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HomeMy WebLinkAboutBLD2014-00076 11113UILDING PERMIT APPLICAON BLD14-00076 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD14-00076 Received Date: 3/5/2014 SITE ADDRESS: 295643 HWY 101 QUILCENE, 98376 OWNER: QUILCENE BIBLE CHURCH PHONE: PO BOX 118 QUILCENE WA 98376-0118 SUBDIVISION: Block: Lot: PARCEL NUMBER: 702231018 Section: 23 Township: 27 N Range: 02 W CONTRACTOR: DAN NIEMAN PHONE: 360-434-0717 PO BOX 846 QUILCENE WA 98376 Contractor's License NIEMACC018MZ Expires 8/15/2014 REPRESENTATIVE: DAN NIEMAN PHONE: (360)434-0717 (Cell) PO BOX 846 (360) 765-3529 QUILCENE WA 98376 PROJECT DESCRIPTIOt Replacing roof, same for same, no struc change TYPE OF WORK COM SQUARE FOOTAGE: COMMERCIAL: TYPE OF IMP ALT MAIN: INDUSTRIAL: VALUATION 12,500.00 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: NUMBER OF EMPLOYEES: WATER SYSTEM: BATHROOMS: Exist: Prop: Total: Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $179.00 MEB 03/05/14 148423 State Building Code $4.50 MEB 03/05/14 148423 APPROVED Total: $183.50 Jefferson County DCD \firlcmerlArh+e\fnrme\G RI 11 Ann PIA rn+ 4/iP)fl1A • k r, 3 p i t t i i • 2(4 sCq s u � 1 e.r.../....._Tiz) psi 6( ______rv_ iSON c°G 4t,' J I RSON COUNTY 6Ltii1 ✓ ` w , ti DEPARTMENT OF COMMUNITY DEVELOPMENT , wo Mice 621 Sheridan Street I Port Townsend,WA 98368 I Web:www.co.jefferson.wa.us/communitydevelopment Tel:360.379.4450 I Fax:360.379.4451 I Email:dcd(caco.iefferson.wa.us Building Permits&Inspections I Development Consistency Review I Long Range Planning I Watershed Stewardship Resource Center Master Permit Application MLA: Project Description(include separate sheets as necessary): /4477 -L. A4 ) lIC6-pr Tax Parcel Number. 7OZ-23/- o($ Property Size: (acres/square feet) Site Address and/or Directions to 5-1../. y. Property .fit 564'3 > y ,01 Q V1 C,F�n Property Owner(s)of Record: - Telephone: Fax email: Maiing Address: Applicant/Agent(if different from owner): t11 J1/llA1/ Telephone:i4 C Fax 6Q• • email:,OlentAn 015 4$7 # C a min.C.4* Mailing Address: 0,1)5 f44, vu-e-46440) Lt/a• '37Z. . What kind of Permit?(Check each box that applies ❑Lot or Road Segregation %BUlding ❑Critical Areas Stewardship Plan ❑ Demolition Permit ❑Variance(Minor,Major or Reasonable Economic Use) ❑Single Family ❑Garage Attached/Detached ❑Conditional Use[C(a),C(d),or C1** ❑ Manufactured Home ❑ Modular ❑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 ❑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)* ❑Shoreline Management Substantial Development** ❑Temporary Use ❑Shoreline Management Variance ❑Wireless Telecommunication* ❑Comprehensive PlaNUDC/Land Use District Map Amendment ❑Forest Practices Act/Release of Six-Year Moratorium ❑Jefferson County Shoreline Master Program Amendment **fay 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: DESIGNATION OF AGENT I hereby designate I.'A) _ . -,ii d. to act as my agent in matters relating to this application for permit(s). ASP- OWNER SIGNATURE . .: t !—r Date: 3/.5+�� • By signing this a.•i.= •n 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. 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 requ .ter inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the apps : • ,, or she wants prior notice. / d Signature: .f �.�fltr / Date: rg/r//'T The acti or a .ons Appicant will undertake as a result of the issuance of this permit may negatively impact upon one or more threatened or endange -• pecies 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 appicart 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 'n compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transfer, - o -ibiity for adherintg to and complying with the ESA. The Appicart has read this discia' r a signs and dates it below. Signature: it r ----1 Date: S cr. 07/24/2013 IIIBUILDER 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 ass iii the responsibility of the General Contractor for the proposed project. Signatu = --- w di- r Date: GE. RAL ONTRACTOR MANUFACTURED HOME INSTALLER: PHONE: FAX: teernPrAi -,0A/0:-. -,0 £Oy tilt. (IA 431.OV 7 (50) 7 ,31- MALNG ADDRESS: f�.R.