance ❑Wireless Telecommunication'` ❑ 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 ❑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 L c,c.ev-, \Q S1-No a to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE `.3 L. Date: 10 — 13 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 tha he or she ants prior notice. Signature: _ Date: 10- 1 _ - 13 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 responsibility for adhering to and complying with the ESA. The Applicant has read this 1'" r and signs and dates it below. Signature: a Date 10-2 - 13 n.\TN_..__]./`__.__\444444CflDT AC444 44\1lDll cl1D TAC\/`..___.nun c_ _\i,i n.._• n__c__.:__c no no J__ 0 • 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 res onsibility of the General Contractor for the proposed project. Signature: '-'410.,'-'410.,__ Date: 1( 1" 1 ` `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: O New ITif Wood Existing: ( ❑ Sewer 3k Addition 0 Steel Proposed: t Bank ❑ Community System ❑ Alteration/Remodel X Concrete Total: 'L._ Height: x Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition 0 Other: Bedrooms: Water Supply: Existing: 2. Setback: ❑ Private well ❑ Two Party Type of Heat: Proposed: I 101 Public c'o•,cel A,.- Z�..c r ec c. Total: 3 Name of System: If this is a Commercial Proiect you must answer the following: Numberof??arking 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 Pro•ane Tank and/or A••liance Installation •ermit mark all items below that a••I : '.:M I Underground Tank I Above ground Tank Size of Propane Tank: . s t'T eat Stove I Cook-Stove I Woodstove I Fireplace Insert I Hot Water Tank I Pellet Stove I Other ,.Is this appliance being installed in a Manufactured/Mobile Home? Yes / 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 O ly - Amount .Revision Main Floor Heated Lj Li 0 3 ef�ri 2 EH Bid App Review: 0 C� 2�" Floor Heated _ Consistency Review: G ' 2 — i Other Heated Base fee: " el) e Mezzanine Additional Section: ----- (� Heated Basement Plan Check fee: Unheated Basement ,A 14-0 5' e) State Surcharge fee: q o Other Unheated Pot Water Review fee /..-- - Garage/Carport SUBTOTAL L2-t?' ca Decks 1 +tr 911/Rd Approach fee: Other C, 8- o. TOTAL: $ Receipt Number: I q :"l Cash/Check Number: 1 L(r ESTIMATED COST(REQUIRED) Date: 10( 13 .Fair market value of all labor and materials foundation to finish l o ,D Initials: A=(` .- - .-_._._..\uisi4 1. 0444444 rlD1-T Dr\DT.TC\r'...........TID TT II........\T.f De«..:.A4.4.1:,.,..:,...C 7D 11R,L.,- -. } • • Cr LO H O O C3 L.L. N 0 Z LL '� O H O •- N CO -- -- 1.17 -� Q cl N — N L!7 -o LLI O -to — � J O O L co -o x CY -O ++ Cn Z O U C:3 = H LU O O CO +I -O H O O I -• O .0 .0 -C CA r- ¢ _co V U U W Z O cc 0 J 0- 0- = � � U I- I- O O CD CD O Y CO -O ti U = O CT O 0-∎ U I CC J CO -O Q) w 0 C = X CO 3 I— ¢ cd to --. o c■) o co S ti J U 0 CO -0 ¢ ti co Z Cn o = � co CO "-, H - 1-- - LID X 3 ).-- N = CO O Q I- 1- Z Cr �-. co 3 -0 CC O O 2 3 C Y LLI CO ]- C= LL-1 � H I- LL J LL UJ Ct LLI 0_ N 1-- 3 IX } CO CC J CC O � H � LLI Q 0 CI Y -- C C c— O LL CA CC X -"•. 0 O ›- U CO 0_ O O U] O - O CC ¢ O Q O Cn Q 1- CC U I- 3 CO J 0 J N O Cr LJJ 11J C] = ¢ 3 J Z I- -3 ]C Q C_.) LJJ -O LL O 3 ›- X L L1 Q 2 Cz U H (7) Cr O LLI I- CD J } O 7 0 J CO CZ LLI I- O }- Y CO Z O CO CO = CC O) Cr CD Q J J O O = 0- O O ti co co m co ,-0 U co i_, � C3 U O) CL 3 Co - 4J O O CO >. O N Cn I� O CO O CO O 4 ' O CO O •- t7) 3 CO O LO O 4 ' O CO N O O -O L •■ O I� U CD N %- CO = # C O Co N -- L 3 L O Y C — CU O i-J CI) co N N m N -- O 3 _C CD o Co Cu -O 7 CO U L L C1 — O CO C1 S- O CO X 4-1 U -O X CO CO CL CO -- -- CO N I- I- X q- H CA CO ci- X x H Q Op Front Parcel Review • Parcel 931800901 Printed: October 11, 2013 COREY J WOODLEY Site Address: 979 OAK BAY RD 979 OAK BAY RD t PORT HADLOCK WA 983399707 1A4-.0 JS PORT HADLOCK, WA 98339! PORT HADLOCK WA, 98339 Parcel Number: 931800901 S-T-R: 12-29N-01W Legal Description BAYVIEW ADDITION TO HADLOCK BLK 9 LOTS 1 _ 1JO R I A THRU 8 (LS RD R OF W W/6,7& 8)CON @OWNER'S RE( 05/07 Flood District: Fire District: 1 rtanning Area: 4 Flood Map(FIRM)Panel No: School District 49 Zoning: COMP PLAN DESIGNATION: R-12,„i 1. 