HomeMy WebLinkAboutBLD2012-00390 ILDING PERMIT APPLICA BLDI2-00390
Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT#: BLD12-00390 Received Date: 12/3/2012
SITE ADDRESS: 461 KENNEDY RD
OWNER: W WA CORP 7TH DAYADV PHONE:
32229 WEYERHAEUSER WAY S
FEDERAL WAY WA 98001-9347
SUBDIVISION: Block: Lot: T 28
PARCEL NUMBER: 901034008 Section: 3 Township: 29 N Range: 01 W
CONTRACTOR: KRUSE CONSTRUCTION LLC PHONE: (360)681-7138
PO BOX 432
SEQUIM WA 98382
Contractor's License KRUSECL981 LC Expires 6/3/2014
REPRESENTATIVE: KRUSE CONSTRUCTION LLC PHONE: 360-582-3755
PO BOX 432
SEQUIM WA 98382
PROJECT DESCRIPTION ADD FOOD SINK & PREP SINK IN CEDERBROOK ADVENTIST
CHRISTIAN SCHOOL
TYPE OF WORK COM SQUARE FOOTAGE: COMMERCIAL:
TYPE OF IMP PLM INDUSTRIAL:
TI N 000.00
MAIN:
VALUA 6 O ADD'L: HEAT TYPE:
CODE EDITION: 2009 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY:
OTHER:
CONST TYPE: SHORELINE:
CONST TYPE: GARAGE: SETBACK:
DECK: BANK HEIGHT:
SEWAGE DISPOSAL: CON NUMBER OF EMPLOYEES:
WATER SYSTEM:
BATHROOMS:
-is :
Prop:
Total:
Routing Date:
Type Amount Paid ---1Ev: Date: Receipt: Approved/Date
ApppOliFT
Permit $125.25 LYK 12/03/12 139796 4
Plan Check $81.41 LYK 12/03/12 139796
State Building Code $4.50 LYK 12/03/12 139796 r-- " `?
Total: $211.16 eitcrson County Piannirn
Building DQ artmRnt
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• •
BUILDING PERMIT
EXPIRATION NOTICE
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT#: BLD12-00390
SITE ADDRESS: 461 KENNEDY RD Date Issued: 12/20/2012
PORT HADLOCK,WA 98339 Date Expires: 12/20/2013
APPLICANT: W WA CORP 7TH DAY ADV
32229 WEYERHAEUSER WAY S
FEDERAL WAY WA 98001-9347
SUBDIVISION: BLOCK: LOTS: T 28
PARCEL: 901034008 Section: 3 Township: 29N Range: 01 W
According to our records, YOUR BUILDING PERMIT HAS NOT PASSED A FINAL INSPECTION
AND WILL EXPIRE ON 12/20/2013.
To keep your building permit active you must pay a $228 renewal fee. This will keep your
permit active for one year after the date of expiration.
If renewal fee is not paid by time of expiration, no more inspections can be performed until
received.
Please contact our office if you have any questions.
Sincerely,
Permit Technician
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• •
',3 JEFFERSON COUNTY;_.4
4 DEPARTM NT OF COMMUNITY DEVELOPMENT
4:. 621 Sheridan Street,Pcrt Townsend,WA 98368 I Web:www.co.iefferson.wa.uslcorrmurutydevelopment
Tel: 360.379.44501 Fax:350.379.4451 I Email:dcd(a�co.iefferson.waus
SquareONE Resource Center/ Building Permits & Inspections I Development Review I Long Range Planning
March 14, 2014
W WA CORP 7TH DAY ADV
32229 WEYERHAEUSER WAY S
FEDERAL WAY WA 98001-9347
RE: SUBJECT: FAILURE TO RENEW
SITE ADDRESS: 461 KENNEDY RD
PERMIT#: BLD12-00390 PARCEL: 901034008
LEGAL DESCRIPTION: BLOCK: LOT: T 28
PROJECT DESCRIPTION: ADD FOOD SINK & PREP SINK IN CEDERBROOK
ADVENTIST CHRISTIAN SCHOOL
The Community Development Office sent you a renewal notice indicating the need to either renew or
schedule a final inspection on your building permit. To date, a final inspection has not been successfully
passed nor has a renewal fee been paid.
