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Home My WebLink AboutBLD2010-00369 �UILDING PERMIT APPLICAtON BL 369 Revview iew Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD10-00369 Received Date: 10/21/2010 SITE ADDRESS: 8123 FLAGLER RD NORDLAND, 98358 OWNER: GEORGE FISHER PHONE:917-744-7000 ANN FISHER 2402 E ESPLANADE LN#1102 PHOENIX AZ 850169104 GLENNAN SUBURBAN ACRE SUBDIVISION: Block: 4 Lot: 13 PARCEL NUMBER: 953700432 Section: 29 Township: 30 N Range: 01 E CONTRACTOR: LD RICHERT CONSTRUCTION PHONE: (360)379-5222 PO BOX 127 PORT TOWNSEND WA 98368 Contractor's License LDRICC*066L0 Expires 5/29/2011 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOr INTERIOR REMODEL - REPLACE WINDOWS FLOORS, CABINETS,PAINT JPS y cstire-✓ TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ALT MAIN: 800 VALUATION 125,000.00 ADD'L: 1,000 HEAT TYPE: EEE CODE EDITION: 2009 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: 2 Exist: 2 Prop: 0 Prop: 0 Total: 2 Total: 2 Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $1,133.75 LYK 10/21/10 120220 APPROVED Plan Check $736.94 LYK 10/21/10 120220 State Building Code $4.50 LYK 10/21/10 120220 OCTc ?( 2010 Total: $1,875.19 Jefferson County Pianninc & Building Department 0 • ,,,,0-* `) ' c rr DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street,Port Townsend,WA 98368 Tel:360.379.4450 Fax:360.379.4451 Web:www.co.Jefferson.wa.us/communitydevelopment 4C-5-t(: P ,�o E-mail:dcd(a�co.jefferson.wa.us CERTIFICATE OF OCCUPANCY PERMIT#: BLD10-00369 APPLICANT: GEORGE FISHER TRUSTEE PHONE: 917-744-7000 ANN FISHER TRUSTEE 2402 E ESPLANADE LN #1102 PHOENIX AZ 85016-9104 SITE ADDRESS: 8123 FLAGLER RD Issue Date: 10/21/2010 NORDLAND, 98358 Final Date: 9/17/2014 SUBDIVISION: 9537 Block: 4 Lot: 13 PARCEL NUMBER: 953700432 Section: 29 Township: 30 N Range: 1 E PROJECT DESCRIPTION: INTERIOR REMODEL TO ADU OVER GARAGE - REPLACE WINDOWS FLOORS, CABIN 1 S,PAFNT THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2009 EDITION. OCCUPANCY GROUP: R-3 TYPE OF CONSTRUCTION: 5N SPRINKLER SYSTEM yes no THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 9/17/2014 \\tidemark\data\forms\F_BLD_Occupancy.rpt 9/19/2014 i .. , . i (...Wt "kC . tr ...I., •••••110 kl••••..............1 J....*.*OI■••••••I.Iii.......■0 .C.... _ \ 1 . 0 c*s% 0 t ;.) ....R.3 W"4:1 2. L -v• z v Tr . • . 0 . 4.,,, ....... ---il t7 • Sr` al N:N I 6•10 t .....14 C-• ...... " _ 0 . H , . (Pi , rk-1 r * V . NW"' ICI ts1 k . % ■ 1 ............„ ......, ---Th i x GI n1 i 1 r4,c Ft i L_.. . I, . R. I C I—I E R. T" a'm cn f CA X GEN! ERA L CC> NI ST.R.L/CTIC> hi A NJ ri E>ESICht If RI-I 71 P X)- B(2 X 127 P CI P.7 712 W 1.451a NI I) VW fk$1-111,4 G 7C/111 963158 1 3642. 379. 5222 \,. ,.• %.. , _ .1 ■ 1 Y ; : ; : .: rrl • . 1 F, O O W ,,, C. CP n ET e CD . ,... v f o N C 4) aQ - sl e, U\1 Z a m n / rn •o 5. �3 --I—I I.. 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O m cr O a ` \ ,,` I (/i II rn C .p 7/./ - `, I < - ,i, cn_ - .�ON OO JEFFERSON COUNTY III I� 1 ill `� DEPARTMENT OF COMMUNITY DEVELOPMENT r 4\ : 621 Sheridan Street• Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax , ww w.Co.jefferson.wa.us/commdevelopment s Master Permit Application MLA: �lh Project Description(include separate sheets as necessary: -Evil.A a Cel, eV Co o /J a STA.Hcrta, .. Orpty(' Tax Parcel Number "33-i(XD`4'.°2._ Property Size 3"3 /4L (acres/square feet) Site Address and/or Directions to Property: $(23 F.,44. 20 lJae-a WA Property Owner(s)of Record: Coe-o Loe JL1 StiO✓"L Telephone: Fax: - email: Mailing Address: 2.40 2 C 66 PLPeN Ar 04, (,N 110 2 Pr)0 w0- A2. 9,5 01 Applicant/Agent(if different from owner) LI) 121646,4s cs COM7 get el OK- Telephone: S(9 I" O 5 '5 Fax: ,�3'7'i 45.22 email: Ian 1 G heAr Ci fr To to W •• Mailing Address: 4 I'2. a P( ' %r .C o k What kind of Permit?(Check each box that ap lies ❑Lot or Road Segregation :wilding 4N ' 0 4. 1,, ❑Critical Areas Stewardship Plan ❑ Demolition Permit r ❑Variance(Minor,Major or Reasonable Economic Use) ,-.2'Single Family 0 Garage Attached/Detached 0 Conditional Use[C(a),C(d),or C]** ❑ Manufactured Home ❑ Modular - 0 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 0 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-A•• ' ..-o C.,/,w, ence Please identify any other local,state or federal permits required for this props •I, if known:. LP Aar, ,i DESIGNATION OF AGENT I hereby designate c to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE t•F5etW bl Ca 'tot Date: it' JD 1 lb 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 attorneys 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 an requir, later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the ap,licati•" .