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Home My WebLink AboutBLD2013-00054 - RE ROOF BUILDING PERMIT APPLI�ION BLD13-00054 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD13-00054 Received Date: 2/19/2013 SITE ADDRESS: 22 TAHLEQUAH LN PORT TOWNSEND, 98368 OWNER: WEST& LA DUE PROPERTIES LLC PHONE: 360-385-3036 PO BOX 880 C H I MAC U M WA 98325-0880 RAIN CROW INDUSTRIAL CENTER SUBDIVISION: Block: Lot: 4 PARCEL NUMBER: 001212033 Section: 21 Township: 30 N Range: 01 W CONTRACTOR: CLOISE & MIKE CONSTRUCTION INC PHONE: 360-340-1176 PO BOX 2042 PORT ORCHARD WA 98366 Contractor's License CLOISMC991L7 Expires 8/31/2014 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP RE-ROOF EVERGREEN FITNESS BUILDING TYPE OF WORK COM SQUARE FOOTAGE: COMMERCIAL: TYPE OF IMP ALT MAIN: INDUSTRIAL: VALUATION 20,500.00 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: NUMBER OF EMPLOYEES: WATER SYSTEM: BATHROOMS: Exist: Prop: Total: Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $335.25 LYK 02/19/13 140007 APPROVED Plan Check $217.91 LYK 02/19/13 140007 State Building Code $4.50 LYK 02/19/13 140007 FEB 1 9 2013 Total: $557.66 Jefferson County DU: \\firlcmor4\r1ofo\forme\G RI Il Ann PIA rn• ')/10/7(19 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#: BLD13-00054 SITE ADDRESS: 22 TAHLEQUAH LN Issue Date: 02/19/2013 PORT TOWNSEND, 98368 Final Date: 2/20/2013 APPLICANT: WEST&LA DUE PROPERTIES LLC PHONE: 360-385-3036 PO BOX 880 CHIMACUM WA 98325-0880 SUBDIVISION: RAIN CROW INDUSTRIAL CENTER Block: Lot: 4 PARCEL NUMBER: 001212033 Section: 21 Township: 30 N Range: 01 W PROJECT DESCRIPTION: RE-ROOF EVERGREEN FITNESS BUILDING 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 2/20/2013 \\tidemark\data\forms\F_BLD_Occupancy.rpt 3/20/2013 7 . „gON % JEFFER COUNTY IP k4. ' DEPARTMENT OF COMMUNITY DEVELOPMENT `' ` 14 621 Sheridan Street • Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax 0 www.co.jefferson.wa.us/commdevelopment F3IN Master Permit Application MLA: no rfl ,f 1 o) t D s i pti separate sheets s ne sary): Tax Parcel Number: Ok(V 1 i ZQ 3-3 Property Size: 0, (acres/square feet) Site Address and/or Directions to Property: 2 TGWegvtcL a v. - �c. .../ -"Property Owner(s)of Record: f',4l a t,�t7 ItI&S i " Telephone: ..0 3g5"3Qap Fax: email: Mailing Address: pplicant/Agent(if different from owner): Ch S e d-y"l;k� (ivt��-TUi G1�- Telephone: 3(e('- 769-0/ // Fax: 36n•-P711-6?7 7 email: G✓�fcx� i - 1'ow+ y�l�co-lcM�-I Mailing Address: tP0J Bic , O'/Z r c]-Ore.,1 cwr G/i4 9P,X6 What kind of Permit?(Check each box that applies ❑ Lot or Road Segregation email: ❑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 C]'""" ❑ Manufactured Home .❑ Modular - • - ❑ Discretionary"D"or Unnamed Use Classification Commercial* a •- I Use(Essential Public Facilities)** ❑ Change of Use l =-. E C a "t •ary Line Adjustment ❑ Address 0 Road bhp =--•_ E. : 1 1 Iat** ❑ Home Business ❑Cot(ade Industry ❑ 1 • g Site Plan*' ❑ Propane i FEB 1 0 2013 ❑❑ • ,, •lat** ❑ Sign ; . n-d kurai Residential Development(PRRD)/Amendments** ❑Allowed"Yes"Use Consistency Analysis O' • - -cation/Alteration** ❑ Stormwater Management i i 1l or;ine Master Program Exemption/Permit Revisions** ❑ Site Plan Approval Advance Determination(SR000NTY ❑Shor:ine Management Substantial Development** ❑ Temporary Use _DEPT.OF COMMUNITY DEVELOPMir,•• _ine 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: DESIGNATION OF AGENT I hereby designate /OM CCXA 4 to act as my agent in matters relating to this application for permit(s). \WNER SIGNATURE—'gyp& • Date: 11 Lfh 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 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 he or she wants prior notice. f` \7 /..ignature: :"... Date: (=2-1141 1 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)even if you are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual Yignature:and non-transferable responsibility for adhering to and complying with the ESA. The Applicant has read this disclai er and signs and dates it below. r>> Date: ' 2T/�R�G:\PermitCenter\###FORMS###\DRD FORMS\Current DRD Forms\Master Permit Application 5-29-08.doc Contractors or Tradespeoplrinter Friendly Page • Page 1 of 2 General/Specialty Contractor A business registered as a construction contractor with L81 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 CLOISE a MIKE CONSTRUCTION INC UBI No. 602128841 Phone 3603401176 Status Active Address P 0 Box 2042 License No. CLOISMC991L7 Suite/Apt. License Type Construction Contractor City Port Orchard Effective Date 6/27/2001 State WA Expiration Date 8/31/2014 Zip 98366 Suspend Date County Kitsap Specialty 1 General Business Type Corporation Specialty 2 Unused Parent Company Other Associated Licenses License Name Type Specialty 1 Specialty Effective Expiration Status 2 Date Date DESHAAN Construction DESHACI993N2 CONSTRUCTION Contractor General Unused 8/22/2001 10/17/2005 Archived INC JDUBB Construction JDUBBCI994NP CONSTRUCTION Contractor General Unused 8/17/2001 10/17/2005 Archived INC JORICH Construction JORICCI994NP CONSTRUCTION Contractor General Unused 8/17/2001 10/17/2005 Archived INC JAISRI*991MP JAI'S ROOFING Construction Carpentry/Framing Roofing 7/17/2001 7/12/2002 Archived INC Contractor Business Owner Information Name Role Effective Date Expiration Date COWAN, CHRISTINA MARIE Director 08/31/2010 ORAND, CLOISE II President 06/27/2001 ORAND, MICHELLE MARIE Secretary 06/27/2001 COWAN, THOMAS J Vice President 10/10/2005 COWAN, THOMAS J Vice President 07/09/2003 08/27/2012 ORAND, CLOISE Treasurer 06/27/2001 05/25/2006 HOLBROOK, MICHAEL J Vice President 06/27/2001 05/25/2006 Bond Information Bond Bond Company Name Bond Account Number Effective DatelExpiration DatelCancel DatelImpaired Date https://fortress.wa.gov/lni/bbip/Print.aspx 2/19/2013 Contractors or Tradespeopllrinter Friendly Page Page 2 of 2 8 American Contractors 100194380 06/12/2012 Until Cancelled Indem CO 7 Platte River Ins Co 41228905 06/12/2011 Until Cancelled 07/02/2012 6 American Contractors 100129890 06/12/2010 Until Cancelled 08/20/2011 Indem CO 5 COLONIAL AMERICAN LPM4075722 06/12/2008 Until Cancelled 06/12/2010 CAS ft STY CO 4 PLATT RIVER INS CO 41066125 06/12/2006 Until Cancelled 07/02/2008 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 Amou 12 Companion VGL1241749 07/16/2012 07/16/2013 $1,000,01 Specialty Ins Co 11 Starr Surplus SPLGGL00971 07/16/2011 07/16/2012 $1,000,01 Lines Insurance 00 COMPANION 10 SPECIALTY INS VGL1030963 07/16/2010 07/16/2011 $1,000,01 CO UNITED 9 SPECIALTY INS AGL0920712 07/16/2009 07/16/2011 $1,000,01 CO UNITED 8 SPECIALTY INS AGL0810462 07/16/2008 07/16/2009 $1,000,01 CO 7 NS ST MERCURY FMFL001898 07/16/2006 07/16/2008 $1,000,01 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 Infraction /Citation Date RCW Code Type Status Violation Amount NBER000414 6/28/2010 18.27.200(1)(b) RCW CONSTRUCTION INFRACTION Satisfied $500.00 https://fortress.wa.gov/lni/bbip/Print.aspx 2/19/2013 Jefferson County BuildinPivision Permit•ber: 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 FINAL INSPECTION FINAL INSPECTION M ST 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#: BLD13-00054 Received Date: 2/19/2013 SITE ADDRESS: 22 TAHLEQUAH LN Issue Date 2/19/2013 PORT TOWNSEND, 98368 Expiration Date 2/19/2014 OWNER: WEST& LA DUE PROPERTIES LLC PHONE: 360-385-3036 PO BOX 880 CHIMACUM WA 98325-0880 RAIN CROW INDUSTRIAL CENTER SUBDIVISION: Block: Lot: 4 PARCEL NUMBER: 001212033 Section: 21 Township: 30 N Range: 01 W CONTRACTOR: CLOISE & MIKE CONSTRUCTION INC PHONE: 360-340-1176 PO BOX 2042 PORT ORCHARD WA 98366 Contractor's License CLOISMC991L7 Expires 8/31/2014 PROJECT DESCRIPTION: RE-ROOF EVERGREEN FITNESS BUILDING TYPE OF WORK COM SQUARE FOOTAGE: COMMERCIAL: TYPE OF IMP ALT MAIN: INDUSTRIAL: VALUATION 20,500.00 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: BATHROOMS: Permit $335.25 LYK 02/19/13 140007 Exist: Plan Check $217.91 LYK 02/19/13 140007 Prop: State Building Code $4.50 LYK 02/19/13 140007 Total: Tota l: $557.66 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