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Home My WebLink AboutBLD2013-00050 - RE ROOF---� 4 • BUILDING PERMIT APPLI TION BLDI3-00050 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD13-00050 Received Date: 2/11/2013 SITE ADDRESS: 5331 FLAGLER RD NORDLAND, 98358 OWNER: J PETER GEERLOFS PHONE: 360-385-4224 GLENDA GEERLOFS 5331 FLAGLER RD NORDLAND WA 98358-9617 THURLOW SHORT PLAT SUBDIVISION: Block: Lot: 2 PARCEL NUMBER: 921081021 Section: 8 Township: 29 N Range: 01 E CONTRACTOR: TOLLEFSON BUILDERS INC PHONE: (360) 732-4080 TODD HULBERT PO BOX 100 CHIMACUM WA 98325 Contractor's License TOLLEBI977N9 Expires 3/16/2013 REPRESENTATIVE: TOLLEFSON BUILDERS INC PHONE: (360) 732-4080 TODD HULBERT PO BOX 100 PROJECT DESCRIPTION ROOF REPAIR TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP REP MAIN: VALUATION 30,000.00 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: Approved/Date Permit $441.75 LYK 02/11/13 139990 Plan Check $287.14 LYK 02/11/13 139990 APPROVED State Building Code $4.50 LYK 02/11/13 139990 FEB 1 1 2013 Total: $733.39 Jefferson County DCD \+irlcmorNrle+e\+nrme\G PI II Ann Rlrl rn+ 9/19/9(11'3 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#: BLD13-00050 SITE ADDRESS: 5331 FLAGLER RD Issue Date: 02/11/2013 NORDLAND, 98358 Final Date: 4/17/2013 APPLICANT: J PETER GEERLOFS PHONE: 360-385-4224 GLENDA GEERLOFS 5331 FLAGLER RD NORDLAND WA 98358-9617 SUBDIVISION: THURLOW SHORT PLAT Block: Lot: 2 PARCEL NUMBER: 921081021 Section: 8 Township: 29 N Range: 01 E PROJECT DESCRIPTION: ROOF REPAIR 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 4/17/2013 \\tidemark\data\forms\F_BLD_Occupancy.rpt 5/22/2013 V " +� JEFFERSON COUNTY d iDEPARTM•OF COMMUNITY DEVELOPMENT 621 Sheridan Street• Port Townsend •Washington 9836 360/379-4450 • 360/379-4451 Fax www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: r ( l A Proj esc.•1 ude separate sheets as necessary): WO Tax Parcel Number OAS 1 '. ) Property Size: (acres/square feet) Site Address and/or Directions to Property: 'S331 -7Pcjek R& OoRcSWWSL tx)a., Cas 35 Property Owner(s)of Record: 3.?e,-IerZGeeclaf s C1.41(Geeklacs Telephone: 340 385-4 Z A- Fax: email: ogee alo-(s Q.olrt us,vk ' Mailing Address: 9 -01) MeAl Applicant/Agent(if different from£wner): Telephone: Fax: email: Mailing Address: What kind of Permit?(Check each box that applies 0Building r wardshi Plan ❑ Demolition Permit E C 1EU '�- 11°r Major or Reasonable Economic Use) ❑Single Family ❑Garage Atta, �%- -. e• • Condition: �- [C(a),C(d),or C]** ❑ Manufactured Home ❑ Modular LJ,i i ❑ Discretio . /9 or Unnamed Use Classification ❑ Commercial* ',! I S I U = ential Public Facilities)-- ❑ Change of Use i FEB E B ❑Boundary I' 3 •justment ❑ Address ❑ Road Approac ! ❑ 1 ort •I- ❑Home Business ❑Cottage Indust ' " g Site Pla ** ❑Propane ERSO�� Ogg ❑Sign ■ _ DEPT.OJEFFF COMEMRSI !i ura -esidential 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 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 1 **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 to Q �iIL: a to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE . �__ Date: 54:41.,' 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 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 an 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 app i -c: !:7' or ,- ...k prior notice. -� / / signature: ,��'g� Date: GJ i U l / 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 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)e =i 1•u are in complian«-.,'., the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-trans •ns1.11 •r - hering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. natur . �� Date: Z///f i3 G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc T -': • • Date . time received 12-S-1? am V Mon. ,Wed: Thur. Fri. ••BED: l3 - S D Date: /q - OWNER: Contact Names• ADDRESS: 5-3 31. FLk_i .r--- Contact Number 3GO34.4 g 7- r 206 , 4 Notes: •Foundation Plumbing - Framing Propane Tank Mechanical ' Setbacks Under-ground Framing Under ground Furnace _ Footing Rough in Air seal i Above ground _ Gas Stemwall _ Hydronic Exterior shear Exterior lines Oil ^_ Straps Interior shear Interior lines Ducts ,_ . Post Hole _ Ventilation i Appliance _ Underfloor Gas/wood stove Man•Hornes • Setbacks — • Insulation. Final Inspection =a Foundation Block&Tie _ floor wall ceiling Address Posted . ' f'■:.- kEsl. . • :',C,IVis".`, ..p. _ ' - -t. • r rir-r:---''''-4..''-.4-''.-.4'47&-1::1 . • :.-:A:Ria,a•g 9 2,::1-s, ' ' 11,vt: ' . - ' t :.4 , W • . - _. / 1' Date IF I 6:2 time receivedA44 itD/ pm Mon. Tues. Wed: Thur. --Fri. BED: 1 — 5-7) . . Date: OWNER: be avd( el- - 1 . v . Contact Name: ADDRESS: -S 3 I 1-----GL ( c, contact Number:360 Notes: . ,_..0 0-6,. • 206 ( . • . Foundation Plumbing - Framing . Propane Tank - Mechanical Setbacks Under-ground Framing Underground Furnace Footing Rough in Air seal Above ground - Gas Stemwall _ Hydronic Exterior shear — Exterior lines Oil Straps Interior shear interior-lines . Ducts 4 Y Post Hole Ventilation . Appliance . Man-Homes . Underfloor Gas/wood stove — . Setbacks Insulation Final Inspection Foundation- . ,5 '0 Nock&Tie floor _wall ceiling Address Posted i -.: A ' —WOE -111111101011111111.11111•111.1111.1111.116111 ----- - - -- --- ---- ---------__ '' Jefferson County 9 Buildin 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 t7etr.-rl 4fri-1 FINAL INSPECTION L / 7-i' FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD13-00050 Received Date: 2/11/2013 SITE ADDRESS: 5331 FLAGLER RD Issue Date 2/11/2013 NORDLAND, 98358 Expiration Date 2/11/2014 OWNER: J PETER GEERLOFS PHONE: 360-385-4224 GLENDA GEERLOFS 5331 FLAGLER RD NORDLAND WA 98358-9617 THURLOW SHORT PLAT SUBDIVISION: Block: Lot: 2 PARCEL NUMBER: 921081021 Section: 8 Township: 29 N Range: 01 E CONTRACTOR: TOLLEFSON BUILDERS INC PHONE: (360) 732-4080 TODD HULBERT PO BOX 100 CHIMACUM WA 98325 Contractor's License TOLLEBI977N9 Expires 3/16/2013 PROJECT DESCRIPTION: ROOF REPAIR TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP REP MAIN: VALUATION 30,000.00 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: Type Amount Paid By: Date: Receipt: BEDROOMS: BATHROOMS: Permit $441.75 LYK 02/11/13 139990 Exist: Exist: Plan Check $287.14 LYK 02/11/13 139990 Prop: Prop: State Building Code $4.50 LYK 02/11/13 139990 Total: Total: Total: $733.39 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