HomeMy WebLinkAboutBLD2011-00176 40 ,
MLA11-00151
BUILDING PERMIT APPLICATI Review T :I
ype
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD11-00176 Received Date: 7/6/2011
SITE ADDRESS: 2432 OAK BAY RD
PORT HADLOCK, 98339
OWNER: GREGORY A GRAVES PHONE:
KATHLEEN R GOULD
1315 226TH CT SE
SAMMAMISH WA 980757183 OAK RIDGE SHORT PLAT
SUBDIVISION: Block: Lot: 1
PARCEL NUMBER: 921182030 Section: 18 Township: 29 N Range: 01 E
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOr NSFR W/ATT GARAGE & U/G 500 GAL PROP TANK
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 2,394
VALUATION 335,920.00 ADD'L: 540 HEAT TYPE: HTP
CODE EDITION: 2009 HEAT BASE: HEAT TYPE: EEE
OCCUPANCY: R-3 UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: 5N SHORELINE:
CONST TYPE: GARAGE: 677 SETBACK:
DECK: 700 BANK HEIGHT:
SEWAGE DISPOSAL: ALT
WATER SYSTEM: 05783
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 3 Prop: 4
Total: 3 : 4
C.
Routing Date:
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $2,315.35 LYK 07/06/11 123681 APPRcJVED
Plan Check $1,504.98 LYK 07/06/11 123681
State Building Code $4.50 LYK 07/06/11 123681 SEP p 11J11
Potable Water Application $62.00 LYK 07/06/11 123681
Total: $3,886.83 Jefferson County Planning
&Building Department
Jefferson County Building Ctsion
Permit Number: BLD11-00176
Applicant: GRAVES
BUILDING PERMIT INSPECTION APPROVALS applicable Code: 2009 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
/ 13Setbacks f/_ I
Erosion Control ( lll(
Foundation Footing % ), Li / / 1 `
Footing Drains % �y / L �L
Foundation Stem Wall / g /
d�ider�gr d-�lumbing l/
Under Floor Framing 5 J3 / (�11 O� ,Adb4Straps(hold downs) I'��1 �� ia'
77,115
Ext. Shear Wall Nailing a, a) I� I �Jy Z L 4 - c J 1 t
Rough-in Plumbing )3- j,,_ ) (7i1)
Shower Pan -7 -155 ( L
Framing S , )_ ,7 61
Blocking S _a3-/ -
Airseal S-^ 3�2_ R
Insulation: Walls G .6 _lZ &/Insulation: Floors (�v
Insulation: Ceiling v /4 O,� I-6 /Z -;
�� l (v�
Int. Shear Wall Nailing S-�3- I.L /kg
Wallboard Nailing / 19 I L
Gas Line: Interior lJ Y-_
Gas Line: Exterior
Propane Tank
Heat/Chimney Clearance ;- j?
Duct Test Cert
Blower Airtight Test -y -
Smoke&CO2 I_y --14 �
Drywell/Alt Drainage J�
Address Posted 1 `� „�
FINAL INSPECTION I�I —
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
•
`3 ,c DEPARTMENT OF COMMUNITY DEVELOPMENT
.
621 Sheridan Street,Port Townsend,WA 98368
Tel:360.379.4450 Fax:360.379.4451
Web:www.co.jeffetson.wa.us/communitydevelopment
E-mail:dcda,co.jefferson.wa.us
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CERTIFICATE OF OCCUPANCY
PERMIT#: BLD11-00176
APPLICANT: GREGORY A GRAVES PHONE: 360-437-4030
KATHLEEN R GOULD
PO BOX 339
PORT HADLOCK WA 98339
SITE ADDRESS: 2432 OAK BAY RD Issue Date: 09/26/2011
PORT HADLOCK, 98339 Final Date: 9/23/2014
SUBDIVISION: Block: Lot: 1
PARCEL NUMBER: 921182030 Section: 18 Township: 29 N Range: 1E
PROJECT DESCRIPTION: NSFR W/ATT GARAGE & U/G 500 GAL PROP TANK
THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2009
EDITION.
OCCUPANCY GROUP: R-3
TYPE OF CONSTRUCTION: 5N
SPRINKLER SYSTEM ye no
THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 9/23/2014
\\tidemark\data\forms\F_BLD_Occupancy.rpt 9/23/2014
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O Issued Date Drawn By Katy Gould & Greg Graves JLK Custom Designs, LLC sp PRELIH bET Si/4/V9 JLK
PRELIM bET 8/4/Qi9 JLK iNE ORUlMM[A NJD DOC
0 CLIENT REVISION 5/11/II JLK 8521 BYBEE CT. SE. AND USED AS AN INSTALS
I SHALL
, , 7 2432 OAK BAY ROAD Snoqualmie, Wa 98065 OM DESIGNS
IV PORTHADLOCK Ater J WRITTPN REUSE PERMS!
