HomeMy WebLinkAboutBLD2010-00107 AUILDING PERMIT APPLICA•N MRA ew 00 28
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD10-00107 Received Date: 4/12/2010
SITE ADDRESS: 233 OSPREY LN
BRINNON, 98320
OWNER: MICHAEL DIEHL PHONE: 360-302-0156
JUDITH ROGERSON
PO BOX 10218
BAINBRIDGE ISLAND WA 98110021.8
SUBDIVISION: Block: Lot: TX 1
PARCEL NUMBER: 601192002 Section: 19 Township: 26 N Range: 01 W
CONTRACTOR: OLYMPIC RIDGE INC PHONE: 360-302-0156
15940 LINDSEY LANE
POULSBO WA 98370
Contractor's License OLYMPRI986NA Expires 8/7/2010
REPRESENTATIVE: . KLINKE' PHONE: 360-302-0156
159, • .% EY LANE 360-598-3992
PO " :O ' •
PROJECT DESCRIPTIOr NEW ADU W/ATT CARPORT
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP ADU MAIN: 560
VALUATION 125,000.00 ADD'L: 280 HEAT TYPE: EEE
CODE EDITION: 2006 HEAT BASE: HEAT TYPE:
OCCUPANCY: R-3 UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: 5N SHORELINE:
GARAGE: 336
CONST TYPE: DECK: 280 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: ALT
WATER SYSTEM: PWELL
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 1 Prop: 1
Total: 1
Rou ing Date: , .4
1240
Type Amount Paid By: Date: Receipt:Permit $1,133.75 LYK 04/12/10 117544 AMIN b
Plan Check $736.94 LYK 04/12/10 117544 JUL
State Building Code $4.50 LYK 04/12/10 117544
Total: ` $1,875.19 Jefferson County m
&Building Doartmtw
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�� JEFFERSON COUNT
' `" j DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street• Port Townsend •Washington 98368
360/379-4450 . 360/379-4451 Fax
Asog www.co.jefferson.wa.us/commdevelopment
................„...)
Master Permit Application MLA: 1 O _ 12a
Project Description(include separate sheets as necessary):
Tax Parcel Number. Property Size: x . (acres/square feet)
Site Address and/or Directions to Property: /
Cam.! ` _. d' r Ai - fie[i/C(+ /19/0
Property Owner(s)of Record: /7). )i.h/ r,- 2 cenre.r�,.,
J
Tele hone:e76o-- 3Dd elC,r` Fax: z.e) -- ("FP- 7 99,,,,Z email: ,�
Mailing Address: 1'•CV• a,,,, /D .te ,,...(v 5 . 1/ CA)r.,_ 4fzeo
Applicant/Agent(if different from owner): 019....34c .R. G,,,. .� tV OAk-
Telephone: io— —Jo 2 Oka< Fax: -7Kro email: ' ,.j
Mailing Address: /fe.ea i' le. (feel Ctil • a/ 5.O
lop kind of Permit?(Check each box that applies 0 Lot or Road Segregation
Auilding ❑Critical Areas Stewardship Plan
❑ Demolition Permit ❑Variance(Minor,Major or Reasonable Economic Use)
❑Single Family ❑Garage Attached/Detached ❑Conditional Use[C(a),C(d),or C]**
❑ Manufactured Home ..❑ Modular . - ❑Discretionary"D".or Unnamed Use Classification
❑ Commercial* ❑Special Use(Essential Public Facilities)**
❑ Change of Use ❑Boundary Line Adjustment APR 1 2 2010
❑ Address ❑Road Approach ❑Short Plat**
❑Home Business ❑Cottage Industry ❑Binding Site Plan**
❑ Propane ❑Long Plat**
❑Sign - ❑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 ❑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 0 LL( AP�tts9 1.4%-)e--• to act as my agent in matters relating to this application for permit(s).
•a jz ,.t:RE :C1 SIB--Jt Date: '�t 4
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 t• efferson County and its employees,representatives or agents for the sole purpose of application
review and any required .later inspections. 's a and right of entry will be assumed unless the applicant informs the County in writing at the
time of the applicatio he Are he , prior no". .
04 ture: i/ Date: f
The action or actions -i.• '-- 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 i ued 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 are in compliance with the Jefferson County development code.The Applicant acknowledges that he she or it holds individual
and non-transfer resp�/s'i�bility for a ring t�o,,anndp mplying with the ESA. The Applicant has read this disclaimer And signs and dies it below.
nature: wY' k L• t of +`— Date: .7--1 IAA-W.