5" COMMUNITY PLAN: UGA: UGA Trans [✓] Plot plan states "property line" [vl Assessor's Map(Property lines on submitted plot plan must match the property lines as identified on the Assessor's 1/4 map) [✓] Legal Access to Property ■ NO [hi Parcel Tags or Scanned Documents YES [4-1 ESA's: Special Reports Nearby YES 10 [✓] Designated Ag YES [ Shoreline Designation: YES [r]" Shoreline Slope Stability:ft $ NO Stream Type:YES ¶ Fish&Wildlife:YES Stia Wetlands: YES (NO Rare Plants:YES (IQ Seismic: YES NO Landslide: YES Vtb Flood: YES -1Wo, Erosion: YES N Aquifer Recharge Area:YES (N SIPZ: cnone) At Risk High Risk Coastal CMZ: High Risk Moderate RiskDisconnected CMZ Stormwater site plan submitted: YesNo [y]' Forest Lands: YES NO Adjoining Forest Lands: Commercial/ Rural/ Inholding [ -1 Mineral Lands: YES h ti [ i.j- Agricultural Lands: YES [ I] Archaeology: YES f.• [a-] No Shooting Zone: 4i NO 'y ,GJiufapck. No ,s [ 4 Stormwater: New Impervious Surface c©f:, Land Disturbing Activity ESA's Stormwater Req's:Min Req#2 Min Req#1 thru#5 Min Req#1 thru#10 Engineering [1.-], Notice Provisions/Disclosure:Airport YES MRL YES Forest Lands YES [ Landscaping Required: Yes No [!/j Parking Spaces Required 2 Other (dl Building Height: 35' UBC Standard [ y]' Impervious Surface coverag W rcentage: Resource Lands&Public: 10% Rural Residential: 2,54 Rural Industreer UDC Sec 6.7 Rural Commercial: 60% Area of Building Coverage:60%in Rural Industrial Lands only [2....V Total Building(s) Size: 14 /o <Z�or� # Y Yv) RVC:20,000 SF CC:5,000 SF NC:7,500 SF GC: 10,000 SF All others:s lect to septic&water constraints/None specified [ 11— Setbacks: Front: V Left Side: 4 h Right Side: se Rear: Cr Shoreline Setback: /y/A LSHA Setback: mem [✓j Road Classification: -'- cs 9 9, e Road Approach: EXISTYNG No Q'D RAP [L-11 SEPA Required: YES - MP 1 [ ✓I Flood Certificate: [1.--1 Existing Case(s)&Condition(s): Violations: Yes t ql [;/f Recorded Date of Subdivision: $ ih48 FN Over 5yrs=UDC Plat Conditions: AX8 <5yrs=Plat Conditions on plat or Old Ordinance [✓jam Lots/Require Declarat on of Restrictive Covenant 456 @ submitted: S NO UGA No Protest Agreement YES NO, submitted: YES NO /474 [r] Site Visit conducted YES [ y]' Require Final Zoning Approval YES V� [ 1 ADMIN: Setbacks entered in Permit Plan case qa YES New Parcel Tags entered in Permit Plan 4,5, YES Special Reports Scanned /A YES No parcel tags found for parcel Cases Associated with APN 931800901 Cases Name Review Type Status Planner BLD13-00314 WOODLEY P Application Received: 10/7/2013 Permit Issued/Case closed: Case Finaled: ADDITION OF BEDROOM BEDRCYOUANDBATHROOM MLA06-00257 BLD06-00275 MLA06-00257 WOODLEY I F D JOHNSON Application Received: 5/19/2006 Permit Issued/Case closed: 6/6/2006 Case Finaled: 9/24/2007 NEW SFR W/ATTACHED GARAGE ALSO U/G 200 GAL PROPANE TANK RAP05-00277 WOODLEY C Application Received: 10/28/2005 Permit Issued/Case closed: Case Finaled: 6/6/2006 rap&911 SEP05-00357 WOODLEY F Application Received: 10/18/2005 Permit Issued/Case closed: 12/18/2005 Case Finaled: 7/13/2007 LOTS 1-8 SOM05-00357 WOODLEY F Application Received: 7/13/2007 Permit Issued/Case closed: Case Finaled: \\tidemark\data\forms\R_Parcel_CRMLA.rpt 10/11/2013 Page 2 of 2 DEVELOPMENT REVIEW TIME S ET �-�" Time Comments Ti Date " ri lfe44— — Sat, I — • September 18,2012 \\tidemark\data\forms\R_MLT_Case_CRMLA.rpt S ON c°6 JEFFERSON COUNTY �n f �y 1-; DEPARTMENT OF COMMUNITY DEVELOPMENT v j 621 Sheridan Street • Port Townsend • Washington 98368 OCT 3 2013 r�► Y ,.O 360/379-4450 • 360/379-4451 Fax ING http://www.co.jefferson.wa.us/commdevelopment/ JEFFERSON COUNTY DEPT.OF COMMUNITY DEVELOPMENT Stormwater Calculation Worksheet MLA# PROJECT/APPLICANT NAME: C®r�v L a 6 ckle:3 DETERMINING STORMWATER MANAGEMENT REQUIREMENTS: This stormwater calculation worksheet should be completed first to classify the proposal as "small,""medium," or"large." The size determines whether a Stormwater Site Plan is required in conjunction with a stand-alone stormwater management permit application, building permit application, or other land use approval application that involves stormwater review. The basic information will also be helpful for completing a Stormwater Site Plan, if required. - PARCEL SIZE(I.E.,SITE) Size of parcel -7I t acres An acre contains 43,560 square feet. Multiply the acreage by this figure. Size of parcel in square feet I 1-7 it.1 sq/ft Land-disturbing activity is any activity that results in movement of earth, or a change in the existing soil cover(both vegetative and non-vegetative) and/or the existing soil topography. Land disturbing activities include, but are not limited to clearing, grading, filling, excavation, and compaction associated with stabilization of structures and road construction. Native vegetation is vegetation comprised on plant species, other than noxious weeds, that are indigenous to the coastal region of the Pacific Northwest and which reasonably could have been expected to naturally