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Home My WebLink AboutBLD2010-00107 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 • i ON c • �� 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 Contractors or Tradespeople Printer Friendly Page • Page 1 of 2 General/Specialty Contractor A business registered as a construction contractor with L&tl 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 Olympic Ridge Inc UBI No. 602191592 Phone 3603020156 Status Active Address 15940 Lindsey Ln License No. OLYMPRI986NA Suite/Apt. License Type Construction Contractor City Poulsbo Effective Date 8/1/2002 State Wa Expiration Date 8/ 7/2010 Zip 98370 Suspend Date County Kitsap Specialty 1 General Business Type Corporation Specialty 2 Unused Parent Company Other Associated Licenses License Name Type Specialty 1 Specialty Effective Expiration Status 2 Date Date All In One Construction ALLONBS005LF Building &tAmp; Contractor General Unused 6/6/2000 6/4/2011 Active Supply OLYMPR*066JD Olympic Rid Construction General Unused 4/4/1994 3/25/2003 Archived Ridge Contractor KLINKEJ106BQ Klinker, E J Construction General Unused 1/18/1990 1/1/1993 Archived Contractor GILLEC*110ND Gillett Company Construction General Unused 8/4/1989 5/30/2000 Archived p y Contractor CDGILC*161KH C D Gillett Construction General Unused 5/8/1984 4/12/1989 Archived Construction Contractor CDGILC*175MK C D Gillett Construction General Unused 7/12/1983 4/12/1984 Archived Construction Contractor CDGILC*181MG C D Gillett Construction Carpentry/Framing Unused 7/7/1982 4/12/1983 Archived Construction Contractor C ltAmp; D Construction CDCONC*221QG Carpentry/Framing Unused 11/7/1978 8/21/1981 Archived Construction Co Contractor SEATTR*938KJ Seattle Construction Cabinet And Unused 5/11/2007 5/11/2009 Expired Reflections Contractor Millwork Business Owner Information Name Role Effective Date Expiration Date Klinker, Elliott J President 08/01/2002 https://fortress.wa.gov/lni/bbip/Print.aspx 4/12/2010 Contractors or Tradespeople Printer Friendly Page Page 2 of 2 • Bond Information Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date 1 CBIC SE3537 08/01/2002 Until Cancelled 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 Amou AMERICAN 9 SAFETY 05103108 03/25/2010 03/25/2011 $1,000,01 INDEMNITY CO 8 United 05100642 03/25/2009 03/25/2010 $1,000,01 Specialty Ins Co 7 GENERAL BAG000333500 03/25/2008 03/25/2009 $1,000,01 FIDELITY INS CO 6 GENERAL BAG00003335 03/25/2007 03/25/2008 $1,000,01 FIDELITY INS CO 5 QUANTA GAG000787500 03/25/2006 Until Cancelled INDEMNITY CO $1,000,01 4 CBIC INSSE3537 03/25/2005 03/25/2006 04/04/2006 56,000,01 3 CBIC INSSE3537 03/25/2004 03/25/2005 51,000,01 MOUNT VERNON 2 FIRE CL2258294 03/25/2003 Until Cancelled $1,000,01 INSURANCE Summons/Complaint Information Summons/ Complaint Cause Number Tax Warrant Id Plaintiff County Complaint Date Complaint Amou CATHCART, 1 052002548 WALLACE JEFFERSON 08/11/2005 $0.1 & VETIS KAY Judgement Information Judgement Cause Number Tax Warrant Id Plaintiff County Judgment Date Judgment Amount Payment CATHCART, 1 052002548 WALLACE JEFFERSON $0.00 VETIS KAY https://fortress.wa.gov/lni/bbip/Print.aspx 4/12/2010 • 28'-0" / / ' — \ , 1---.—{ , / Attic \\ 1 // Attic \I/ Loft _ I s? r 1 b I A Unfinished t - i-, c., I* 13/6 x 11/2 4. , / I \ / \ / I \ ________, i //Open'lir,belo \ I \ Attic / I \ \\ / }--11.----,.--11—{ \ Upper Floor Scale: 1/8" = 11-0" \ , , ______ 0 i., Carport 28'-0" 19 Li: 0 _1 ■at j CD Kitchen ---) b 0 - (., gir•-x. Great Room I Bed-1 13/6 x 11/6 > 11/4x11/6 0 Er \r(3)\ \ -,) 1 y)Pi ‘p,t I 1 L beck scSg ..\\Langemack"d , . . . . 0 f?,,s 4441 1 PA COMIIIIIIIK k VIIrporl ACTVIree. r 1 Vii4=17:: Main Floor 'ies,., 110 Scale: 1/8" = 11-0" Job. 2009-242 ADU 4-8-10 bk Lo Ai n o Qet)13 ek(Poti- A f w JEFFERSON COUNTY PERMIT CENTER , ----3-.1;- , ,r ,...,_.APPLICANT NAME:U V (C i 1) 1.1 c' - tjli 360-AIPHONE: I,` a SITE ADDRESS:C A pVQJL- Lo DATE: li- 0 . H LTH APPROVAL PERMIT# SE FOOD SERVICE 2. SHORELINE BANK HEIGHT SETBACK 3. FLOOD ZONE 4. FOREST PRACTICE APP (CLASS ) 5. PLANNING APPROVAL ICAL AREA REVIEW 1 u'F- k -Ic+ , . ZONING 8. HEIGHT 9. LOT COVERAGE 10. ADDRESS 11. FEE NTRACT '.S.LICENSE Or RGY SHEET _----, 14. BOND HOLDER/LENDER 15. NTT 16. SETBACKS 17. PROVIDE WA STATE ENGINEER STAMP/ARCHITECT'S STAMP '18. STORMWATER SITE PLAN 19. D.O.T. ACCESS APPRL. ve,.. 20. FIRE FLOW FOR COMMERCIAL STRUCTURES 4 21. PLAN R /IEW OCCU � ANCY: .�,;. \ TYPE OP CONST: 23. ilerfaArsi IMPA EXPOSUE: 24. -% o WIND: z_ 25. SNOW: I-__ 26. 27. 28. 29. ..._ 30. 31. 32. 33. 34. 35. 36. 37., 38. 39. H:\HME\PLNCNTR\I N FOBLG\BLDCKLIS\2/2000 • 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. • . -V.., .—• l ....._ ..--- 0 ° ---- . . 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