• 111
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:
—dit/ P ) r9, - '
MAILING 'DDR SS: lc7e-tn Gmlf_/_ . 1K,6Z (,,), Ewa: elt e- 40 C49,0,: /PL
CONTRACTOR'S LICENSE WAINS
NUMBER: 04 illPie.2.gef.G. Afif. NUMBER
ARCHITECT/ENGINEER: PHONEryez ) )10 el/yr FAX:( -)--0 .......
cv•z-to,00rstry/- t„.
kV
MAILING ADDRESS:
,',r- 6t/O'er /,J y A./. Email_
—0--
P_Nit Type: Frame Typre: Bathrooms: Shoreline: Type of Sewage Disposal:
e
New [g/Wood Existing: ...._0— 0 Sewer
O Addition 0 Steel Proposed: / Bank 0 Community System
O Alteration/Remodel 0 Concrete Total: / Height: ertidividual System
O Repair 0 Masonry 70 SEP Permit# ID-,14-
O Demolition CI Other: Bedrooms: Water Supply:
Existing: —o•— Setback: PePrivate well 0 Two Party
Type of Heat: Proposed: / /....,.., ' 0 Public
u
Total: / r e 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 I No
When applying for a permit to install a propane tank you must also submit a site plan showing all of the buildings,all properly
lines,tank location and size,distances from the propane tank to all property lines,buildings and septic system components,
includin. the reserve area.
,:-..-3,,,,,.; :..-• ,.-.;.,r.,-,wi..4.-,!..,;.n,:::- ,...:-..--,,,:-.,,,y4Y;,-,,s,..4:Art-wq.-----.,-_ ---,i.,fc,-,,„....,-,:-.:,,;,f-,,,c4,,,,,,,,,„.,,,,„
Square Footage Current Pre"- -° A.,°. 1„::.,1-1:-:-.t.:Iti,1,4,2-,:;;., .;:la,.._;..,:ae.,J
Main Floor Heated '-'-4'"'"j2Lic;,`-;;;;:' EH Bld APP Review:
CCO /441:`'!rilWj'' • ff,
Floor Heated ... 'Ztli:lib,le&-z,,ve it'i Consistency Review: 1
, ' • el
. .,,Wilk:-,.,..,- ,
Other Heated ,,;:-.:.-Yv:v ' - - Base fee:
- ' . '15
Mezzanine ,---,-,--:',-- - '-. Additional Section: ----
Heated Basement Plan Check fee:
(134„ I r
Unheated Basement — — '-'..;...!-.7f44-'.:-.-1,--.. -',-' State Surcharge fee: a)
_ . ..
Other Unheated ...',4i.ii.'-i-77-!.-- Cit Water Review fee:
—0 -
' III kb II •
Garag:-Carpo • (0 Vtrs : - SUBTOTAL lg-n q
. ,
Decks 911/Rd Approach fee: _
--• ,l'at•-1I3L)- -
..2.404-
Other R,,,-,,.;,.y ' ' , TOTAL: $I S'4:1 1 1
—Cs---- 6.;"---4',..4=,, ,..-•'. '
Receipt Number: ( 17544
Cash/Check Number:
. „
e." 5.1 ) .
ESTIMATED COST(REQUIRED) Date:
&Fair market value of all labor a e aterials foundation to finish , _J. - impa.,
Initials: 1111111.
/ a.r;0 Ill .
06/30/2014 18:53 2067804005 MD=JR PAGE 01/01
•
TELECOPIER MESSAGE To: Community Development
From: Michael Diehl II Judith Rogerson @Fax: 360-379-4451
Date: June 30,2014(US) Re permits: BLD10-00101 & -00107
Pages: 1,including this
W\ `
OXi
Jefferson County Community Development,Permits &Pe mit Technicians)
We have two 2010 building permits for pro' :- grey Lane, Brinnon.
Permit BLD 10-00101 is for the home, and Pe g• BLD-00107 is fs r an ADU.
qn
We are working towards a final inspection on the home, but will not be proceeding
with the ADU. As part of finalizing Permit-00101,we have been in touch with Jefferson
County Health, where Ms. Linda Atkins helpfully informed us that the septic/health
aspects of Permit-00101 cannot be finalized while Permit-00107 remains "open".
As we will not be doing the building covered by Permit -00107 for the ADU, and
will not be renewing that permit,please cancel it, but without impeding Permit -00101.
When Permit-00107 has been canceled or terminated,please advise Ms.Atkins so
that she can move the house permit aspects forward,to allow us to seek a final approval
on Permit-00101. It is our hope to request the related inspection before July 12, 2014
(possibly on July 10), but time is short to finish some details and arrange the inspection.
