HomeMy WebLinkAboutBLD2013-00253 CERTIFICATE OF OCCUPANCY
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
(360)379-4450 FAX(360)379-4451
Carl Smith, Director/Building Official
PERMIT#: BLD13-00253
SITE ADDRESS: SUNSET LAKE RD Issue Date: 08/19/2013
PORT TOWNSEND, 98368 Final Date: 9/26/2013
APPLICANT: STUART MORK PHONE: 206-781-0336
LAURA K COOPER
7710 31ST AVE NW
SEATTLE WA 98117-4642
SUBDIVISION: Block: Lot: TX 2+
PARCEL NUMBER: 901201009 Section: 20 Township: 29 N Range: 01 W
PROJECT DESCRIPTION: INSTALL PROPANE TANK--mech permit
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 9/26/2013
\\tidemark\data\forms\F_BLD_Occupancy.rpt 10/8/2013
�UILDING PERMIT APPLICA N BLD 53
Revieew w Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT#: BLD13-00253 Received Date: 8/19/2013
SITE ADDRESS: SUNSET LAKE RD
PORT TOWNSEND, 98368
OWNER: STUART MORK PHONE: 206-781-0336
LAURA K COOPER
7710 31ST AVE NW
SEATTLE WA 98117-4642
SUBDIVISION: Block: Lot: TX 2+
PARCEL NUMBER: 901201009 Section: 20 Township: 29 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION INSTALL PROPANE TANK--mech permit
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP MEC MAIN:
VALUATION ADD'L: HEAT TYPE: PRO
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 $228.00 MEB 08/14/13 142396
Total: $228.00
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0_1(.1 �• )5 MECHANICAL AND DEMOLITION PERMIT
,;(40 . S Jefferson County Department of Community Development'4 621 Sheridan Street, Port Townsend, WA 98368
`t� - (360)379-4450 FAX (360)379-4451
PERMIT#: BLD13-00253 Received Date 8/19/2013
SITE ADDRESS: SUNSET LAKE RD Issue Date 8/19/2013
PORT TOWNSEND, 98368
APPLICANT: STUART MORK PHONE: 206-781-0336
LAURA K COOPER
7710 31ST AVE NW
SEATTLE WA 98117-4642 TX 2+
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 901201009 Section: 20 Township: 29N Range: 01W
CONTRACTOR: OWNER/BUILDER PHONE:
OWNER, STUART MORK PHONE: 206-781-0336
if different: LAURA K COOPER
7710 31STAVE NW
SEATTLE WA 98117-4642
PROJECT DESCRIPTION: INSTALL PROPANE TANK--mech permit
Directions
To Site:
THIS PERMIT IS VALID FOR ONE YEAR AND IS NOT RENEWABLE.
THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WITHIN THAT YEAR.
THE EXPIRATION DATE IS 8119/2014.,
REQUIRED INSPECTIONS:
Tank/Line/Appliance:
FinalApproval:
BUILDING INSPECTION HOT-LINE 379-4455.
REQUESTS MUST BE RECEIVED BY 3 PM THE DAY BEFORE THE INSPECTION IS NEEDED.
Office Hours 9:00 a.m. -4:30 p.m. Monday-Thursday
SPECIAL CONDITIONS APPLY- SEE REVERSE
HOT LINE AVAILABLE 24 HOURS A DAY
LS CA,Vviettl 4I eAAAJZA ( e' 2- & : 1-4--6,..— &(1)6M .
SPECIAL CONDITIONS FOR CASE#BLD13-00253:
1.) No address has been assigned to parcel#901201009. Jefferson County Ordinance No.
01-0421-10 Section 6(1)does not mandate an address fora mechanical permit.
Jefferson County does not require an address, however it is recommended:
1)The address assignment defines your parcel with a physical number
2) It makes emergency services aware of your location
3) Provides an Emergency Locator Number for emergency personnel to locate you in the
event they are needed.
\\tidemark\data\forms\F_BLD_Permit_Propane.rpt 8/19/2013
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Point& Pay - Create Order • Page 1 of 1
•
Thank you for your payment!
This service has been provided by Jefferson County Dept of Community Development, WA and
Point& Pay. We value your business. Please keep this receipt for future reference.