An annual renewal fee is due unless a final inspection is passed and a certificate of occupancy is issued.
Please submit payment of$228.00 to renew your permit to 621 Sheridan St. Port Townsend, WA 98368.
If you have any questions you can contact our office at 379-4450 between 9:00 a.m. and 4:00 p.m.
Monday through Thursday.
If we do not receive payment or hear from you within thirty (30) days from the date of this notice, we will
proceed with cancelling the building permit. If the structure has not passed a final inspection we will begin
the process of placing a notice to title on your property. Once cancelled, a new permit will need to be
applied for, new fees paid, and the structure built to current building codes.
Sincerely,
4
/
Permit Technician
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JEFFERSON COUNTY DCD
BUILDING PLAN REVIEW JEFFERSON COUNTY
DEPT.OF COMMUNITY DEVELOPMENT
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rwili, oN cO JEFFERSONQUNTY
r.' DEPARTMENT OF COMMUNITY DEVELOPMENT
'w ` '4 621 Sheridan Street • Port Townsend •Washington 98368
` 360/379-4450 • 360/379-4451 Fax
L1
www.co.jefferson.wa.us/commdevelopment
7Nc
Master Permit Application MLA: 3Q (MLA-
Project Description(include separate sheets as necessary): L diefrjjed (liimf,4' 41 /'€ett/4,
t a S PW S; ie a& //aa/ 4401,90 ; wasprooQ •ry f fr ctih3Tua sctic'/ Pori fiadictil
Tax Parcel Number:etn10 94:(10c Property Size: (acres/square feet)
Site Address and/or Directions to Prope y:
L/6L____KQ,/u it f of NedJ4 Li!
Property Owner(s)of Record: r D /
"' ' Telephone: Fax: email:
Mailing Address: Q rh IQ r L-tY ,( QL Lb A QF oc t
Applicant/Agent(if different from ownery:
Telephone: - 1. 6o' C Fax: email:
Mailing Address: IO• • to, _ 2 Se . (,t/4 f fi I Z
What kind of Permit?(Check each box that applies ❑Lot or Road Segregation
❑Building El Critical Areas Stewardship Plan
❑ Demolition Permit ❑Variance(Minor, Major or Reasonable Economic Use)
Q Single Family_._ ❑Garage Attached/Detached __0 Conditional Use[C(a),C(d),or C1**
II r anu a ure• 'ome . • odular • - ❑Discretionary"tT or unnamed use Classification
I 14 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 .. ❑Planned Ikur• "- •@Wild 7.te :,.. nk( i ' endments**
❑Allowed"Yes"Use Consistency Analysis ❑Plat Vacation ,t r;; ( L U V
❑Stormwater Management ❑Shoreline Master r•• - -►• to 'ern -°unions**
❑Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Ma a . e ntSubstantial Developme t `I❑Temporary Use ❑Shoreline Ma ge rient iancg s
❑Wireless Telecommunication* ❑Comprehensive`Pia /UD '`nd U e riot M-p
n endment
❑ Forest Practices Act/Release of Six-Year Moratorium ❑Jefferson Cour*Slioreline Master Program Arrierfd ent
*May require a Pre—Application Conference ❑Tree Vegetation Re 6 0�„N�
**Requires a Pre-A pir j rR,
Please identify any other local,state or federal permits required for this-p ,
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.
XI 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 wants prior notice.
