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Home My WebLink AboutBLD2014-00178 BUILDING PERMIT APPLIG ION BRevie-0w 01pe78 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00178 Received Date: 5/21/2014 SITE ADDRESS: 1761 OLD GARDINER RD SEQUIM, 98382 OWNER: MARY L FORSMAN PHONE: 360-797-7745 1761 OLD GARDINER RD SEQUIM WA 98382-8747 SUBDIVISION: Block: Lot: PARCEL NUMBER: 002341025 Section: 34 Township: 30 N Range: 02 W CONTRACTOR: SEAN MARSHALL PHONE: 360-681-2333 SNS ROOFING LLC 372 BLUE GROSSE RUN SEQUIM WA 98382 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP RE-ROOF SFR SAME FOR SAME TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP REP MAIN: VALUATION 13,500.00 ADD'L: HEAT TYPE: CODE EDITION: 2012 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: OSS WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date: Type Amount Paid Bv: Date: Receipt: Approved/Date Permit $201.00 MEB 05/20/14 148683 State Building Code $4.50 MEB 05/20/14 148683tl"°ROVES Total: $205.50 MAY 21 2014 Jefferson County DCD NfirlomorL\dotolfnrme\F RI 11 Linn Rid rnt F/91/9f11A ect, JEFFERSCOUNTY 1-) F'31 `t` DEPARTMENT OF COMMUNITY DEVELOPMENT b 1 M V .1414;-.,,bc 621 Sheridan Street• Port Townsend•Washiington 98368 360/379-4450 • 360/379-4451 Fax www.cojefferson.wa.us/commdevelopment C Master Permit Application MLA: Project Description(include separate sheets as necessary): -te,c Mc ''' P he 4 tr-• Coi �i t o Okee :{-` 1.(t c CDC a� Tax Parcel Number. C/�2`3 k 025 Property Size: (acres/square feet) T Site Address and/or Directions to Property: /J 74,/ Old 62 2Alai NE /ZoA.a Property Ownerts)of Record: �4 41/4-"i Telephon ) 747-7 74 S Fax: email: Mailing Address: o✓e. ifferent from owner): 4 /k.J MA f2 N eOf�� 5N R'O`B F s\ �•� email: 5 N Ste.-Fibdoc■(SI I e k os ,r+ Telephone: `?1O� fob(-2333 Fax: 3toa Id l 2 333 Mailing Address: 172- 003 E. GQdss�, R�rl SEaarwJ 'J 4 513$2---- What kind of Permit?(Check each box that applies XBuilding ❑Critical Areas Stewardship Plan ,i c ❑ Demolition Permit ❑Variance(Minor,Major or Reason-• : •i %Single Family Garage Attached Detached ❑Conditional Use[C(a),C(d),or CI*' ❑ Manufactured Home t Modul- ❑Discretionary"D"or Unnamed Use • - bon ❑ Commercial* ❑Special Use(Essential Public Faciliti-_ # MAY 2 0 2014 ❑ Change of Use ❑Boundary Line Adjustment ❑ Address ❑Road Approach ❑Short Plat*' ❑Home Business ❑Cottage Industry ❑Binding Site Plan'* L JEFFERSON COUNTY ❑Propane ❑Long Plat"* r f.',:,.:_►,!Fgt.(PMEIVT ❑Sign ❑Planned Rural Residential Develo. r.., J ,- ❑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: ^nr DESIGNATION OF AGENT I hereby designate `.�G if, d'i A2W d4�/t— to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Date: $'t'i'p I4 By signing this application form,the owner/agent attests th= + =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 wan prior n • . Signature: 4.... �� Date: 5--!°r -(if 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 disclaimer and signs and dates it below. Signature: ,!^ l/_"'7 Date: `r1 Y G:\PennitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc -115010VIE MAY 2 0 2014 JEFFERSON COUNTY RE-ROOFING SUPPLEMENTAL APPLICATION DEPT OF COMMUNITY DEVELOPMENT Owner Name: M4/2-y ht4SiN4--,4 phone: 34o) 797- 774'S Applicant or Agent(if different from owner): S A,. ANAas4440- phone: .. 4 0 -MSS Site Address: /7 41 alb me2/NE/e. Parcel: 1 " C Scope of vvork sq ft: 41() (40 1. Is the original roof being removed.(P NO 2. Are you replacing with the same material: YES NO 3. Materials removed: '3--1-At abaCc S -17 4. Does the scope of work increase the pitch or fotrint or original roof. ES (531 5. Are you adding dormers? YES (:) 6. Are you increasing the living or heated space? 41:31 7. Are you doing solar installation? YES 8. If you answered"YES"to#4 or#5 above: Is the project located less than 150 feet from a marine or river shoreline or 100 feet from a lake shoreline? YES NO 9. If you answered"YES"to#8 above,submittal of a site plan and fees in the amount of$532 are required. 10. If you answered"YES"to#4,5 or 6,Environmental Health Review and a fee of$78.00 are required. 