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Home My WebLink AboutBLD2013-00038WNW BUILDING PERMIT APPLIiION BRD1e 000 8 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD13-00038 Received Date: 1/29/2013 SITE ADDRESS: 260 RIDGE DR PORT TOWNSEND, 98368 OWNER: RONALD L HANSON PHONE: 360-379-5114 JAYN M HANSON 260 RIDGE DR PORT TOWNSEND WA 98368-9493 CAPE GEORGE VILLAGE DIV 3 SUBDIVISION: Block: Lot: 24 PARCEL NUMBER: 940500023 Section: 13 Township: 30 N Range: 02 W CONTRACTOR: RICH'S WOODSTOVES &SPAS PHONE: (425) 742-7283 16504 HWY 99 LYNNWOOD WA 98037 Contractor's License RICHSWS1100K Expires 4/7/2014 REPRESENTATIVE: PHONE: PROJECT DESCRIPTION WOODSTOVE TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP MEC MAIN: VALUATION ADD'L: HEAT TYPE: CODE EDITION: 2009 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: AP "•�v5 VED Propane Tanks/Stoves $0.00 LYK 01/29/13 �J Total: $0.00 JAN 2 9 2013 Jefferson County DCD \\}irlomnr4\rl.+oWnrmc% PI Il Ann PIA rn+ 1/90/9!11' 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#: BLD13-00038 SITE ADDRESS: 260 RIDGE DR Issue Date: 01/29/2013 PORT TOWNSEND, 98368 Final Date: 12/13/2013 APPLICANT: RONALD L HANSON PHONE: 360-379-5114 JAYN M HANSON 260 RIDGE DR PORT TOWNSEND WA 98368-9493 SUBDIVISION: CAPE GEORGE VILLAGE DIV 3 Block: Lot: 24 PARCEL NUMBER: 940500023 Section: 13 Township: 30 N Range: 02 W PROJECT DESCRIPTION:WOODSTOVE THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2009 EDITION. OCCUPANCY GROUP: TYPE OF CONSTRUCTION: SPRINKLER SYSTEM yes no THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 12/13/2013 \\tidemark\data\forms\F_BLD_Occupancy.rpt 12/17/2013 rierl d - JERSON CONTY DEFFEPARTMENT OF COUMMUNITY DEVELOPMENT 621 Sheridan Street• Port Townsend•Washington 98368 ,, .. 360/379.4450. 360/379-4451 Fax www.co.jefferson.wa.us/commdeveiopment Master Permit Application ML°A: no (r Gn Project Description(include separate sheets as necessary): pace sT4,r.,b tt�G i=1r PLACE- lwo0.D crew E) INS-r4LLA-V1OWJ Tax Parcel Number.(?) 94 ooa Property Size: !7 A C t (acres/square feet) Site Address and/or Directions to Property: 2 6� R I DG8 Pit CAPE- G-C-C)a C- , GASPS 6Zoo-Ca. (LO -'Tor ILA.DGS DF. 4 BLo clt_z NOOH TO SPnuc2_ (SPnuce+-P.1 D6IJ Property Owner(s)of Record: 'Rory4LA L 1-14rasoK1 ��,,�� /�� Telephone:360 379-5//ei Fax: [ _ (`n iiVil 4` - 27 a-oi.c6yy, Mailing Address: 260 R-i OGP. D2 PDO--r TOGS `� Kn WA )RRkR- , Applicant/Agent(if different from owner): N A 1 Telephone: N A Fax N A I i ` JAN an il:2O1&A l��1 I Mailing Address: NA- '� ` _ t kind of Permit?(Check each box that applies JEFF[RSOi�!GOii�lTY AdgBuiiding twsrmL..�...-r-co K OF WOOD s-r ov&) ❑C I A l Op ENT ❑ Demolition Permit ❑Vary Use) ❑Single Family ❑Garage Attached/Detached ❑Conditional Use[C(a),C(d),or C]** Use ❑ 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 ❑PIat Vacation/Alteration** ❑Stomhwater 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 *Slay requires Pro on Conference ❑Tree Vegetation Request **Requires a Pre-Application Conference Please identify any other local,state or federal permits required for this proposal,if known: . LOCn.L OttLY• DESIGNATION OF AGENT I hereby designate to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE `L �4tiy , Date: Oi-2.9-.'O 13 By signing this application form,the ownerlagent 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 any required later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the time of the application that or she wants,prior notice. Signature: zp eye,, Date: 01-?A- 20 13 The action or actions Applicant will undertake as a result of the issuance of this permit may negatively impact upon one or more threatNhd 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 Spen7Ns Act or'ESA.*Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this permit has been awed will not violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your aotion(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-tra is responsibility for adhering to and complying with the ESA. The Applicant has read this disdairrer and signs and dates it below. Signature: Date: O i-2-q-24 13 G:\PeanitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-0$.doc i Qpr.iALD L t1A+,rsoN 2• R-1OGE. DR. 4'Oar TOtA'4 sI' D 9$-364 inraGb 5�rovP,. n+rsratcs7l J 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 responsibility of the General Contractor for the proposed project. Signature: Date: GGENERAL CONTRAIQ IR MANUFACTURED HOME INSTALLER: PHONE: FAX: RI c, -1' S (sIz_VI=RI:4l,>= ( ) ( ) MAILING ADDRESS: _ ► _ • ' p ••♦ ✓�^ n .. n /� ) t_ CONTRACTOR'S UOINSE e. • . - • WAINS NUMBER: NUMBER° ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: FMAN. Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New ❑ Wood Existing: ❑Sewef ❑ Addition ❑ Steel Proposed: Bank 0 Community System ❑ Alteration/Remodel ❑ Concrete Total: Height: 0 Individual System • Repair 0 ❑ Demolition 0 Other Bedrooms: Wr3 Permit Existing: Setback: 0 Private well 0 Two Party Type of Heat: *Pfoed Total. -+ --- 0 Public Nome of System: If this Is a Commercial Protect you must answer the following: Number of Parking Spaces: Current:. Proposed'1 R L l L umber of ADA Parking Spaces: Number of occupants(includes owners,tenants,employees,etc) Current Proposed IBC Occupancy: IBC Type of construction: - r hfave Food Service? Yes / No If this is a Propane Tank and/or ADDIIaDCe Installation .- mark . i tt_ ._.__ ..1__ I Underground Tank I Above Wesrst� 1 Fireplace Insert ^ 1 H�ott Wad Tank i Pellet Stove I Heat Stove I Cook Stov i tove 1 Other Is this appliance being ins ufactured/Mobile Home? Yes /1 ) When applying fora permit to install a propane tank you must also submit a site plan showing all of the buildings,all property Ilnes,tank location and size,distances from the propane tank to all property lines,buildings and septic system components, including the reserve area. S.. are Foote,e Current - . Main Floor Heated EH Bld App Review: 2"0 Floor Heated Consistency Review: Other Heated Base fee: 132 ° Mezzanine Additional Section: Heated Basement .' Plan Check fee: Unheated Basement r State Surcharge fee: Other Unheated Pot Water Review fee: Garage/Carport SUBTOTAL Decks 911/Rd Approach fee: Other i � $ t��2 TOTAL: rte-»:, Receipt Number: 1 I°) Cash/Check Number: e en a cpu 1.40(.46. ESTIMATED COST(REQUIRED) Date: 'Fair market value of all labor and materials foundation to finish Initials: G:\PennaCenter\###FORMS###\DRD FORMS\Master Pewit Application 5-29-OB.doc Contractors or Tradespeopl,inter Friendly Page Page 1 of 2 General/Specialty Contractor A business registered as a construction contractor with L8I to perform construction work within the scope of 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 RICH'S WOODSTOVES&SPAS UBI No. 600486095 Phone 4257427283 Status Active Address 16504 Hwy 99 License No. RICHSWS1100K Suite/Apt. License Type Construction Contractor City Lynnwood Effective Date 9/12/1989 State WA Expiration Date 4/7/2014 Zip 98037 Suspend Date County Snohomish Specialty 1 General Business Type Corporation Specialty 2 Unused Parent Company WOODSTOVES ETC INC Business Owner Information Name Role Effective Date Expiration Date CHAPMAN, LARRY 01/01/1980 CHAPMAN,MARIANNE 01/01/1980 Bond Information Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date 4 MERCHANTS BONDING WA11335 08/16/2004 Until Cancelled $12,000.0008/13/2004 CO(MUTUAL) 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 American 23 Economy 02CE186393-6 02/01/2013 02/01/2014 $1,000,000.00 01/29/2013 Insurance Co American 22 Economy 02CE186393-5 02/01/2012 02/01/2013 $1,000,000.00 02/01/2012 Insurance Co AMERICAN 21 ECONOMY INS 02CE1863934 02/01/2010 02/01/2012 $1,000,000.0001/25/2011 CO AMERICAN 20 ECONOMY INS 02CE1863932 02/01/2009 02/01/2010 $1,000,000.0002/05/2009 CO(AMEC) AMERICAN 19 ECONOMY INS 02CC7474932 02/01/2008 02/01/2009 $1,000,000.0001/07/2008 CO AMERICAN 18 ECONOMY INS 02CC7474931 02/01/2007 02/01/2008 $1,000,000.00 01/24/2007 CO AMERICAN 17 ECONOMY INS 02CC74749310 02/01/2006 02/01/2007 $1,000,000.00 01/05/2006 CO 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 https://fortress.wa.gov/lni/bbip/Print.aspx 1/29/2013 err °o e °?, JEFFERSON COUNTY Q —. � DEPARTMENT OF COMMUNITY DEVELOPMENT -14.4'1 Nat° Date: t�,-I LTime Received: i s-R am/pm Mon. Tue. Wed. Thur. 0 Date: 17._-13 ` l3 BLD: ) 3- 3e. Contact Name: Owner: Contact Number: 360 775 5-71/ Address: ,(o p (.1 0696- b►r 206 Notes: W (J SSE. Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing Under ground 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 Setbacks Floor Foundation Wall Address Posted Block&Tile Ceiling • 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#: BLD13-00038 Received Date 1/29/2013 SITE ADDRESS: 260 RIDGE DR Issue Date 1/29/2013 PORT TOWNSEND, 98368 APPLICANT: RONALD L HANSON PHONE: 360-379-5114 JAYN M HANSON 260 RIDGE DR PORT TOWNSEND WA 98368-9493 24 SUBDIVISION: CAPE GEORGE VILLAGE DIV 3 Block: Lot: PARCEL NUMBER: 940500023 Section: 13 Township: 30N Range: 02W CONTRACTOR: RICH'S WOODSTOVES &SPAS PHONE: (425) 742-7283 16504 HWY 99 LYNNWOOD WA 98037 Contractor's License RICHSWS1100K Expires 4/7/2014 OWNER, RONALD L HANSON PHONE: 360-379-5114 if different: JAYN M HANSON 260 RIDGE DR PORT TOWNSEND WA 98368-9493 PROJECT DESCRIPTION: WOODSTOVE 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 1/29/2014. REQUIRED INSPECTIONS: lank/Una/Appliance: a.)07) tO U t. FinalApproval: 7_1 C� C \; 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 HOT LINE AVAILABLE 24 HOURS A DAY \\tidemark\data\forms\F_BLD_Permit_Propane.rpt 1/29/2013