occur on the site. Examples include species such as Douglas fir,western hemlock,western red cedar,alder, big-leaf maple, and vine maple; shrubs such as willow, elderberry, salmonberry, and salal; herbaceous plants such as sword fern,foam flower, and fireweed. LAND DISTURBING ACTIVITY,CONVERSION OF NATIVE VEGETATION,AND VOLUME OF CUT/FILL Calculate the total area to be cleared,graded,filled, Answer the following two questions related to excavated, and/or compacted for proposed development conversion of native vegetation: project. Include in this calculation the area to be cleared for: �JJ Does the project convert%acres or more of Construction site for structures H "1 0 sq/ft native vegetation to lawn or landscaped areas? Drainfield,septic tank,etc.lk.St C)11 ;r..s/bo t\¢.isq/ft Circle: Yes No Well, utilities,etc.QSt �Sa'.►.91 r o to Q.w sq/ft Does the project convert 21/2 acres or more of native vegetation to pasture? Driveway, parking,roads, etc.U S C y.v SI. J„ reOsq/ft Circle: Yes No Lawn, landscaping, etc.U S� �c x sa:, /"0 iNtArl sq/ft Other compacted surface, etc.U5. eJr;d„� /r 'r ' q/ft Indicate Total Volumes of Proposed: Total Land Disturbance 0 sq/ft Cut 31 Fill (cu/yd) [over] stormwater calc worksheet Rev 9-9-2010—REV 9/9/2010 1 • • Impervious surface is a hard surface that either prevents or retards the entry of water into the soil mantle as under natural conditions prior to development. A hard surface area which causes water to run off the surface in greater quantities or at an increased rate of flow from the flow present under natural conditions prior to development. Common impervious surfaces include, but are not limited to roof tops, walkways, patios, driveways, parking lots or storage areas, concrete or asphalt paving, gravel roads, packed earthen materials, and oiled,macadam or other surfaces which similarly impede the natural infiltration of stormwater. STORMWATER CALULATIONS–IMPERVIOUS SURFACE NEW EXISTING Structures(all roof area) SO sq/ft Structures(all roof area) r'1 O sq/ft Sidewalks °SC s Ass,, /ho ,- sq/ft Sidewalks 0 sq/ft Patios V St. s i'• n: hwa sq/ft Patios 0 sq/ft Solid Decks V 5; ,• SA'. ) sq/ft Solid Decks () sq/ft (without infiltration below) (without infiltration below) Driveway, parking, roads,etcVsc 01.. I ,r`sq/ft Driveway, parking, roads,etc 3 2 sq/ft Other sq/ft Other R sq/ft ti Total New _ ,� sq/ft Total Existing 1 13 2 sq/ft TOTAL NEW+TOTAL EXISTING* . 'Ili sq/ft *This amount will be used BY STAFF to cneck total lot coverage. - The following questions will help determine whether the proposed project is considered development or redevelopment. DEVELOPMENT v.REDEVELOPMENT Divide the total existing impervious surface above by the size of the parcel and convert to a percentage. b % Does the site have 35%or more of existing impervious surface? Circle: Yes No FURTHER INSTRUCTIONS: If the answer is yes, the proposal is considered redevelopment and the attached Figure 2 should be used to determine the applicable Minimum Requirements. If the answer is no, the proposal is considered new development and the attached Figure 1 should be used. At this juncture, the applicant should refer to the applicable Flow Chart to determine the Minimum Requirements for stormwater management. DCD staff will help verify the classification of the project and the application requirements. For proponents of "small" projects who must comply only with Minimum Requirement #2—Construction Stormwater Pollution Prevention—an additional submittal is not required. The proponent is responsible for employing the 12 Elements to control erosion and prevent sediment and other pollutants from leaving the site during the construction phase of the project. Pick up the Construction Stormwater Pollution Prevention (SWPP) Best Management Practices (BMPs) Packet. Proponents of"medium" projects—those that must meet only Minimum Requirements #1 through #5—and for "large" projects—those that must meet all 10 Minimum Requirements—are required to submit a Stormwater Site Plan. DCD has prepared a submittal template of a Stormwater Site Plan, principally for rural residential projects. Complete the template in the Stormwater Site Plan Instructions and Submittal Template or prepare a Stormwater Site Plan using the step-by-step guidance in the Stormwater Management Manual. APPLICANT SIGNATURE By signing the Stormwater Calculation Worksheet, I as the applicant/owner attest that the information provided herein is true and correct to the best of my knowledge. I also certify that this application is being made with the full knowledge and consent of all owners of the affected property. (LAN�WNEYe OR AUTHORIZED EPRESENTATIVE SIGNATURE) (DATE) yLi or o otot g Y gk Fi q 4 os 1 r f i a o � + a aY s i �� > vl r 1'tPo EVa a'$V & r- � �� (..,f; _.