HomeMy WebLinkAboutBLD2013-00333 BUILDING PERMIT APPLIC1ON BLD13-00333
Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT#: BLD13-00333 Received Date: 10/22/2013
SITE ADDRESS: 761 ROBBINS RD
NORDLAND, 98358
OWNER: DONALD J MAYNARD PHONE:
DIANE M MAYNARD
761 ROBBINS RD
NORDLAND WA 983589673
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 921093003 Section: 9 Township: 29 N Range: 01 E
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOII REPAIR TO EXISTING DECK
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP REP MAIN:
VALUATION 7,500.00 ADD'L: HEAT TYPE:
CODE EDITION: 2012 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: GARAGE: SHORELINE:
CONST TYPE: DECK: 385 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL:
WATER SYSTEM:
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: Prop:
Total: Total:
Routing Date:
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $157.00 MEB 10/17/13 145468
Plan Check $102.05 MEB 10/17/13 145468 APPROVED
State Building Code $4.50 MEB 10/17/13 145468
Total: $263.55 OCT 2 9 2013
Jefferson County DCD
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•
,40 °o JEFFERSON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
I�1P
621 Sheridan Street I Port Townsend,WA 98368 I Web:liwiw.coiefferson.wa.us/communitydevelooment
�S 1 9>o Tel:360.379.4450 I Fax:360.379.4451 I Email:dcd(a.co.iefferson.wa.us
Building Permits&Inspections I Development Consistency Review I Long Range Planning I Watershed Stewardship Resource Center
Master Permit Application MLA:
Project Description(include separate sheets as necessary):
Dec k Repair
Tax Parcel Number: 4 2,\ Oct 3 oo,.."2 4 Property Size: 47. 3 (acre quare feet)
Site Address and/or Directions to Property:
V6 f Robb S Kis O L 4# J (&) . 368
Property Owner(s) L")of Record: a4J a t I i•.vry- Q Ala
� —
Telephone: - 37 4 1 e 7 7`� Fax: email: I 4-41Y ?�1�-I"t4 t C. Ce�
Mailing Address: 766# ",41,•—/s /4.6 /✓dl�t�L�i�v'T �.l�
Applicant/Agent(if different from owner):
Telephone: Fax: email:
Mailing Address:
What kind of Permit?(Check each box that applies ❑ Lot or Road Segregation
j4Building ❑Critical Areas Stewardship Plan
$1 Demolition Permit ❑Variance(Minor, Major or Reasonable Economic Use)
f Single Family ❑Garage Attached/Detached ❑Conditional Use[C(a), C(d),or --
n Manufactured Home ❑ Modular ❑ Discretionary"D"or Unnamed Us la ie
❑ Commercial* ID Special Use(Essential Public Fa ili
❑ Change of Use ❑ Boundary Line Adjustment
❑ Address ❑ Road Approach ❑Short Plat**
❑ Home Business 0 Cottage Industry 0 Binding Site Plan**
OCT 1 7 2013
❑ Propane ❑ Long Plat** J
❑Sign ❑Planned Rural Residential Deva pm4ent(PRRD)/Amendments'"` 1
❑Allowed"Yes"Use Consistency Analysis ❑Plat Vacation/Alteration*" JEFFERSON COI,ViY
❑Stormwater Management ❑Shoreline Master Program Exemptio l fr EVELOPMEN-
❑Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Substantial eveiupnieiP" '�T
❑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 - .ct as my agent in matters relating to this ap lication for permit(s).
OWNER SIGNATURE (� �� 1/ /i i Date: �lb 2 U13
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 a -•uired later inspections. Staff access and right of-. try will be assumed unless the applicant informs the County in writing at the
time of the , .pl ion that h- .r se want pfotice. /
Signature:,;.,//l _� ,,. � Date:
w/ f( /2M'3
The actio e coons Applicant will undertake -s 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' sued will not violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your
action(s)eve- if y. are in compliance with the Jefferson County d-.-o. ent code.The Applicant acknowledges that he,she or it holds individual
and non-tra, -ra'le rest:), sibi or a. - • g . and complyin. it e ESA. The Applicant has read this disclairrter and sgns and dates it below.
Signatur- Date: to ID 2'
07/24/2013
• 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 a ing the r onlity yrteneral Contr r for the proposed project.
