HomeMy WebLinkAboutBLD2013-00356 BLD13-00356
UILDING PERMIT APPLICON Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT#: BLD13-00356 Received Date: 11/8/2013
SITE ADDRESS: 10 BAYCLIFF PL
PORT TOWNSEND, 98368
OWNER: W RON GENTRY PHONE:
CARYL B F GENTRY
201 KALA HEIGHTS DR
PORT TOWNSEND WA 983689506 KALA POINT#3
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 965000028 Section: 27 Township: 30 N Range: 01 W
CONTRACTOR: WARD CONSTRUCTION PHONE: 360-301-4792
1427 1ST ST
PORT TOWNSEND WA 98368
Contractor's License WARDCC*925N7 Expires 8/27/2014
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOP INSTALL ELEVATOR IN EXISTING HOUSE
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP ALT MAIN:
VALUATION 30,000.00 ADD'L: HEAT TYPE:
CODE EDITION: 2012 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: GARAGE: SHORELINE:
CONST TYPE: DECK: 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 $377.00 MEB 11/08/13 145526 APPROVED
Plan Check $245.05 MEB 11/08/13 145526 G
State Building Code _ $4.50 MEB 11/08/13 145526 NOV 12 2013
Total: $626.55
Jefferson County DCD
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r,o („;c DEPARTMENT OF COMMUNITY DEVELOPMENT
,..,t „, 621 Sheridan Street,Port Townsend,WA 98368
Tel:360.379.4450 I Fax:360.379.4451
Web:www.co.jefferson.wa.us/communitydevelopment
ySin1 Nc'0 E-mailw
:dcd @co.jefferson.wa.us
CERTIFICATE OF OCCUPANCY
PERMIT#: BLD13-00356
APPLICANT: W RON GENTRY PHONE:
CARYL B F GENTRY
201 KALA HEIGHTS DR
PORT TOWNSEND WA 983689506
SITE ADDRESS: 10 BAYCLIFF PL Issue Date: 11/12/2013
PORT TOWNSEND, 98368 Final Date: 10/22/2014
SUBDIVISION: 9650 Block: Lot:
PARCEL NUMBER: 965000028 Section: 27 Township: 30 N Range: 1W
PROJECT DESCRIPTION: INSTALL ELEVATOR IN EXISTING HOUSE
THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2012
EDITION.
OCCUPANCY GROUP:
TYPE OF CONSTRUCTION:
SPRINKLER SYSTEM yes 'no
THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 10/22/2014
\\tidemark\data\forms\F_BLD_Occupancy.rpt 10/22/2014
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JEFFERSON COUNTY ✓�,�a DEPARTMENT OF COMMUNITY DEVELOPMENT
'' ''4 621 Sheridan Street • Port Townsend • Washington 98368
360/379-4450 • 360/379-4451 Fax
q p. www.co.jefferson.wa.us/commdevelopment
SANG.'
Master Permit Application MLA:
Project Description (include separate sheets as necessary):
ate✓ r-k. IN ExiSr/N6 i ic-
Tax Parcel Number: /6 5" c• Q o 6 a_k2 Property Size: A,O D Sq Fr(acres/square feet)
Site Address and/or Directions to Property:
/) e4* k i F r j c i W P O/NT, Mpg 4119 id I r Y r o 5 t 5fi,V I'TY IT
Property Owner(s)of Record: V- C -►(,y& 6 671 rK.