��� �+b� y xfia I p 9 Y,,kQ , ,.� ,' d`A ,. �� : a,. o c 1 .,.e�`< �,` -® stormwater talc worksheet Rev 9-9-2010—REV.9/9/2010 2 • BLD13-00314 BUILDING PERMIT APPLICATION. . I evi 3-Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD13-00314 Received Date: 10/7/2013 SITE ADDRESS: 979 OAK BAY RD PORT HADLOCK, 98339 OWNER: COREY J WOODLEY PHONE: 979 OAK BAY RD PORT HADLOCK WA 983399707 BAYVIEW ADDITION TO HADLOCK SUBDIVISION: Block: Lot: PARCEL NUMBER: 931800901 Section: 12 Township: 29 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTION ADDITION OF BEDROOM AND BATHROOM TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ADD MAIN: 440 VALUATION 46,568.00 ADM: HEAT TYPE: CODE EDITION: 2012 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: 440 #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: SETBACK: DECK: 154 BANK HEIGHT: SEWAGE DISPOSAL: OSS WATER SYSTEM: 05783 BEDROOMS: BATHROOMS: Exist: 2 Exist: 1 Prop: 1 Prop: 1 Total: 3 Total: 2 Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $550.00 MEB 10/03/13 145424 Plan Check $357.50 MEB 10/03/13 145424 State Building Code $4.50 MEB 10/03/13 145424 Total: $912.00 11+„+e.,,nri.1,+�+.Vfnrmcl RI n Linn Ri,+n,+ 1!1/7/')(11'3 ��. ,gON cod, JEFFERSON III 09ADIS - S ( Lt COUNTY W ,�.� DEPARTMENT OF COMMUNITYDEVELOPMENT "' ` '� 621 Sheridan Street • Port Townsend • Washington 98368 360/379-4450 • 360/379-4451 Fax �qS N��o www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: Project Description(include separate sheets as necessary): Tax Parcel Number:(71 3 S 4 0 O r'3 p I r Property Size: �l s / fr1 i f 7 q (acres /square feet) Site Address and/or Directions to Property: q 1 C1 0 e k- 3c.\,,) ''i ( - Pt,r V-\ (A A0CA( L;A (1 -; 3C\ Property Owner(s)of Record: r Telephone:C3 3 0 1 - 2°O D 2, _Fax: email: Co c-e n L),,,,,, ' "`e-,,,;;I. C-P r Mailing Address:_of 7 ci 0 1\ Pc. i��:^1 H f,�l�c.\e 1...) A �S' rA Applicant/Agent(if different from owner): Telephone: Fax: email: _ Mailing Address: What kind of Permit?(Check each box that applies ❑Lot or Road Segregation Building ❑Critical Areas Stewardship Plan ! V Demolition Permit ❑Variance(Minor, Major or Reas r r t 1 ❑ Single Family ❑Garage Attached/Detached ❑ Conditional Use[C(a), C(d),or ] ❑ Manufactured Home _❑ Modular • - ❑ Discretionary"0"or Unnamed U• :sification ❑ Commercial* ❑Special Use(Essential Public F I i ** OCT 3 N13 ❑ Change of Use ❑ Boundary Line Adjustment ❑ Address ❑Road Approach_ ❑Short Plat** U ❑ Home Business ❑Cottage Industry ❑ Binding Site Plan** JEFFERSON COUNTY ❑ Propane 0 Long Plat** , i♦ NITY DEVELOPMEN. ❑ Sign ❑ Planned Rural Residential DeveI •••-: "°-e- • - ❑Allowed"Yes"Use Consistency Analysis ❑ Plat Vacation/Alteration** ❑ Stormwater Management ❑ Shoreline Master Program Exemption/Permit Revisions** ❑ Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Substantial Development** ❑Temporary Use ❑ Shoreline Management Variance ❑Wireless Telecommunication* ❑ 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 ❑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 L, of c -..p 2)%51,o p to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE L--J Date: 1 O — 2 13 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 tha he or she ants prior notice. Signature: �, dry Date: t 1(-)- : 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 responsibility for adhering to and complying with the ESA. The Applicant has read this'tic,-I-"-'pr l and signs and dates it below. Signature: � Date. -10 -- N3 • • 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 res onsibility of the General Contractor for the proposed project. Signature: 0.4.0/__ Date: t � . 1 — 1 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: ❑ New X Wood Existing: t ❑ Sewer K Addition ❑ Steel Proposed: i Bank ❑ Community System ❑ Alteration/Remodel X Concrete Total: 1,_ Height: X Individual System C Repair ❑ Masonry SEP Permit# _ o Demolition ❑ Other: Bedrooms: Water Supply: Existing: 2. Setback: ❑ Private well ❑ Two Party Type of Heat: Proposed: I X Public C.0* \ 0.-,, ...c n r�r._ Total: 3 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 Pro•ane Tank and/or A.