11. Any additional Information: 2013-10-31_REROOF.DOCX Updated October 31,2013 S-N-S Roofing LLC Page 2 of 2 Insurance history • • Savings No savings accounts during the previous 6 year period. Lawsuits against the bond or savings No lawsuits against the bond or savings accounts during the previous 6 year period. Tax debts No tax debts during the previous 6 year period. License Violations No license violations during the previous 6 year period. Workers' comp Do you know if the business has employees? If so, verify the business is up-to-date on workers' comp premiums. L&I Account ID Account is current. 217,549-00 Doing business as SNS ROOFING LLC Estimated workers reported Quarter 1 of Year 2014"1 to 3 Workers" L&I account representative TO/CAROLYN CRAWFORD (360)902-4715-Email: CRAI235 @Ini.wa.gov IWorkplace safety and health • No inspections during the previous 6 year period. Washington State Dept.of Labor&Industries.Use of this site is subject to the laws of the state of Washington. .'lice Washington'', Wes_ https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602922928&LIC=SNSRORL918LC&SAW= 5/21/2014 • • Jefferson County Building Division Permit Number: Applicant: BUILDING PERMIT INSPECTION APPROVALS Applicable Code: 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 garA 5/z3/ A final inspection will not be scheduled until all of the following are completed and signed off by the applicable Department: • Building Permit Conditions are met • Septic Permit Final/Complete for any building containing plumbing • Land Use Conditions met and signed off • Public Works Permit Final(where applicable) FINAL INSPECTION 5%.311 FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • • CONDITIONS for Building Permit# : \\tidemark\data\forms\F BLD Permit_Bldg.rpt 5/21/2014 • BUILDING PERMIT • Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD14-00178 Received Date: 5/21/2014 SITE ADDRESS: 1761 OLD GARDINER RD Issue Date 5/21/2014 SEQUIM, 98382 Expiration Date 5/21/2015 OWNER: MARY L FORSMAN PHONE: 360-797-7745 1761 OLD GARDINER RD SEQUIM WA 98382-8747 SUBDIVISION: Block: Lot: PARCEL NUMBER: 002341025 Section: 34 Township: 30 N Range: 02 W CONTRACTOR: SEAN MARSHALL PHONE: 360-681-2333 SNS ROOFING LLC 372 BLUE GROSSE RUN SEQUIM WA 98382 PROJECT DESCRIPTION: RE-ROOF SFR SAME FOR SAME TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP REP MAIN: VALUATION 13,500.00 ADD'L: HEAT TYPE: CODE EDITION: 2012 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DEC K: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: OSS WATER SYSTEM: Type Amount Paid By: Date: Receipt: BEDROOMS: BATHROOMS: Permit $201.00 MEB 05/20/14 148683 Exist: Exist: State Building Code $4.50 MEB 05/20/14 148683 Prop: Prop: Total: $205.50 Total: Total: 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 "--s°x P°G. JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT Date: 540iTime Received: p?;a I/ a ap Mon. Tue. Wed. Thur. 0 Date: S72-3//4/ BLD: ELI) I (- Do 17r Contact Name: genel Owner: Contact Number: 360 1177^ 7369 Address: 176/ old .cl ne - , 206 Notes: w k 9J 2( Foundation Plumhb^- cmmrr a arnnane Tank Mechanical Setbacks Under-gro 'Iect72€___ eoz.11. ground Furance Footing Roug ground Gas Stemwall Hydr or lines Oil Straps Hot Water 3 ko Li -77_ 73 6 9 or lines Ducts Post Hole Appliance CO DV•Ctl IN9 Gas/Wood stove Man-Homes sz S D Setbacks Q C Oth Final Inspection K' Foundation lot, a �;-Ee • Address Posted Block&Tile • 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. JEFFERSON COUNTO 1DCD No 48683 DATE 05/ 0/2014 RECEIVED FROM i J—/ —S O ) ,—vc- DESCRIPTION BARS# AMOUNT...Q., ol „ ,,.. ,, COIN /g �D ...0„... . , „,a CHECKS �. �” 4 S`� lt,2 044-K 2 w rgi �0 i ,eE1/ m y ill ," � °' RECEIVED BY �MLLI—%/I//f r TOTAL , �' a4Q4:5? "be, JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT Date: 5/a///yTime Received: pR;a li a idp Mon. Tue. Wed. Thur. 0 / Date: 572-3//V BLD: 3LJ /7 / ` — DD l 7 r Contact Name: genel Owner: // Contact Number: 360 1 77- 7359 Address: / 7b/ old oz=t -Jin,2v , 206 Notes: Ri'l9J -C-0•C ---e.,,,,,,,,Z Foundation Plumhrr° Cr=mino Prnnane Tank Mechanical (€ ,24'Setbacks Under-gro ID CIA-91 ground Furance Footing Rou@ ground Gas Stemwall Hydr . o or lines Oil Straps Hot Water L4 -77.._. 73 S 9 or lines Ducts Post Hole Appliance 40 C'° ��; Gas/Wood stove Man-Homes U�`(� S b Same. cat.h Final Inspection Setbacks Foundation �0 i-i-e • Address Posted Block&Tile r�`— MIME (j 11.1111111111111111111 • 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.