- $46 EMAL: n feI d amm. •irel CONTRACTORS LICENSE LVIVL/Js"�"Vae_ t.Mb .7, NUMBER NUMBER: `� ARCHITECT/ENGINEER: it f l E rn a_291 a PHONE ( ) FAX:( ) MALNG ADDRESS: EMAL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New X Wood Existing: 1 ❑ Sewer ❑ Addition ❑ Steel Proposed: Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: Height: )4 Individual System Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other: Bed Water Supply: Exist••: Setback: ❑ Private well ❑ Two Party T rcf P •••sari: ❑ Public .ti 0 Total: Name of System: If this is a Commercigl 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 Pmppane Tank and/or Appliance Installation permit,mark all items below that apply: Underground Tank Above ground tank Size of Propane Tank: Heat Stove Cook Stove Woodstove Fireplace.nsert rehtO i evotS telleP I knaT retaWtoH 1 Is this appliance being installed in a Manufactured/Mobile Home? Yes / No When 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 size,distances from the propane tank to all properly lines,buildings and septic system components, including the reserve area. Square Footage Current Proposed For Office Use Only Amount Revision Main Floor Heated EH BId App Review. 2"a Floor Heated Consistency Review Other Heated Base fee: 1 ".p_ c� Mezzanine Additional Section: C��"( Heated Basement Plan Check fee: Unheated Basement State Surcharge fee: Other Unheated Pot Water Review fee: lvf1� Garage/Carport SUBTOTAL Decks 911/Rd Approach fee: Other TOTAL: $ Receipt Number r tl 6 L42 Cash/Check Number: ESTIMATED COST(REQUIRED) Date: /t,' .Fair m et value of all labor and materials foundation to finish < 3 )Q Initials: 1_5, 07/24/2013 • • / 0-0 A44-7,frri-i,p-c__ # 0 z 5-t) S • RE-ROOFING SUPPLEMENTAL APPLICATION Owner Name: a._ e, /0249 phone: 360• 4511'07/7 Applicant or Agent(if different from owner):AA//,Qi91u phone: 4: Site Address: i ? c l3 4'/ tgwceh.n/f, Parcel: 702.- 23( CVO Scope of work sq ft: $2-50 45 1. Is the original roof being removed etri NO 2. Are you replacing with the same material: YES(9 3. Materials removed: /, vc t 5ilekeira.0 4. Does the scope of work increase the pitch or footprint or original roof? YESc7 5. Are you adding dormers? YES • 6. Are you increasing the living or heated space?NO 7. Are you doing solar installation? YES g 8. If you answered "YES"to#4 or#5 above: Is the project located less than 150 feet from a marine or river shoreline or 100 feet from a lake shoreline? YES NO 9. If you answered"YES"to#8 above,submittal of a site plan and fees in the amount of$532 are required. 10. If you answered "YES"to#4, 5 or 6, Environmental Health Review and a fee of$78.00 are required. 11. Any additional Information: 2013-10-31_REROOF.DOCX Updated October 31, 2013 • . JEFFERSON COUNTY DEPARTMENT COMMUNITY DEVELOPMENT RE-ROOFING REQUIREMENTS If the scope of work does not include structural change and does not change the load bearing capacity,your application needs to include: • Master Permit Application • Roofing Supplemental Application • Permit fees based on valuation. If the scope of work involves a structural change(such as change of pitch,adding dormers etc)OR changes the load bearing capacity of the current roof,your application needs to include: • Master Permit Application • Roofing Supplemental Application • Plans, including structural calculations stamped by a licensed engineer or architect • Permit fees Fees are based on valuation of the fair market value for all labor and materials with a minimum of$152.00(plus state fee of$4.50). Additional fees may apply if plans are required. Examples of approximate fees,current as of October 2013: Cost of Re-roofing $6,000 $15,000 $20,000 Base Fee $152 $212 $267 Plan Check-if applicable $98.80 $137.80 $173.55 TOTAL $156.50(+$4.50) $216.50(+$4.50) $271.50(+$4.50) Plans that include dormers,stairs, increased living or heated space,or increased roof area may require Environmental Health Review and fee of$78.00. Plans that include dormers or increased roof area or height for projects located within shoreline jurisdiction and less than 150'from OHWM may require Planning Review and fee of$532.00. A site plan is required for projects in shoreline jurisdiction. Exemptions: If the scope of work does not change the load bearing capacity OR the original structure AND is less than 200 sq ft,a permit is not required. Emergency Damage Repair: If the work is to repair a roof damaged by sudden,unforeseen events such as storm damage, roofing permits will be issued over the counter for minor repairs. Rebuild involving structural repair will require wet stamped engineered plans within 30 days of the emergency issuing AND the applicant will need to schedule inspections per the building permit process. **Temporary,emergency repairs such as tarps and tarp tie-downs do not need a building permit. Codes Referenced: 2012 IBC 1510 and IRC R907.Created 10/14/2013. 