Signature: Date: 1°//7/ 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 bui,• ❑ Wood Existing: ❑ Sewer
❑ Addition ❑ Steel Proposed: Bank ❑ Community System
❑ Alteration/Remodel ❑ Concrete Total: Height: ❑ Individual System
❑ Repair ❑ Masonry SEP Permit#
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: ❑ Private well ❑ Two Party
Type of Heat: Proposed: ❑ Public
Total: 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:
Underground Tank Above ground tank Size of Propane Tank:
Heat Stove Cook Stove Woodstove Fireplace.nsert rehtO 1 evotS telleP i knaT retaWtoH I
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 properly
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 ce Use'Onl x.> Amount �'k , Revision �v a,
Main Floor Heated EH Bid App Review: r` `
2nd Floor Heated Consistency Review: f'` ''– -
Other Heated , ' Base fee: _
Mezzanine i- �'; i.:4S- Additional Section:
0
Heated Basement '
asement '' Plan Check fee: I 07..t
Unheated Basement State Surcharge fee: bt
"7
c
Other Unheated Pot Water Review fee: _ —
Garage/Carport SUBTOTAL –j „
- ,
r
Decks �" a @ 911/Rd Approach fee:
350 385
Other ' . q 4.0.
TOTAL: $ 2....6,Z45:5-.
>, ' ., . Receipt Number: 1 Gtsr I(01
Cash/Check Number: 43/�-ls
–1 (p
ESTIMATED COST(REQUIRED) Date:
•Fair market value of all tabor and materials foundation to finish 10 1 I! 1l3
4 7$'QD•D Initials: ,,syl l3
07/24/2013
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• BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT#: BLD13-00333 Received Date: 10/22/2013
SITE ADDRESS: 761 ROBBINS RD Issue Date 10/29/2013
NORDLAND, 98358 Expiration Date 10/29/2014
OWNER: DONALD J MAYNARD PHONE:
DIANE M MAYNARD
761 ROBBINS RD
NORDLAND WA 983589673
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 921093003 Section: 9 Township: 29 N Range: 01 E
CONTRACTOR: OWNER/BUILDER PHONE:
PROJECT DESCRIPTION: REPAIR TO EXISTING DECK
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP REP MAIN:
VALUATION 7,500.00 ADD'L: HEAT TYPE:
CODE EDITION: 2012 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: GARAGE: SHORELINE:
CONST TYPE: DECK: 385 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL:
WATER SYSTEM: Type Amount Paid By: Date: Receipt:
BEDROOMS: BATHROOMS: Permit $157.00 MEB 10/17/13 145468
Exist: Exist: Plan Check $102.05 MEB 10/17/13 145468
Prop: Prop: State Building Code $4.50 MEB 10/17/13 145468
Total: Total: Total: $263.55
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
•
Jefferson County Building D ion Permit Nur*: BLD13-00333
Applicant: MAYNARD
BUILDING PERMIT INSPECTION APPROVALS Applicable Code: 2012 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
Foundation Footing
Framing .00/171
FINAL INSPECTION //3/1
FINAL INSPECTIO�MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
• •
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Date I —3 0 time received i 23 ( am / re, Mon. Tues. .Wed: Fri.
BLD: . 3?3 ' Date:
OWNER: l Contact Name:
ADDRESS: y 1 R0(96Z 4tc Contact Number 360 3 74' /27 7•
a:,.
Notes: 206 . q-
Foundation Plumbing - Framing Propane Tank . Mechanical •
Setbacks _ Under-ground Framing Under ground _ Furnace _
Footing Rough in Air seal Above ground _ Gas
Stemwall _ Hydronic Exterior shear Exterior lines Oil —
Straps Interior shear
Post Hole Interior lines _ Ducts
Ventilation Appliance
Underfloor Gas/wood stove
Man-Homes .
Setbacks • insulation. Final inspection >`?
Foundation-_ p _.,1
Block&Tie floor wall ceiling e s
9 Address Posted
DS ON c r
o
,4
4. - JEFFERSON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
4.9s
Date: 12/27 Time Received: /A / a Tue. Wed. Thur. Fri.
_ Date:
BLD: /t?— g;3 Contact Name:
Owner: Contact Number: 360 "37? / 2 77
Address: 0 / Rog i Ad 206
Notes: ESL( K_
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 t[ \
Setbacks Floor
Foundation Wall Address Posted
Block&Tile Ceiling
/oN
^QQ45O °0�� JEFFERSON COUNTY
.4 DEPARTMENT OF COMMUNITY DEVELOPMENT
4'SHI NO�°÷
Date: 2_ Time Received: /' ? a pm Mon. Tue. w
del'
Thur. Fri.
Date:
BLD: 73 - 00333 Contact Name:
Owner: MAINAEV Contact Number: 360 37q- i2:77
Address: 7i/ gob b;QS Rd 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.