Signature: Date:
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: Date:
G:\PermitCenter\###FORMS###\DRD FORMS\Current DP.D Forms\Master Permit Application 5-29-08.doc
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:
Kku,Se Ca/aSii-64(4ox LL C (340) 1.14,74/g/ ( )
MAILING ADDRESS: P o. LOX432 .Se ,1M (v a f jg2, EMAIL:
CONTRACTOR'S LICENSE `r (/" WAINS
NUMBER: GC jQr(, e d c L 7 •I L c NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
• New Wood Existing: ❑ Sewer
❑ Addition ❑ Steel Proposed: Bank ❑ Community System
Alteration/Remodel ❑ Concrete Total: _ Height: ❑ Individual System 1
❑ Repair ❑ Masonry SEP Permit# CO- i ( 1
❑ 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 jincludes owners,tenants,employees,etc) Current - Proposed
• ------ - - ------ ------
IBC Occupancy: IBC Type of construction: WillyoTihave Food Service? Yes / No
If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply:
I Underground Tank I Above ground Tank Size of Propane Tank:
I Heat Stove i Cook Stove I Woodstove i Fireplace Insert I Hot Water Tank i Pellet Stove 1 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 [urrent Proposed For Office Use ®tllly_ Amount Revision -
Main Floor Heated EH Bid App Review:
2nd Floor Heated Consistency Review:
Other Heated Base fee: 5
s
Mezzanine Additional Section:
Heated Basement Plan Check fee: 1,.+ ,
'1'
Unheated Basement State Surcharge fee: 4
Other Unheated Pot Water Review fee: -�-
Garage/Carport SUBTOTAL - 'I 1(°
_
Decks 911/Rd Approach fee: _ —
Other ad ''r TOTAL: $ I(p
i
ME Receipt Number: ) 3q-19(40
Cash/Check Number: %1 10
ESTIMATED COST(REQUIRED) Date: -��( -
',Fair market value of all labor and materials foundation to finish f
Initials: C.
GAPermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc
12/02/2012 @7:28 3603854610
CEDARBROOK ADV SCH PAGE 01/01
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6. 1 c) JEFFERSON COUNTY
DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street
Port Townsend,WA 98368
Ai See ff, Director
' Letter of Representation
When an applicant for a permit is not the owner of the property it is necessary for the
property owner to submit a letter of representation. The letter needs to have the
owner's original signature. An example is below:.
Date
To Whom It May Concern:
I, John Doe, owner of 123 Fir Street, Pprnal# 123-456-789, give permission to Tom
Sawyer to apply for a permit on the abie 'LL 449311*Ii E --\
H j ,
1
,
, 1L,
Sincerely,
DEC - 3 2012 d
: Li Ly
i i A
JEFFERSON COUNTY
!
DEPT.OF 0 ■ r I F 1.'1 ) -
Date E.(.04 :C-ail--0 rz._ '
To Whom It May Concern:
Prt'nCip AV Cesim-h ok Ad
I, lit.,a i , I-.. , owne(of . , (1, .! tort. - •
(.• 71 miner's name) (address" legal descopttoe)
Parcel# , give peffnission to Ketkj ,
(parcel number) (applicant's name)
to apply for a 6ititft;Al permit from Jefferson County on the above
(type bf)eng)
referenced property.
Sincerely, ,
or A 0 ! • . ' -
Building Permits/Inspections Development Review Division Long Range Planning
(360)379-4450 FAX: (360)379-4451
aRimmitconterwoRmagater of eeplevertmen.doc
Contractors or Tradespeople Prir Friendly Page • Page 1 of 1
General/Specialty Contractor
A business registered as a construction contractor with Lftl 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 KRUSE CONSTRUCTION LLC UBI No. 602207595
Phone 3605823755 Status Active
Address P 0 Box 432 License No. KRUSECL981 LC
Suite/Apt. License Type Construction Contractor
City Sequim Effective Date 6/3/2002
State WA Expiration Date 6/3/2014
Zip 983820432 Suspend Date