•liance Installation •ermit mark all items below that a••I : I Underground Tank 1 Above ground Tank Size of Propane Tank: ('"Heat Stove 1 Cook Stove I Woodstove I Fireplace Insert 1 Hot Water Tank I Pellet Stove I Other _ Is this appliance being installed in a Manufactured/Mobile Home? Yes / When applying for 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 ti /J 3 6 � EH Bld App Review: ,CfiJ Floor Heated `h— Consistency Review: 2 n tif Other Heated Base fee: M.co 1 Mezzanine Additional Section: / Heated Basement Plan Check fee: n � , Unheated Basement �Aii-0 .�, ; State Surcharge fee: J q Other Unheated Pot Water Review fee / - Garage/Carport SUBTOTAL t 2 7; Decks ' 9 ti 3i1,30 911/Rd Approach fee: Other (1 C• -;,8-4 O. TOTAL: $ Receipt Number: 14 Cash/Check Number: ' "'l Li( ESTIMATED COST(REQUIRED) Date: J/ 'Fair market value of all labor and materials foundation to finish I -- 5( 0 c o _ oc7 Initials: A=i` , Map Output • • Page 1 of 1 ArcIMS HTML Viewer Map I i __...., , r l —931 00104 931800105`x.-" 931 0901121 06 - 931 I �' --2 93t8004FkS 934$0 1 93t80C�101 46134 02 93180054}3 ___t 931 931800402 9i18:: 931 931800104 931 901121401 (-- IE Legend t 931S00rOt �1 Selected Features 931800109 931800801_ _., ! . 931,,,,,:, Towns ��1 i 931 + 2 11 �. 931 1 a County$tat 963000701 931800707 931800703 1 --',...s* Rai Carters r- ,. _' 931800706931 i",�* JC Roads ----9 1 931 f Parcais 1 931800705 L I _a.____, -- 93i8009011:007"- - -----_ __ — - I ii �� 262700043 7 -- 962700004 962700041 962700042 ''-,., '962700044 962700043 r,,, 962790045 962100044 , 1 j 1 962700056 962700115 f l 962700046 962 Maps 0rn dsd by Atiersab csaly caws spa m 0 so■New 20641 j FOR INFORMATIONAL PURPOSES ONLY- Jefferson County does not attest to the accuracy of the data contained herein and makes no warranty with respect to its correctness or validity. Data contained in this map is limited by the method and accuracy of its collection. Thu Oct 03 13:13:11 2013 http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&ClientVersion=4.... 10/3/2013 4 ■ , 1110 _____________,_____....... IL________ _-..............■,..../(2 . SLIDER •-• 7____. 4?-0"x 4•-0" Y._ ....._ _ 2 14 M ''. X DJ 02 G "‘ w 71 pekil OD i Efeo x 0 K .r t F1,......,- 0 VI 4 'OA K 9 14 d .. L1.1 a M i 0 ;26........... ....,........ tit 9, > I ' . 0 0 0 A'".•.'' ■•'• kl,.., . - = co sisai > . , 1 rn x tn 71 I'FA 8 r7,A 1 e". r St, 3 4.•-0" I_ .er et > O• g k- V) .‘" XI z i• Fe • .-t EJ 0 (:) 0 1' C i —1 r.. z V-0" V-6" 6x12 HDR : .C> DB L TRMR I 33-0 f 4.---Ii-:.:*•° ..^:'°• . --- 1 .. tn.j • •<1 ■.,,T. °: .o -.2,• .- • :-■ rr'.2,4 . 33,.. . c r,--•8;3 ..., S. t 3zr' 8,,,Ig '., 1■1- ra 0 > ,O) 6 9 0 0 n M r, • \ , z O'. .. i> 1 P 7 ZA • 0 ox 0 r. N —11 •.:1 s. S. W •. CI 0 •■• • .. I C A :... Z I •- •'■ ...._ 0 , • u, r. —I c, > , 0 > ' Z 1"-- > Z ) ' ., •LI 4..1..,., .x,••••• x".:,-°3 •!..;"• f-'...—°.'1 _ ! I Standard Conditions for Residential Development in Jefferson County 1. LIGHTING: Lighting fixtures shall be designed and hooded to prevent the light source from being directly visible from outside the boundaries of the property. The intensity or brightness of all lighting, during construction and after project completion shall not adversely affect the use of surrounding properties or adjoining rights-of-way. Exterior lighting for residential uses shall not exceed twenty feet (20') in height from the finished grade, excepting when such lighting is an integral part of a building or structure. Ground level lighting is encouraged. 2. BUILDING HEIGHT: The building height is not to exceed 35 feet. 3. OUTDOOR STORAGE: Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 4. UNLICENSED VEHICLES: Not more than 2 unlicensed vehicles shall be stored on any lot unless totally screened from view of neighboring dwellings and rights-of-way. Such screening shall meet all applicable performance and development standards specific to the district in which the storage is kept, and shall be in keeping with the character of the area. Screening shall meet the requirements of Chapter 18.30 JCC. Outdoor storage of 3 or more junk motor vehicles is prohibited except in those districts where specified as an automobile wrecking yard or junk (or salvage) yard and allowed as a permitted use in Table 3-1 or Chapter 18.18 JCC, and such storage shall meet the requirements of JCC 18.20.100, Automobile wrecking yards and junk (or salvage) yards. In no case, shall any such junk motor vehicles be stored in a critical area. 5. PARKING: A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 6. This permit has been reviewed consistent with JCC 18.40.130 & 140. Notice: this permit does not excuse the applicant from complying with other local, state and federal ordinances, regulations or statues, applicable to the proposed development, but consistent with RCW 90.58. Future development beyond that specified in this permit shall require further review. 