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HomeMy WebLinkAboutBLD2014-00214 • BUILDING PERMIT APPLIC ION BLD14-00214 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00214 Received Date: 6/16/2014 SITE ADDRESS: 140 N BAY WAY PORT LUDLOW, 98365 OWNER: PAUL R BARLOCK PHONE: 206-234-5561 SUSAN K BARLOCK 8790 GOSHAWK RD BLAINE WA 98230 OAK BAY WATERFRONT SUBDIVISION: Block: Lot: PARCEL NUMBER: 976800015 Section: 29 Township: 29 N Range: 01 E CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTION DEMO PERMIT OF ALL EXISTING STRUCTURES- ( HOUSE, GARAGE, CARPORT) TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP DEM MAIN: VALUATION 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: CON WATER SYSTEM: 1 PW ELL BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $76.00 SRE 06/16/14 148747 APPROVED Total: $76.00 JUN 2 6 2014 Jefferson County DCD • \\tidemark\data\forms\F_BLD_App_Bld.rpt 6/16/2014 / .. SoH � • 0 y -�,) LI 4):: p JEFFERSON COUNTY , • ' �� DEPARTMENT OF COMMUNITY DEVELOPMENT l ` " 621 Sheridan Street • Port Townsend •Washington 98368 __ 4, "' > 360/379-4450 . 360/379-4451 Fax - C (� O n!7 I 1 p www.co.jefferson.wa.us/commdevelopment D L t/ �, `SBriga Master Permit Application MLA,i JUN 1 6 2014 'Project Description(include separate sheets as necessary): - .. ' V)eIM C> All Sitt,uC e...) 4.0 01o0-14 i- r.- - ., ... f JEFFERS, t ■ i •Tax Parcel Number: R rf 43' Odp , T Property Size: — DEPT.OF COMMUNI�y� ^ r Site Address and/or Directions to Property: L C2 V .1?/ly 40,11 Fog LuPGcae) w 4... Property Owner(s)of Record: `Q TJU 1- A . IN A Q 1.0 Che Telephone: ID 6- a 3 4- 5 '( I Fax: email: Pi:La.1►a c Lowe. A5D Mailing Address: 2-7 9 a Csos 4t 0,....LL. 19 , 1.Ilei u„■ ci$?3 o Ac90vcv✓e s7`e fri S Applicant/Agent(if different from owner): , b'a'st Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies ❑Lot or Road Segregation 13Building ❑Critical Areas Stewardship Plan 1. 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 ❑ Address ❑Road Approach ❑Short Plat** ❑ Home Business ❑Cottage Industry ❑ Binding Site Plan** ❑ Propane ❑Long Plat** ❑Sign . ❑Plannea 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)* ❑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 to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Date: 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 r:-. 'ed later inspections. Staff's access and right of entry will be assumed unless the applicant informs the County in writing at the time of the app/' • that he or sh-wan •rior not j. Signature: Al_ /f �� — ` Date: /6 LO/5 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-tra er le response ty for her�ing o and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: %'c'�� Date: /KA« 20/4 �, • ! 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 assu • he responsibilit of the General Contractor for the proposed project. Signature: i — _ Date: ye Zalfr GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: HONE: FAX: Fe ANSI)0 1 tzot_�-1,3‘.v A cs,uv4r- E-r (31& g,21 9ZtD2 ( ) MAILING ADDRESS: 436 i Nrzwt f EMAIL: CONTRACTOR'S LICENSE I7 4-010. 9 WAINS NUMBER: c't2A1JSTE cL1 _ NUMBER ARCHITECT/ENGINEER: PHONE ( ) ` FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New ❑ Wood Existing: C Sewer ❑ Addition ❑ Steel Proposed: Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: _ Height: C Individual Stem ;yam y 1 y ❑ Repair. 