Please call the MOBILE number below if there are any questions. Thank you.
Michael Diehl & Judith Rogerson
Michael Diehl P.O.Box 10218 Voice: 206.780.4004
Judith Rogerson Bainbridge Island WA FAX 206.780.4005
98110-0218 Mobile: 206.941.5984
United States of America
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28'-0"
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Upper Floor
Scale: 1/8" = 11-0"
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28'-0"
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Kitchen
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Great Room
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13/6 x 11/6 > 11/4x11/6
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scSg ..\\Langemack"d
, . . . . 0 f?,,s 4441 1 PA COMIIIIIIIK k VIIrporl ACTVIree.
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Main Floor
'ies,., 110
Scale: 1/8" = 11-0"
Job. 2009-242 ADU 4-8-10
Jefferson County Building CORsion Permit Null: BLD10-00107
Applicant: DIEHL
BUILDING PERMIT INSPECTION APPROVALS applicable Code: 2006 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
Setbacks
Erosion Control
Foundation Footing
Footing Drains
Foundation Stem Wall
Underground Plumbing
Under Floor Framing
Straps(hold downs)
Ext. Shear Wall Nailing
Rough-in Plumbing
Framing
Blocking
Airseal
Insulation:Walls
Insulation: Floors
Insulation: Ceiling
Int. Shear Wall Nailing
Wallboard Nailing
Gas Line: Interior
Gas Line: Exterior-
Propane Tank
Heat/Chimney Clearance
Drywell/Alt Drainage
Address Posted
Pigt.ce_ NfiLnel co f ( UtSinlied,
FINAL INSPECTION
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
BUILDING PERMIT S
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT#: BLD10-00107 Received Date: 4/12/2010
SITE ADDRESS: 233 OSPREY LN Issue Date 7/12/2010
BRINNON, 98320 Expiration Date 7/12/2011
OWNER: MICHAEL DIEHL PHONE: 360-302-0156
JUDITH ROGERSON
PO BOX 10218
BAINBRIDGE ISLAND WA 981100218
SUBDIVISION: Block: Lot: TX 1
PARCEL NUMBER: 601192002 Se tion: 19 Township: 26 N Range: 01 W
CONTRACTOR: OLYMPIC RIDG PHONE: 360-302-0156
ND ' LANE
POUL ':- 70
Contractor's License OLY' °'I986NA Expires 8/7/2010
PROJECT DESCRIPTION: NEW ADU W/ATT CARPORT
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP ADU MAIN: 560
VALUATION 125,000.00 ADD'L: 280 HEAT TYPE: EEE
CODE EDITION. 2006 HEAT BASE: HEAT TYPE:
OCCUPANCY: R-3 UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: 5N GARAGE: 336 SHORELINE:
CONST TYPE: DECK: 280 SETBACK: 40
BANK HEIGHT: 40
SEWAGE DISPOSAL: ALT
WATER SYSTEM: PWELL Type Amount Paid By: Date: Receipt:
BEDROOMS: BATHROOMS: Permit $1,133.75 LYK 04/12/10 117544
Exist: 0 Exist: 0 Plan Check $736.94 LYK 04/12/10 117544
Prop: 1 Prop: 1 State Building Code $4.50 LYK 04/12/10 117544
Total: 1 Total: 1 Total: $1,875.19
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
SPECIAL CONDITIONS APPLY -SEE ATTATCHED
CONDITIONS for Building Permit# :BLD10-0• •
0107
1.) SEE BLD10-00101 for conditions that apply to this property and project.
2.) 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.
3.) A Stromwater Management Plan has been submitted and approved by the Department of
Community Development. Once the subject permit has been issued the applicant shall
fully implement the provisions of the submitted plan and contact the Jefferson County
Department of Community Development to arrange a schedule to inspect the property for
plan compliance. A Certificate of Occupancy will not be issued until the Department
verifies plan compliance. No clearing for roadways or utilities shall occur on the project
site until clearing necessary for the installation of temporary sedimentation and erosion
control measures have been completed.
4.) The project is subject to compliance with the Department of Ecology In Stream Flow Rule
of WRIA 17. The parcel is located within the Devils Lake subbasin in a designated
Coastal Management Area; as such, the follow is required:
Installation of a water meter, meeting Department of Ecology specifications, is
required for all new uses throughout the watershed. (WAC 173-517-180). Brochures with
specifications are enclosed with the permit.
Refer to enclosed documents for more information or contact Ecology at
360-407-6300.
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