7. BMPs: The project shall adhere to the Best Management Practices (BMPs) to control stormwater, erosion and sediment during construction. BMPs shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 8. NOTICE: This permit does not excuse the proponent from complying with other local, state, and federal ordinances, regulations, or statutes applicable to the proposed development, but consistent with RCW 90.58. Development pursuant to this permit shall be undertaken subject to the applicable policies and performance standards of the Jefferson County Shoreline Management Master Program and the Jefferson County Unified Development Code. If during excavation or development of the site an area of potential archaeological significance is uncovered, all activity in the immediate area shall be halted, and the Administrator shall be notified at once. The Federal Endangered Species Act rules to protect threatened Chinook and Summer-run Chum salmon became effective on January 8, 2001. Bull trout have been listed as threatened since early 2000. Under the ESA, any person may bring lawsuit against any individual or agency that "takes" listed species (defined as causing harm, harassing, or damaging habitat for the listed species). In addition, the National Marine 2013-03-07_SFR_StdConditions 3/7/2013 1 • • Fisheries Service can levy penalties. Portions of Jefferson County, including marine waters, are included as "critical habitat"for a listed species. Development of property along any marine shoreline, freshwater shoreline, or floodplains could harm habitat if protective measures are not taken. To minimize the potential to damage habitat, all property owners developing adjacent to marine shoreline, freshwater shoreline, or floodplains are advised to do the following: All development activities should avoid unstable slopes, wetlands, and forested areas near surface waters Remove minimal vegetation for site development, especially large trees Allow trees that have fallen into surface waters to remain there Infiltrate stormwater from buildings and driveways onsite through drywells rather than discharging directly into surface waters or roadside ditches The Federal Bald and Golden Eagle Protection Act requires landowners within 660 feet (1/8th of a mile) of an eagle nest to consult with the US Fish and Wildlife Service. This Eagle Act prohibits anyone from "taking" bald eagles. This federal law defines the term "take" and describes the possible legal consequences when a "take" occurs. Among other actions, "take" includes a disturbance of bald eagles or their habitat. Under federal law a permit may still be required for activities that impact bald eagles or their habitat. Contact the US Fish and Wildlife Service (http://www.fws.gov/pacific/eagle/) to learn more about how this law affects your project. Any individual, group, or agency can bring suit for a listed species "taking", even if you are in compliance with Jefferson County development codes. The risk of a lawsuit against you can be reduced by consulting with a professional fisheries habitat biologist, and following the recommendations for site development provided by the biologist. 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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 Setbacks 1/0114 Erosion Control i J� r�. i Foundation Footing ,A It of Footing Drains Foundation Stem Wall /AO Underground Plumbing / 1yA Q/ Under Floor Framing •/A Straps(hold downs) 7 j j , Ext.Shear Wall Nailing Zt, `I Rough-in Plumbing 3/31 t4 Framing t//7/ / Blocking 11. 741 Airseal I(L Insulation:Walls Insulation:Floors t©'4 Insulation:Ceiling `id -T----e Int.Shear Wall Nailing Wallboard Nailing 14,r5frt i.e.-- Gas Line: Interior Gas Line: Exterior Propane Tank Heat/Chimney Clearance Mechanical Systems Blower Airtight Test Smoke&CO2 1461// Drywell/Alt Drainage Address Posted (9)11//1-// .51030617- PA IS fse/ILf FINAL INSPECTION 6N p/ FINAL INSPECTIO MUST BE APPROVED PRIOR TO BUILDING I O ILDIN U G BE NG OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR CONDITIONS for Building Permit# :BLD13-00314 1.) The project shall adhere to the Best Management Practices(BMPs)to control stormwater, erosion and sediment during construction. BMPs shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 2.) The site plan as submitted with the building permit application on October 3, 2013 has been reviewed for consistency under the UDC, and has been approved by Jefferson County Department of Community Development. Any modifications, changes, and/or additions to the stamped, approved site plan dated October 28, 2013 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 3.) This parcel is within a no shooting area per JCC 8.50. 