Telephone: 02 1 0 - Ai q'4-- 4/0 Fax: email:
Mailing Address: 917 f f1'4L4 /4/&Vrr p.Q
Applicant/Agent if different from owner: Gv*4,(p C�ISTK Ocrye--9
Telephone: a 35 l —Ai 7 7 a Fax: email: ,J I'Ml w4kx> 5?414s-
Mailing Address: /1/02" I S-r s r Pd ax at t • e.oni
What kind of Permit? (Check each box that applies ❑ Lot or Road Segregation
":uilding ❑ Critical Areas Stewardship Plan
r Demolition Permit El Variance(Minor, • melt- Aor- . . •r_u -
Li Single Family ❑ Garage Attached/Detached ❑ Conditional Use[C(a),: :- 1 j E I _A
❑ Manufactured Home .❑ Modular ❑ Discretionary"D"or Unnamed se-- ldssifcdtic i-
❑ Commercial* Et 4-Tv-2 ❑ Special Use(Essential Public Facilities)** 1
❑ Change of Use ❑ Boundary Line Adjustment
❑ Address ❑ Road Approach 0 Short Plat** rrn' r . ,�
❑ Home Business ❑ Cottage Industry ❑ Binding Site Plan'**
❑ Propane ❑ Long Plat**
❑ Sign .. ❑ Planned Rural R sidential Development (PRRD)/Amendments**
❑Allowed"Yes" Use Consistency Analysis ❑ Plat Vacation/Alt aiwr*__ _i
❑ 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:
/L
/„ D C O s„ DE J�N4TION OF AGENT
I hereby designate bV ( fw C/U/yto act as my agent in matters relating to this application for permit(s).
OWNER SIGNATURE_ Date: / /i 3 —/ 3
By signing this application form,the owner/agent att is 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 prov'• access and right of ent o Jefferso County and its employees,representatives or agents for the sole purpose of application
review and any r -d later inspections. Sta i access al, right of entry will be assumed unless the applicant informs the County in writing at the
time of the as. • on that he or s •a .ri•r notice. / /Signature iI •• ,�la[� i Date: / ( ' 3 ' /3
The action. actions Applicant will undertake as a result of the issuance of this permit may negatively impact upon one or more threatened or
endanger;. species and could lead to a potential"take"of an endangered species as those terms are defined in the federal law known as the
"Endany-,red 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 file ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your
action(s)even if you are i• ompliance with the Jeff- son Cou development code.The Applicant acknowledges that he she or it holds individual
and non-transferable - .onsibility for'-+ -r'•• to :nd comp /`ng with the ESA. The Applicant has read this di claimer and signs and dates it below.
Signature: „�ti�. Date: (/ 1 -40r 3 -/ 3
i
• 0
BUILDER STATEMENT
The signer of this s ent does hereby -rtify at they are he Owners of the parcel referenced herein,that they are not licensed contractors and that
they will be as i the respons'• l/the 'eneral Co actor for the proposed pr '
Signature: #' AY" e� Date: *--1
GENERA •NTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
//b GO si c(/6-T 7 d- ( 110 3o1 - 1 P ( )
MAILING ADDRESS: To- g c ,( c9,// a_ EMAIL:
CONTRACTOR'S LICENSE 1114K, ,1 ��� 7 WAINS
NUMBER: D CC -4[ NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
0 New Wood Existing: Sewer N4
C Addition Steel Proposed: Bank C Community System
>eAlteration/Remodel 0 Concrete Total: _ Height: C Individual System
C Repair E Masonry /1# SEP Permit# _
o Demolition Other: Bedrooms: Water Supply:
Existing: Setback: El Private well C Two Party
Type of Heat: Proposed: 0 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 •
13C Occupancy: IGC 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:
I Underground Tank 1 Above ground Tank ize of Propane Tank: fob S 6 41.
1 Heat Stove i Cook Stove i Woodstov: 3 Fireplace Insert 1 Hot Water Tank I Pellet Stove 1 Other _
Is this appliance being installed in a Manu • • •• e ome? Yes / No
Wher, r,' a, _ '_ ., -1 ''''—'t 'f- 47r: rlr? a!!cf the b? ldin i all pr,.lnat
lines, tank location and size, distances from the propane tank to all property lines, buildings and septic system components,
includin the reserve area.
Square Footage Current Proposed For Office Use OY
nl Amount Revision -
Main Hoar Heated LH Did App Re,:ew:
2 -Floor Heated Consistency Review:
Other Heated Base fee: ' i'fn)
Mezzanine Additional Section: F
Heated Basement Plan Check fee: 2s'`cj
Unheated Basement State Surcharge fee: CI`
Other Unheated Pot Water Review fee:
A
Garage/Carport SUBTOTAL 1` J 2..6,. '`
Decks 911/Rd Approach fee:
Other TOTAL $
Receipt Number: 1-[S 6--- 4.