- e or sh ants prior not' Signature: ,�'� Date: 10 12V `lb The action or actions Applica t 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 yo £re in compliance with the Jefferson County development code.The Applicant acknowledges that he sh or it holds individual and non-tran ferab rte� •,,nsibility eying to and complying with the ESA. The Applicant has read this disclaim and sins s and dates it below. '' Signature*.��I .„ ' _ Date: l0 1* r, G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc • • BUILDER STATEMENT The signer of this stat= ent does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that a they will be -ssumin•j - bility of the General Contractor for the proposed project. Signature: --vii,....-- Date: 10( 20 /O GENERAL CONTRACTOR OR ' .UFACTURED HOME INSTALLER: PHONE: FAX: C, g Ic4tw-T 7)51 , (gip '19 c z22 ( ) 5, t� MAILING ADDRESS: , I?i0- EMAIL: t a;l IIrntiye l OL ` 6.,rtift7t al CO" CONTRACTORS LICENSE A WAINS NUMBER: LE)el e OA O(a V LO NUMBER . ARCHITECT/ENGINEER: Imo'/� .l-A PHONE ( )- .�--- FAX:( ) MAILING ADDRESS: • ^ EMAIL -- Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: O New ood Existing: • 0 Sewer O A••ition 0 Steel Proposed: Bank ❑Community System s •Iteration/Remodel ❑ Concrete Total: Height: ividual System ❑ Repair ❑ Masonry SEP Permit# Bedrooms: Water Supply: ❑ Demolition ❑ Other: Pp Y: Existing: Setback: ❑ Private well ❑ Two Party Type of Heat: Proposed: dblic Q� Total: Name of System t t 1£ If this is a Commercial Project you must answer the following: Number of Parking Spaces: Current: Proposed:ember of i4DA Parking Spaces: Number of occupants(indudes owners,tenants,employees,etc) Curren Proposed IBC Occupancy: IBC Type of construction: Will you have Food"Service? Yes / No If this is a Pro•-ne T •..c!, ;1• • �.I .?3ur.:=Ilation -rmit mark all items below that a I' 1 Underground Ta• 1 Above ground Tan Size of Propane Tank: 16144 1 Heat Stove 1 C••kSlave .•'• stove . 1 Fireplace Insert 1 Hot Water Ta•• 1 Pellet Stove 1 Other Is this appliance being installed in a Manufactured/Mobile Home? Ye •o When applying for a'permit to install a propane tank you must also subm 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. * t" Current Fre..sec t' ! E� 1 a�: a t R ;� r, S•uare Foota!e ..._. , .� ti a. Main Floor Heated /./ t .1r EH Bld App Review: 2 Floor Heated G x Consistency Review: ' gyp DDS D Other Heated , : /4,-,'?,,?, Base fee Mezzanine 45,_..... Additional Section: l Heated Basement Plan Check fee: Unheated Basement 4 State Surcharge fee: Other Unheated. �.-� Pot Water Review fee: Garage/Carport - 1'' SUBTOTAL V �9 �.: f 5a J Decks , 911/Rd Approach fee 1 Other r TOTAL. � - Receipt Number: i Cash/Check Number: ,i ESTIMATED COST(REQUIRED) Date: •Fair market value of all lad materials foundation to finish ._. 4 t°1/C7 •On j A I "als sT1%( G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Perrot Application 5-29-08.doc I Jefferson County Building Dion Permit Nun. BLD10-00369 Applicant: FISHER BUILDING PERMIT INSPECTION APPROVALS kpplicable 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 Framing 41/17/14 Insulation:Walls I71 Wallboard Nailing u� / I c Oftt % AT 9M' FINAL INSPECTION .911711( 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#: BLD10-00369 Received Date: 10/21/2010 SITE ADDRESS: 8123 FLAGLER RD Issue Date 10/21/2010 NORDLAND, 98358 Expiration Date 10/21/2011 OWNER: GEORGE FISHER PHONE: 917-744-7000 ANN FISHER 2402 E ESPLANADE LN#1102 PHOENIX AZ 850169104 GLENNAN SUBURBAN ACRE SUBDIVISION: Block: 4 Lot: 13 PARCEL NUMBER: 953700432 Section: 29 Township: 30 N Range: 01 E CONTRACTOR: LD RICHERT CONSTRUCTION PHONE: (360)379-5222 PO BOX 127 PORT TOWNSEND WA 98368 Contractor's License LDRICC*066L0 Expires 5/29/2011 PROJECT DESCRIPTION: INTERIOR REMODEL - REPLACE WINDOWS FLOORS, CABINETS,PAINT �- TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ALT MAIN: 800 VALUATION 125,000.00 ADD'L: 1,000 HEAT TYPE: EEE CODE EDITION: 2009 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: Type Amount Paid By: Date: Receipt: BEDROOMS: BATHROOMS: Permit $1,133.75 LYK 10/21/10 120220 Exist: 2 Exist: 2 Plan Check $736.94 LYK 10/21/10 120220 Prop: 0 Prop: 0 State Building Code $4.50 LYK 10/21/10 120220 Total: 2 Total: 2 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