You have made a payment to Jefferson County Dept of Community Development, WA . Jefferson
County Department of Community Development thanks you for your payment. For questions about
your account, please call 360-379-4452
Name: Stuart Mork
Address: PO Box 00371539, Sioux Falls SD, US, 57186
Contact: 2067810336
Comments:
Payment ID: 11128428 (400.}.. 1 4/ �U
Date: 08/14/13 04:30 PM
Subtotal: $228.00
Fee: $7.50
Total: $235.50
Method: Credit or Debit Card(************8496)
Item Purchased Transaction Description Account Amount
Residential Applications Jefferson Co C D GOV 901201009 $228.00
Signature: Date: / /
By signing this receipt you agree to the terms and conditions of this service.
You will see one line item on your credit or debit card statement indicating the amount you paid and will be
identified as Jefferson Co C D GOV. If you have any questions about the charges please call 1-888-891-6064.
Print Receipt Close Window
https://agent.pointandpay.net/pointandpay_counter/viewReceipt.do?method=viewPayment... 8/15/2013
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00 JEFFERSOMUNTY Ob-c l (. -- 2C3
,4„,,,,,, DEPARTMERY OF COMMUNITY DEVELOPMENT
iriAkiii 1 621 Sheridan Street•Port Townsend'Washiington 98368
9.e450
www.c • 360/379-4451 Fax
www.co.jefferson.wa.us/wmmdevelopment
Master Permit Application MLA:
Project Description(include separate sheets as necessary)://t/ f GL AC7i4'1 c 7;9941
Tax Parcel Weber /2 v f r7 9 ' Property Size: Q,I' C
Nu - (acresl:• are feet)
Site Address and/or Directions to Property: ,.
J�/A, r 7 <<9■ e"
Property Owner(s)of Record: $r'01r 44,7A A l LA v14 CO eh R
Telephone: 2.04 7/7.0•7J4. Fax: • ∎9AtE email: 91%0 1 4' Af
Matihg Address: 771 co ,z,f7 4 vc Iid! xi 1.
97 cc 4,4 iv"// 7
Applicant/Agent(if different from owner):
Telephone: Fax: email:
Mailing Address:
What kind of Permit?(Check each box that applies
OBuilding ❑Critical Areas Stewardship Plan
O DiOn Permit ❑Variance(Minor,Major or Reasonable Economic Use)
❑Single Family 0 Garage Attached/Detached 0 Conditional Use[C(a),C(d),or Ci'"
O Manufactured Home 0 Modular 0 Discretionary"D"or Unnamed Use Classification
O Commercial* 0 Special Use(Essential Public Facilities)**
O Change of Use 0 Boundary Line Adjustment
O Address 0 Road Approach 0 Short Plat'"
O Home Business 0 Cottage Industry 0 Binding Site Plan`"
❑Long Plat"
O Sign 0 Planned Rural Residential Development(PRRD)/Amendments"
O Allowed Use Consistency Analysis Vacation/Alteration
❑Stonmwater Management 0 Shoreline Master Program Exemption/Permit Revisions"
O Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Management Substantial Development**
O Temporary Use 0 Shoreline Management Variance
O Wireless Telecommunication' ' 0 Comprehensive Plan/UDCILand Use District Map Amendment
0 Forest Practices Act/Release of Six-Year Moratorium ❑Jefferson County Shoreline Master Program Amendment
May require a Pro—Appficaslon Conference 0 Tree Vegetation Request
"Regufrea a Pra•Appicatfon 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 rotating 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 but of
his,her or ks 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 an 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 cis employees,representatives or agents for the sole purpose of application
review and any req ',' later • �,-- .,• . Staff access and right of entry will be assumed unless the applicant informs the County In writing at the
time of the ....- „d► 't±l%T I ,' p, #off
Signature: . f A411 Date: t+p'/S`I
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
perms has been , -•will • violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your
action(s)even if z, are in-•.u.., ' Jefferson County development code.The Applicant acknowledges that he,she or it holds individual
and non-Ua 7,„,„L„,.. . ` .7 . • , to and complying with the ESA. The Applicant has read this d timer and signs and dates it below.