0 Masonry SEP Permit# 19 yY Demolition ❑ Other: Bedrooms: Water Supply: 5 -c Existing: Setback: X Private well ❑ Two Party Type of Heat: Proposed: ❑ Public Total: Name of System: If this is a Commercial Prolect 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 Pellet Stove i Other Is this appliance being installed in a Manufactured/Mobile Home? Yes / No 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 Only Amount Revision - Main Floor Heated EH BId App Review: r4q co 2"tl Floor Heated Consistency Review: ^(`� Other Heated Base fee: y 74 - U Mezzanine Additional Section: 1 cl -to Heated Basement - Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL Decks 911/Rd Approach fee: Other TOTAL $ 114 • °C2 Receipt Number Cash/Check Number: 31 ip�`1 I ESTIMATED COST(REQUIRED) Date: •Fair market value of all labor and materials foundation to finish wig 14 Initials: 9 • ' Y � ` a,' ,. , 2940-B Limited Lane NW o �� '0,� ' 44 : Olympia,WA 98502 s. ORCAA , ,: 1-800-422-5623 • (360) 539-7610 *".449,./..,,,..,00.0°.*".449,./..,,,..,00.0°. k 4 Fax: (360)491-6308 1EC V1 D ORCAA Permit Application Status .� � 1 JUN 162014 ) JEFFERSON COUNTY Permit Status 0 Approved ❑ Disapproved _M DEPT OF COMMUNITY DEVELOPMENT Notes 05/06/2014 (�K Review Date Reviewed by 14ASB004422 05/08/2014 05/02/14 Permit# Expiration Date Application Received $325.00 05/02/14 Amount Due ❑ Cash ❑ Check © Credit card Additional notes or permit conditions Port Angeles Field Office: 116 W. 8th St., Suite 113, Port Angeles, WA 98362: (360) 417-1466 Raymond Field Office:301 Ocean Ave., Raymond,WA 98577: (360) 942-2137 Olympic{,Region Clean Air Agency( ) • Ltmited�.ane FYiY Olympia,WA 98502 AL 360-539-7610 I FAX"360-491-6308 , Raymond Office 360-942-2137 www.arcaaorg 1 r AA, CONTRACTOR ASBESTOS PERMIT APPLICATION Asbestos projects within Clallam,Grays Harbor,Jefferson,Mason, Pacific,and Thurston counties REQUIRE A PERMIT and require that the following conditions be met prior to the demolition or renovation. Olympic Region Clean Air Agency(ORCAA)regulations define an asbestos project as the construction,demolition,repair, remodeling,maintenance,or renovation of any public or private building(s),vessel,structure(s),or component(s)involving the demolition,removal,salvage,disposal,or disturbance of any asbestos containing material(ACM).ORCAA defines ACM as 1 percent or more of asbestos.Asbestos-containing roofing material is not considered an asbestos project if it meets all the requirements in ORCAA Regulation 6.3.1. The following is merely a reference guide and not a substitute for agency regulations. 1.A good faith asbestos survey must be conducted by a certified Asbestos Hazardous Emergency Response Act(AHERA)building inspector.Qualified contractors and inspectors may be found in your local Yellow Pages through the Washington state Department of Labor and Industries or on ORCAA's website. 2.Asbestos samples must be sent to a NVLAP Laboratory(National Voluntary Laboratory Accreditation Program)per 40 CFR 763.87.A list of labs can be found on ORCAA's website. 3.The start date on"other structure"asbestos abatements must be at least 10 working days from the submission date of the complete application and payment. 4.It is the responsibility of the building owner and/or asbestos contractor to ensure all ACM identified in the permit and survey and proposed to be removed,has been removed and properly disposed of in accordance with ORCAA's Regulations. 5.Any and all structures on the same parcel of property that are not proposed to be abated must be identified. 6.A copy of the asbestos survey,approved Asbestos Permit,and any subsequent amendments must be kept on site and be available for review by Agency inspection personnel. 7.Use the Completion Notification and Amendment Form to make changes to the original permit. 