County Clallam Specialty 1 General
Business Type Limited Liability Company Specialty 2 Unused
Parent Company
Business Owner Information
Name Role Effective Date Expiration Date
KRUSE, CLIFFORD D Partner/Member 06/03/2002
Bond Information
Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date
1 CBIC SE3522 06/03/2002 Until Cancelled $12,000.00 06/03/2002
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 Amount Received Date
9 CBIC insse3522 06/03/2011 06/03/2013 $1,000,000.00 05/01/2012
8 CBIC INSSE3522 06/03/2009 06/11/2011 $1,000,000.00 05/12/2009
7 CBIC INSSE3522 06/03/2008 06/03/2009 $300,000.00 06/02/2008
6 CBIC INSSE3522 06/03/2007 06/03/2008 $300,000.00 04/30/2007
5 CBIC INSSE3522 06/03/2006 06/03/2007 $300,000.00 04/18/2006
Summons/Complaint Information No unsatisfied complaints on file within prior 6 year period
Warrant Information No unsatisfied warrants on file within prior 6 year period
Infractions/Citations Information No records found for the previous 6 year period
https://fortress.wa.gov/lni/bbip/Print.aspx 12/4/2012
Jefferson County Building I.sion Permit Nut: BLD12-00390
Applicant: W WA CORP 7TH DAY ADV
BUILDING PERMIT INSPECTION APPROVALS Applicable Code: 2009 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
Rough-in Plumbing � L1'tZ
Wallboard Nailing
FINAL INSPECTION efk I� (L
0
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
• BUILDING PERMIT •
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT#: BLD12-00390 Received Date: 12/3/2012
SITE ADDRESS: 461 KENNEDY RD Issue Date 12/20/2012
PORT HADLOCK, 98339 Expiration Date 12/20/2013
OWNER: W WA CORP 7TH DAYADV PHONE:
32229 WEYERHAEUSER WAY S
FEDERAL WAY WA 98001-9347
SUBDIVISION: Block: Lot: T 28
PARCEL NUMBER: 901034008 Section: 3 Township: 29 N Range: 01 W
CONTRACTOR: KRUSE CONSTRUCTION LLC PHONE: (360)681-7138
PO BOX 432
SEQUIM WA 98382
Contractor's License KRUSECL981 LC Expires 6/3/2014
PROJECT DESCRIPTION: ADD FOOD SINK& PREP SINK IN CEDERBROOK ADVENTIST CHRISTIAN
SCHOOL
TYPE OF WORK COM SQUARE FOOTAGE: COMMERCIAL:
TYPE OF IMP PLM MAIN: INDUSTRIAL:
VALUATION 6,000.00 ADD'L: HEAT TYPE:
CODE EDITION: 2009 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: Type Amount Paid By: Date: Receipt:
BATHROOMS: Permit $125.25 LYK 12/03/12 139796
Exist: Plan Check $81.41 LYK 12/03/12 139796
Prop: State Building Code $4.50 LYK 12/03/12 139796
Total: Total: $211.16
NUMBER OF EMPLOYEES:
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
���SO\ `'o G JEFFERSON COUN•
•
1; DEPARTMENT OF COMMUNITY DEVELOPMENT ''
y`siti y°.Co
Date: g -2j Time Received: L255 am/f Mon. Tue. Wed. Thur. Ct-.r1,J
Date: F-22
BLD: 1 Z-- 3 q 0 Contact Name:
Owner: Contact Number: 360 3O .7 zk (-
Address: LA(o t 141. y 1 p 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
0:Li 4 . � JEFFERSON COUNTY
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Date re.--/to 'time received I 33 am /0 Mon. TueS. Wed: ( 3i)-Fri. •
BED: I-1."- 3 i 0 • . Date: i 2 —-2.7
OWNER: - - Contact Name: ---'
. -
ADDRESS: 4o I le_LIA,,,,..eif to Contact Number:360 0 Z677---
•
Notes: . 1-- --ep S- r r-,Ut_ _ -e
. ,
Foundation Plumbing -Framing Propane Tank • Mechanical
' •
Setbacks Under-ground Framing Under:ground Furnace
Footing Rough in X„. Air seal
Above ground Gas —
Stemwall _ Hydronic Exterior shear _____ Exterior lines Oil —
Straps Interior shear Interior lines , Ducts *—
1 —
. Post Hole Ventilation Appliance •
Underfloor Gas/wood stove
Man-Hornes .
Setbacks . Insulation Final Inspection ,A
Foundation- .
-..1-*
Block&Tie floor _wall ceiling. Address Posted .
i
•
•