2013-10-31_RE ROO F.DOCX Updated October 31, 2013 NIEMAN CONSTRUCTION CO Iiii • Page 1 of 2 0 De Washington$tate Department of Labor & Industries I NIEMAN CONSTRUCTION CO INC I Owner or tradesperson PO BOX 846 NIEMAN, DANIEL PHILIP QUILCENE, WA 98376-0846 360-765-4787 Principals JEFFERSON County NIEMAN, DANIEL PHILIP NIEMAN, LAURIE JEAN Doing business as NIEMAN CONSTRUCTION CO INC WA UBI No. Business type 601 892 586 Corporation Governing persons DANIEL P NIEMAN ILicense I Verify the contractor's active registration/license/certification (depending on trade)and any past violations. Construction Contractor Active. Meets current requirements. License specialties GENERAL License no. NIEMACC018MZ Effective—expiration 07/28/1999—08/15/2014 Bond CBIC $12,000.00 Bond account no. SC0922 Received by L&I Effective date 08/15/2002 07/19/2002 Insurance Ohio Security Ins Co $1,000,000.00 Policy no. BLA55892682 Received by L&I Effective date 01/09/2014 01/02/2014 Expiration date 01/02/2015 Savings No savings accounts during the previous 6 year period. https://secure.lni.wa.gov/verify/Detail.aspx?UBI=601892586&LIC=NIEMACC018MZ&SAW= 3/5/2014 NIEMAN CONSTRUCTION CO I Page 2 of 2 Lawsuits against the bond or savin • No lawsuits against the bond or savings during the previous 6 year period. Tax debts No tax debts during the previous 6 year period. License Violations No license violations during the previous 6 year period. IWorkers' comp IWorkplace safety and health ©Washington State Dept.of Labor&Industries.Use of this site is subject to the laws of the state of Washington. Access ANIL Washingtoe it.t.01•1Wk 'Mt+kJ,* https://secure.lni.wa.gov/verify/Detail.aspx?UBI=601892586&LIC=NIEMACC018MZ&SAW= 3/5/2014 p • Jefferson County Building Division Permit Number: Applicant: BUILDING PERMIT INSPECTION APPROVALS Applicable Code: 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 A final inspection will not be scheduled until all of the following are completed and signed off by the applicable Department: • Building Permit Conditions are met • Septic Permit Final/Complete for any building containing plumbing • Land Use Conditions met and signed off • Public Works Permit Final(where applicable) FINAL INSPECTION 1 l� Thd-O- , FINAL IN PE TION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • • CONDITIONS for Building Permit# : \\tidemark\data\forms\F_BLD_Permit_BIdg.rpt 3/5/2014 • ! BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD14-00076 Received Date: 3/5/2014 SITE ADDRESS: 295643 HWY 101 Issue Date 3/5/2014 QUILCENE, 98376 Expiration Date 3/5/2015 OWNER: QUILCENE BIBLE CHURCH PHONE: PO BOX 118 QUILCENE WA 98376-0118 SUBDIVISION: Block: Lot: PARCEL NUMBER: 702231018 Section: 23 Township: 27 N Range: 02 W CONTRACTOR: DAN NIEMAN PHONE: 360-434-0717 PO BOX 846 QUILCENE WA 98376 Contractor's License NIEMACC018MZ Expires 8/15/2014 PROJECT DESCRIPTION: Replacing roof, same for same, no struc change TYPE OF WORK COM SQUARE FOOTAGE: COMMERCIAL: TYPE OF IMP ALT MAIN: INDUSTRIAL: VALUATION 12,500.00 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: BATHROOMS: Permit $179.00 MEB 03/05/14 148423 Exist: State Building Code $4.50 MEB 03/05/14 148423 Prop: Total: $183.50 Total: 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 ww�s coca JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT Date: C(!7 Time Received: 7.,'/ I-- am0 Mon(Tue Wed.` Thur. Fri. `� Date: oZ "-f BLD: _ r Contact Name: 41,Owner: il1�A/��i1�.• ILMIA1 Contact Number: 360 ,,' �� C Address: ■ 206 :.� 7 i Notes: P( 1 U J Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing Underground 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_,.. c_ Setbacks Floor Foundation Wall Address Posted Block&Tile Ceiling