S•. 'W//�JII I�id Date: /f'/3
G:\Pc mitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-Ohl doc
• BUILDER STATEMENT
The signer of this hereby certify they are the Owners of the parcel referenced herein,that they are not licensed contractors and that
they will be ass the Contractor for the Proposed ProJec `
Signature: Date:
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:
O New 0 Wood Existing: o Sewer
O Addition U Steel Proposed: Bank a Community System
O Alteration/Remodel 0 Concrete Total: Height: ❑ Individual System
O Repair ❑ Masonry SEP Permit#
O Demolition 0 Outer: Bedrooms: Water Supply:
Existing: Setback: ❑ Private well D Two Party
Type of Heat: Proposed: 0 Public
Total: Name of System:
if this is a Commercial Protect you must answer the following
Number of Parking Spaces: Current Proposed: Number of al26 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 Prooane Tank andlor Molls e Installation permit mark all Items below that sooty;
Underground Tank t Above ground Tank Size of Propane Tank:
Heat Stove l Cook Stove I Woodstove t Fireplace Insert i Hot Water Tank S Pellet Stove 1 Other
js this appliance brine Installed Ina Manufactured/Mobile Home? Yes / No
Wren applying fora permit to install a propane tank you must also submit a site plan showing all of the buildings,all property
lines,tank location and she,distances from the propane tank to all property lines,buildings and septic system components,
inclu• • the reserve area.
Anc
• are Footer, Current d r j2137,11: " `�° r v 1 .
1,.a,.�m...6S,�Y. i:., "� r -t..� 1,111.cl St
Main Floor Heated tf ,M EH Bid App Review:
2na Floor Heated Consistency Review:
i
Other Heated 7.1 Base fee:
ti s- ;
Mezzanine ri ' Additional Section:
Heated Basement .41 Plan Check fee:
i
Unheated Basement i C ; State Surcharge fee:
Other Unheated 'o" Pot Water Review fee:
Garage/Carport w.: t� M{ ': SUBTOTAL
Decks s 911/Rd Approach fee:
Other c „' TOTAL $
.142'{C.
, .
``�• �,; ` Receipt Number.
Cash/Check Number 1 /%� �/(�L( l
ESTIMATED COST(REQUIRED) Date:
.Fair market value of at labor and materials foundation to finish $��`r�13
Initials: <fi') .
GAPemaCeem\###FORMS###WRIT FORMS\Mister Pnxrrit Application 5-29-0840
•
MECHANICAL AND DEMOLITION PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT#: BLD13-00253 Received Date 8/19/2013
SITE ADDRESS: SUNSET LAKE RD Issue Date 8/19/2013
PORT TOWNSEND, 98368
APPLICANT: STUART MORK PHONE: 206-781-0336
LAURA K COOPER
7710 31STAVE NW
SEATTLE WA 98117-4642 TX 2+
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 901201009 Section: 20 Township: 29N Range: 01W
CONTRACTOR: OWNER/BUILDER PHONE:
OWNER, STUART MORK PHONE: 206-781-0336
if different: LAURA K COOPER
7710 31STAVE NW
SEATTLE WA 98117-4642
PROJECT DESCRIPTION: INSTALL PROPANE TANK--mech permit
Directions
To Site:
THIS PERMIT IS VALID FOR ONE YEAR AND IS NOT RENEWABLE.
THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WITHIN THAT YEAR.
THE EXPIRATION DATE IS 8/19/2014.
REQUIRED INSPECTIONS:
Tank/Line/Ann'in^° _
FinalApproval: a - Jr—�
II
BUILDING INSPECTION HOT-LINE 379-4455.
REQUESTS MUST BE RECEIVED BY 3 PM THE DAY BEFORE THE INSPECTION IS NEEDED.
Office Hours 9:00 a.m. -4:30 p.m. Monday-Thursday
SPECIAL CONDITIONS APPLY- SEE REVERSE
HOT LINE AVAILABLE 24 HOURS A DAY
• •
SPECIAL CONDITIONS FOR CASE#BLD13-00253:
1.) No address has been assigned to parcel#901201009. Jefferson County Ordinance No.
01-0421-10 Section 6(1) does not mandate an address for a mechanical permit.
Jefferson County does not require an address, however it is recommended:
1)The address assignment defines your parcel with a physical number
2) It makes emergency services aware of your location
3) Provides an Emergency Locator Number for emergency personnel to locate you in the
event they are needed.
\\tidemark\data\forms\F_BLD_Permit_Propane.rpt 8/19/2013
JEFFERS. COUNTY bc/h.
• NO. 14L 4 o2
DATE 61161/13
RECEIVED FROM S-��,� "-
DESCRIPTION BARS# AMOUNT
CURRENCY C 2Z, -, u)
A. .
COIN
CHECKS
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imp
{ O
RECEIVED BY TOTAL 7-21r '