4.) JMP \\firlAmark\data\fnrmc\F RI 11 PPrmit Rlrfin rnt 19/9/9n11 • BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD13-00314 Received Date: 10/7/2013 SITE ADDRESS: 979 OAK BAY RD Issue Date 12/2/2013 PORT HADLOCK, 98339 Expiration Date 12/2/2014 OWNER: COREY J WOODLEY PHONE: 360-301-2902 979 OAK BAY RD PORT HADLOCK WA 98339-9707 BAYVIEW ADDITION TO HADLOCK SUBDIVISION: Block: Lot: PARCEL NUMBER: 931800901 Section: 12 Township: 29 N Range: 01 W CONTRACTOR: OWNER/BUILDER PHONE: PROJECT DESCRIPTION: ADDITION OF BEDROOM AND BATHROOM TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ADD MAIN: 440 VALUATION 46,568.00 ADD'L: HEAT TYPE: CODE EDITION: 2012 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: 440 #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: 154 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: OSS WATER SYSTEM: 05783 Type Amount Paid By: Date: Receipt: BEDROOMS: BATHROOMS: Permit $550.00 MEB 10/03/13 145424 Exist: 2 Exist: 1 Plan Check $357.50 MEB 10/03/13 145424 Prop: 1 Prop: 1 State Building Code $4.50 MEB 10/03/13 145424 Total: 3 Total: 2 Total: $912.00 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 SPECIAL CONDITIONS APPLY-SEE ATTATCHED 4, o, JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 4 '`rffl Nos Date: lviilffi Time Received: it 1,5'9 am pr Mon Tue. We . Thur. Fri. Date: 4/1/ Ii BID: 13 Cog 14 Contact Name: Owner: Contact Number: 360 361- 7ADz Address: 979 O,x .6 or Cr] 206 Notes: Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing Under ground Furance Footing Rough In Air Seal Above ground Gas Stemwall Hydronic Exterior shear Exterior lines Oil Straps Hot Water Htr Interior shear Interior lines Ducts Post Hole Ventilation Appliance Underfloor Gas/Wood stove Man-Homes Insulation Final Inspection Setbacks Floor Foundation Wall Address Posted Block&Tile Ceiling • Inspections are required to be called in by 3:00 pm to receive an inspection the next day. Do to staffing issues,at this time,we cannot guarantee that you will receive an inspection the next day. day. Unless you receive a call from us,assume we will arrive on your requested inspection day. • You may leave an inspection request 24 hours a day, and Inspections are available from Monday through Friday. We cannot determine the time we will arrive in advance. However, if you call our office the morning of your inspection,around 9:00 a.m.,we can give an estimate of when the inspector will arrive. Our general office phone number is 360 379-4450. • An approved set of plans are to be on site with building permit for all inspections. If permit and plans are not on site at time of inspection,a re-inspection fee must be paid prior to re-scheduling another inspection. • If no access, no inspections will be performed,and a re-inspection fee must be paid prior to re-scheduling another inspection. • Inspectors will not access a home that has personal affects inside when the owner is not present. Commercial projects require 24 hour notice for inspection. • Fs�N cc JEFFERSON COUNTY �� -< DEPARTMENT 11OF COMMUNITY DEVELOP ��SNf\G. In (Y CC Date: 7,q Time Received: 4 L am/Cm Mon. Tue. Wed Thur. Fri. Date: l BLD: 0-3 11 Contact Name: Owner: Contact Number: 360 Address: q—jc OAK,Bill Ri) 206 Notes: p(.Je r fctj& Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing Under ground Furance Footing Rough In Air Seal Above ground Gas Stemwall Hydronic Exterior shear Exterior lines Oil Straps Hot Water Htr Interior shear Interior lines Ducts Post Hole Ventilation Appliance Underfloor Gas/Wood stove Man-Homes Insulation Final Inspection Setbacks Floor Foundation Wall Address Posted Block &Tile Ceiling 0 co,� S , JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT Date: zl/pf Time Received: PO am/pm Mon. P. i Wed. Thur. Fri. Date: ' /X BLD: /3-3/'f Contact Name: Owner: Contact Number: 360 Ql' O '.. Address: CT71 p&X el g0 206 Notes: ,-kJ'-)B Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground _ Framing Under ground Furance Footing Rough In Air Seal Above ground Gas Stemwall Hydronic Exterior shear Exterior lines Oil Straps Hot Water Htr Interior shear Interior lines Ducts Post Hole Ventilation Appliance Underfloor Gas/Wood stove Man-Homes Insulation Final Inspection Setbacks Floor Foundation Wall Address Posted Block &Tile Ceiling a _ / �kw5O cO JEFFERSON COUNTY ,, till DEPARTMENT OF COMMUNITY DEVELOPMENT Q9SH Date: y 7 Time Received: /7zV /pm Mon. Tue. Wed. 40 Fri. Date: VAst BLD: 4?