Cash/Check Number:
ESTIMATED COST(REQUIRED) Date: ! f� �.�
1,6:' n.e e value of all labor and - - - oundation to finish / —
3 ® , a� Initials:
r
Contractors or Tradespeople•ter Friendly Page Page 1 of 1
•General/Specialty Contractor
A business registered as a construction contractor with L&I to perform construction work within tfi0 kepi,df
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 WARD CONSTRUCTION UBI No. 602859285
Phone 3603014792 Status Active
Address 1427 1St St License No. WARDCC*925N7
Suite/Apt. License Type Construction Contractor
City Port Townsend Effective Date 8/27/2008
State WA Expiration Date 8/27/2014
Zip 98368 Suspend Date
County Jefferson Specialty 1 General
Business Type Individual Specialty 2 Unused
Parent Company
Business Owner Information
Name _ Role Effective Date Expiration Date
WARD,JAMES H Owner 08/27/2008.
Bond Information
Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date
2 Wesco Insurance Co 46W6002272 08/03/2012 Until Cancelled $12,000.00 08/06/2012
1 CBIC SI0127 08/15/2008 Until Cancelled 08/15/2012 $12,000.0008/27/2008
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
Developers BIS00016681-
4 Surety&Indem 01 08/15/2013 08/15/2014 $1,000,000.0008/14/2013
Co
Security
3 National NA103155900 08/15/2012 08/15/2013 $1,000,000.00 08/06/2012
Insurance
2 CBIC C11510127 08/15/2010 08/15/2013 08/15/2012 $300,000.0006/28/2012
1 CBIC C11SI0127 08/15/2009 08/15/2010 $300,000.0007/28/2009
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 C-!?
II�I ))II
fi V A13
^'? N COUNTY
StITY DEVELOPMENT _'
https://fortress.wa.gov/lni/bbip/Print.aspx 11/8/2013
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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#: BLD13-00356 Received Date: 11/8/2013
SITE ADDRESS: 10 BAYCLIFF PL Issue Date 11/12/2013
PORT TOWNSEND, 98368 Expiration Date 11/12/2014
OWNER: W RON GENTRY PHONE:
CARYL B F GENTRY
201 KALA HEIGHTS DR
PORT TOWNSEND WA 983689506 KALA POINT#3
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 965000028 Section: 27 Township: 30 N Range: 01 W
CONTRACTOR: WARD CONSTRUCTION PHONE: 360-301-4792
1427 1ST ST
PORT TOWNSEND WA 98368
Contractor's License WARDCC*925N7 Expires 8/27/2014
PROJECT DESCRIPTION: INSTALL ELEVATOR IN EXISTING HOUSE
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP ALT MAIN:
VALUATION 30,000.00 ADD'L: HEAT TYPE:
CODE EDITION: 2012 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: GARAGE: SHORELINE:
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL:
WATER SYSTEM: Type Amount Paid By: Date: Receipt:
BEDROOMS: BATHROOMS: Permit $377.00 MEB 11/08/13 145526
Exist: Exist: Plan Check $245.05 MEB 11/08/13 145526
Prop: Prop: State Building Code $4.50 MEB 11/08/13 145526
Total: Total: Total: $626.55
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
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Jefferson County Building Buildin Dion Permit Nu, : BLD13-00356
Applicant: GENTRY
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 2..
Framing t2.,Ez-
In anon:Walls
oaf'
Gas Line: Interior
Il/
Gas Line:Exterior '2 _(
69H -6
Heat/Chimney Clearance .,t.. (A
Fireplace Insert 1 - c -- 14 01
Mechanical Systems i A .(j/
•
FINAL INSPECTION 42f j4L ,f
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
•
CONDITIONS for Building Permit# :
11/170011
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