8.The original asbestos permit will expire on the Completion Date.To change the completion date,a Completion Notification and Amendment form must be received PRIOR to expiration.If the permit expires and the project is not complete,you must submit and pay for another asbestos permit.Under no circumstances will a project be extended beyond 1 year from original start date. 9.Upon completion of project,fill out and submit a Completion Notification and Amendment form,documenting actual date of completion. FEES 10-259 linear or 11-159 square feet-$150; 260-999 linear or 160-4,999 square feet-$325; 1,000-9,999 linear or 5,000-49,999 square feet-$650; 10,000+linear or 50,000 sq.feet-$1300; Emergency-$50;Annual-limit of 260 linear or 160 square feet- $500 ADDITIONAL REQUIREMENTS: "Owner Occupied Residential Dwelling" means any single family housing unit which is permanently or seasonally occupied by the owner of the unit after the proposed project.This term includes houses, mobile homes,trailers, houseboats,and houses with 'mother-in-law apartment'or a'guest room.'This term does not include structures that are demolished or renovated as part of a commercial or public project; nor does this term include any mixed-use building, structure,or installation that contains a residential unit, or any building that is leased or used as a rental, or for commercial purposes. Emergency Project:An operation that was not planned but results from a sudden, unexpected event that, if not immediately attended to, presents a safety or public health hazard, is necessary to protect equipment from damage,or is necessary to avoid imposing an unreasonable financial burden.This term includes operations necessitated by non-routine failures of equipment.The property owner must provide written notification explaining the reason for the emergency.There is a$50 non-refundable emergency fee. • • PROPERTY OWNER Name Phone Mobile phone Paul Barlock 206.234.5561 ' 1 E-mail FAX paul.barlock©nnwventures.com 360.933.4514 Mailing address City State ZIP 8790 Goshawk Road Blaine WA 98230 Site contact person Phone Mobile phone E-mail Lan Taylor 360.710.1992 lantaylorkcb©gmail.com Site address City 140 N. Bay Way Port Ludlow ASBESTOS CONTRACTOR Contractor/Business name On-site contact person K C B Lan Taylor Contractor email Mobile Phone FAX jtaylorkcb @yahoo.com 360.830.5022 360.830.5020 Mailing address City State ZIP P.O. Box 220 ISeabeck I WA 98380 PROJECT INFORMATION Completion Structure type Start date date Owner occupied residential dwelling (prior notice) 05/06/14 05/08/14 Number of structures to be abated Total quantity of square feet linear feet 1 asbestos to be removed 14874 Work shift days Work shift hours ❑ Monday Tuesday ® Wednesday ® Thursday 10 a.m. -5 p.m. ❑ Friday ❑ Saturday ❑ Sunday Check materials being removed ❑ boiler/furnace ❑ duct insulation ❑ pipe insulation ❑ fireproofing paints ❑ plaster Z cement board ❑ cement pipe ►�/ flooring ❑ roofing ❑ textured coating ❑ Other Will all identified asbestos be Will this structure be demolished after Disposal site removed from structure asbestos removal Columbia Ridge Landfill Q Yes Q No ® Yes Q No You may attach the asbestos survey below: (Note: a survey is required prior to approval of this permit) i • ASBESTOS PROJECT CATEGORY Project category and fees ❑ 10-259 linear or 11-159 square feet-$150 4 260-999 linear or 160-4,999 square feet-$325 ❑ 1,000-9,999 linear or 5,000-49,999 square feet-$650 ❑ 10,000+linear or 50,000 sq.feet-$1300 ❑ Emergency-$50 ❑ Annual-limit of 260 linear or 160 square feet-$500 PLEASE MAKE A NOTE OF YOUR FEE Applicant name Date beanie Taylor 05/02/14 I do certify that I am the owner, authorized agent of the owner, or authorized contractor for the property subject to this ORCAA application/permit. I authorize ORCAA staff to enter the property listed in this application at reasonable times for purposes of inspecting the work that is the subject of this application/permit and to ensure compliance with permit conditions,applicable laws and regulations. I understand that granting of this permit by ORCAA does not authorize anyone to violate federal,state, or