- 3/V Contact Name: Owner: F7? OAK b,,,, RP Contact Number: 360 Address: 206 Notes: Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing Under ground Furance Footing Rough In Air Seal Above ground Gas Stemwall Hydronic Exterior shear Exterior lines Oil Straps Hot Water Htr Interior shear Interior lines Ducts Post Hole Ventilation Appliance Underfloor Gas/Wood stove Man-Homes Insulation Final Inspection Setbacks Floor Foundation Wall Address Posted Block&Tile Ceiling( ON t co JEFFERSON COUNTY 4 DEPARTMENT OF COMMUNITY DEVELOPMENT' 9SHIN C- 4 Date: /-3 Time Received: j z/g U'pm Tue. Wed. Thur. Fri. Date: p` BLD: /3 - 3/Y Contact Name: Owner: Contact Number: 360 " f l y9 Address: 979 d, <. ,64), 3n/ 2-717 Notes: Foundation Plumbing Framing Propane Tank Mechanical Setbacks 54-, Under-ground Framing Under ground Furance Footing tom. Rough In Air Seal Above ground Gas Stemwall Hydronic Exterior shear Exterior lines Oil Straps Hot Water Htr Interior shear Interior lines Ducts Post Hole Ventilation Appliance Underfloor Gas/Wood stove Man-Homes Insulation Final Inspection Setbacks Floor Foundation Wall Address Posted Block&Tile Ceiling 1 w�SON `o� JEFFERSON COUNTY ✓f/Z `� ` DEPARTMENT OF COMMUNITY DEVELOPMENT /� 4 Date: Time Received: am/pm Mon. Thur. Fri. Date: BLD: /J — '/ Contact Name: Owner: Contact Number: 360 S 30/ ,?9.02____ Address: 7 7' �, ,zp 206 Notes: Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing Under ground Furance Footing Rough In Air Seal Above ground Gas Stemwall Hydronic Exterior shear Exterior lines Oil Straps Hot Water Htr Interior shear Interior lines Ducts Post Hole Ventilation Appliance Underfloor Gas/Wood stove Man-Homes Insulation Final Inspection Setbacks Floor,_ Foundation Wall Address Posted _,Rlrirlr tL Tilc CPilina $ON c 4. . °y' JEFFERSON COUNTY .4 4 DEPARTMENT OF COMMUNITY DEVELOPMENT R,pNI NG-, c� Date: ,./_,, _Time Received: art Mo Tue. Wed. Thur. Fri. Date: ' x, / BLD: ig--" W Contact Name: Owner: Contact Number: 360 ? / .2.1).00— Address: 97Cj' 041, 201.7 ,0 206 Notes: Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing Under ground Furance Footing Rough In 77 Air Seal Above ground Gas Stemwall Hydronic Exterior shear Exterior lines Oil Straps Hot Water Htr Interior shear Interior lines Ducts Post Hole Ventilation Appliance Underfloor Gas/Wood stove Man-Homes Insulation Final Inspection Setbacks Floor Foundation Wall Address Posted Block&Tile Ceiling esON `'oe, JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 9Skt NO Date: 49,,(e Time Received: 5 jo am40 Mon. Tue. r'Wed. Thur. Fri. Date: /Z-7 BLD: /3 -3 j T Contact Name: Owner: Contact Number: 360 301 ©gg5 Address: l77 (Mg jS,q-/ 206 Notes: Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing Under ground Furance Footing Rough In Air Seal Above ground Gas Stemwall Hydronic Exterior shear X Exterior lines Oil Straps Hot Water Htr Interior shear Interior lines Ducts Post Hole Ventilation Appliance Underfloor Gas/Wood stove Man-Homes Insulation Final Inspection Setbacks Floor Foundation Wall Address Posted Block&Tile Ceiling eSOx co� JEFFERSON COUNTY . ` DEPARTMENT OF COMMUNITY DEVELOPMENT 9yH1 Ne` Date: AIG' Time Received: 'c' amf r Mon. Tue. ed. Thur. Fri. Date: 2, / BLD: /3- 3/ / Contact Name: Owner: Contact Number: 360 g© / ,q' z Address: 9 7 9 e2,¢ B,f7, 206 Notes: t--— 7(-- t.( IA Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing Under ground Furance Footing Rough In Air Seal Above ground Gas Stemwall Hydronic Exterior shear Exterior lines Oil Straps Hot Water Htr Interior shear Interior lines Ducts Post Hole Ventilation Appliance Underfloor Gas/Wood stove Man-Homes Insulation Final Inspection Setbacks Floor Foundation Wall Address Posted Block&Tile Ceiling JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT / Q9SRrN°�° Date: 1-24. Time Received: (Z 11 am/ID Mon. Tue. Wed. Thur. Fri. Date: \ —Z. BLD: 1 3 - 31 `- Contact Name: Owner: Contact Number: 360 '30( 0885 Address: Q 19 ©MCQI}.y el 206 Notes: Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing Under ground Furance Footing ' Rough In Air Seal Above ground Gas Stemwall Hydronic Exterior shear Exterior lines Oil Straps Hot Water Htr Interior shear Interior lines Ducts Post Hole Ventilation Appliance Underfloor Gas/Wood stove Man-Homes Insulation Final Inspection 1 Setbacks Floor Foundation Wall Address Posted Block&Tile Ceiling