WA 98339• Ph. 425.890.5039 WTNdi1 MMTTEN PEft"9I
email:jlkcustomsdesigns®comcast.net
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� 0=d JEFFERSON CNNTY
Y • l' DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street• Port Townsend •Washington 98368
360/379-4450 . 360/379-4451 Fax
Ip www.co.jefferson.wa.us/commdevelopment
Master Permit Application MLA: I (— 1t3 1
Prigject Description(include separate sheets as nece sary):
sa MT A s At flP T �
Tax Parcel Number: . D o Pf
�,�1 , ��� operty Size: 3 (acres/square feet)
Site Address and/or Directions to Propert :
.2H3 b• , •644k ebret 16e-k GJ,fl �j 8 3
Property Owner(s)of Record: 6.i r- ir 0. .. �el, . .
Telephoneei )3I3-5 d 63 a Fax:cp i) 3/3-56‘3 email: _..* $4 -Capm
--
Mailing Address: - fh f ; ,i �.,;®= �_ . , i Ir".-' n
ApplicantiAgent(if different from owner): ME C 1 v t-"' Ill
T ailing Add dress:n Fax:
Mailing 'it ■ 1111
What kind of Permit?(Check each box that applies 0 Lot or Road Segr • ti!L v
�•
wilding ❑Critical Areas Ste di• Plan i./
Demolition Permit ❑Variance(Minor, ajor or Reao N mic )
Dingle Family keQarage. Detached 0 Conditional Use[I(a),Crick gF 01101UNITY DEVELOPMEN
❑ Manufactured Home. . .0 Modular 0 Discretionary"D" • • -ma-Use Classification
❑ Commercial* 0 Special Use(Essential Public Facilities)**
❑ Change of Use ❑Boundary Line Adjustment
❑ Address ❑Road Approach 0 Short Plat**
❑ ome Business ❑Cottage industry ❑Binding Site Plan**
.:Or-Propane ❑Long Plat**
❑Sign • •- ❑Planned Ikurai Residential Development(PRRD)/Amendments** . •
❑Allowed"Yes"Use Consistency Analysis 0 Plat Vacation/Alteration**
IB-Stormwater Management ❑Shoreline Master Program Exemption/Permit Revisions**
E rSite Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Substantial Development**
EJ 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=Applicatio n 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. - �1A�" Date: ,3`.17 s l l
By signing this application form, tt• .gent attests that the information provided herein,and in any attachments,is true and correct to the best of
his,her or its knowledge. Any mat- seho od 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 required later ins!:.Sons. 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 • she ants prior notice. _
Signature: _,..<�. - Date: Lily 5 Z" (
The action or actions PM 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 detined 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 respons';. ' .radhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: -- Date: %) 17 5^i z6/ /
�.\n.._...:.r.......-N.u+4+icn � Dr,Fnn r.m\r....-...rru n V ,.\IX n _. :.A..,t:,....:,...c,n no a,...
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 res ility of the General Contractor for the proposed project.
-'>�."--- - Date: . j LA IV r �O// . •
Signature:Via..`=_ _ i
GENERAL CONTRA•WED UFACTURED HOME INSTALLER: PHONE: FAX:
( ) ( )
MAILING ADDRESS: EMAIL:
CONTRACTOR'S LICENSE WAINS
NUMBER: NUMBER
ARCHITECT/ENGINEER: c- Kok Q'( PHONE ( ) FAX:( )
MAILING ADDRESS: 85-Z Eyi,, Ci-5L5 Sk-a/u.ckt„,,',e,tj/9 EMAIL jt k(C.s'10,44 s%�r Cow'-Ca_,Tt.. ,4,.' '
Pro ect Type: F�tne Type: Bathrooms: Shoreline: `type of Sewage Disposal:
New 1 'Wood Existing: 0 ❑ Sewer
o .Addition ❑ Steel Proposed: .A.,S Bank 0 Community System
❑ Alteration/Remodel 0 Concrete Total: 3 r5 Hei ' IWIndividual System
❑ Repair ❑ Masonry SEP Permit# 06'-00
❑ Demolition ❑ Other: Bedrooms: , Water Supply:
Existing: D Setback: ❑. private well ❑ Two Party
Ty f Heat: v.. Proposed: 3 m'Public
Total: Name of System:d )•.•.rz 4'
—If this/b is Commercial Protect 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 appl :
Underground Tank 1 Above ground Tank Size of Propane Tank: .Vigto
I Heat Stove Cook Stove 1 Woodstove J"Fireplace Insert b'Flot Water Tank I Pellet. ove. I Other
is this appliance being installed in a Manufactured/Mobile Home? Yes /�-
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,
includin• the reserve area.
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S.uare Footaf.e Current Pro.•sect 7� _:�? ne�ctPM _ .£.__: a:, _ k.3 ,rily_0El�l ' s:
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