local laws or regulation pertaining to activities associated with this permit. I have read and will abide by the conditions set forth in this permit and any addendum thereto. I do certify under penalty of perjury under the laws of the state of Washington that the information in this application and supplemental data is,to the best of my knowledge true,accurate and complete. This permit is not valid until fees are paid and permittee receives an approved permit. Please contact ORCAA during normal business hours(M-F,8-4:30 p.m.)at 360.539.7610 to arrange payment on your permit application. Permit fees are non-refundable. y L)° 73 0 a N� m ITI Y 1 M Z rh .' h 0 4 ' rn 0 z ,, N rn rNO ______ O R, m..1 rn h h � Viv / ~� ..—vy !: r /� /N. YWAY C f ttZ�� s— 1_ �_ n. C-4 W N \\ \ W ° N28'51'20"W O �,CI)r,� A 119.91 l'l \ f 11 `v,�, NI o i � V v I\\\\ b • f\\\A i i '0 I I aSO0 SQ.) -1) .. \ )OOH 2 y C V M� o r~ g ��' r— \ P R,\iliN m I O i1I Z /cN /� \ /�i ____.....:„...7 _,-1,,,, ... ,�, h I 00 cVin >' À II II z x. o(. GJ V z r?y O I ' I a t<x \ ^�f oozzc� < n• ; .. ❑ g CO 1 Co ul go ,: -.4� �z mo I r4 r,ccj„unri �ac� ti0 2 h O NI O y•� «”y mm hk zz o O —Z C r.,yr c) m 1.(:) z 2 Z x 0 TO 0 U 'i r O� O � O ;i� r ti v`, m o rn b N 2 r o�C m 0 't' c� Y � O r O 2 0 O 2 iC o 0 N �. o 0 � o •:+/ h t� + u) a o 2� V a 4. � o v F y m r:0:0j :)+I I.C R. O� 'y?>1;: C�+'C 0 N i ;; Syr;:'}.?;;; CO L., :tiy`c::: 2 O Y h CTS Pgilk ''' b _ , - n1 s - - iP ` Pe'' j �- CW i: N, ,) ,a 4• _ z o y b O tN O h o � N r / I b a O / C r O Z ti b L _ __ _ " r-- (ISL..", / , 1^ci I I .o & II .� r _. 1_______...) t .3.sli..■ . NI . M Cr)IM al . rf//�� t. - '� o [�1 g Asir—, a)= S 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 /20‘444 `ret■ 4/30/91 a % e v/t/el e' 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 /3o/ r: FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • CONDITIONS for Building Permit# :BLD14-00214 1.) Approval of this permit does not provide any assurance of future approvals for onsite sewage disposal on the property or use of any existing septic systems.Actions taken to date and proposed as part of this project may limit or prevent future development of an onsite sewage system. Future proposals must meet current code at the time of application. 2.) No plumbing has been reviewed or approved for this project by Jefferson County Public Health. Additional requirements may apply if plumbing is proposed. \\tidemark\data\forms\F_BLD_Permit_BIdg.rpt 6/26/2014 • BUILDING PERMIT • Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD14-00214 Received Date: 6/16/2014 SITE ADDRESS: 140 N BAY WAY Issue Date 6/26/2014 PORT LUDLOW, 98365 Expiration Date 6/26/2015 OWNER: PAUL R BARLOCK PHONE: 206-234-5561 SUSAN K BARLOCK 8790 GOSHAWK RD BLAINE WA 98230 OAK BAY WATERFRONT SUBDIVISION: Block: Lot: PARCEL NUMBER: 976800015 Section: 29 Township: 29 N Range: 01 E CONTRACTOR: OWNER/BUILDER PHONE: PROJECT DESCRIPTION: DEMO PERMIT OF ALL EXISTING STRUCTURES- ( HOUSE, GARAGE, CARPORT) TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP DEM MAIN: VALUATION ADD'L: HEAT TYPE: CODE EDITION: 2012 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE. SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: 1 PWELL Type Amount Paid By: Date: Receipt: BEDROOMS: BATHROOMS: Permit $76.00 SRE 06/16/14 148747 Exist: Exist: Total: $76.00 Prop: Prop: 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 SPECIAL CONDITIONS APPLY-SEE ATTATCHED 6,„i • c0°:a JEFFERSON COUNTY 4. ; { DEPARTMENT OF COMMUNITY DEVELOPMENT "ShjNCiC 5 0 r Date: Time Received: � ”" am pm ' on. Tue. Wed. Thur. Fri. Date: 4130 BLD: I if— a( / Contact Name: Owner: Contact Number: 360 gy q2,6,2 Address: j i ft2 ik) Oki +.041 206 Notes: 1 `p, 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