HomeMy WebLinkAboutBLD2012-00043 THIS BUILDING IS
NOT FINALED .
PERMIT WAS CANCELLED
PRIOR TO RECEIVING ALL
INSPECTIONS AND HAS NOT
BEEN ISSUED A CERTIFICATE
OF OCCUPANCY.
SILDING PERMIT APPLICAAWN Review 00026
Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD12-00043 Received Date: 2/13/2012
SITE ADDRESS: 2747 TARBOO LAKE RD
QUILCENE, 98376
OWNER: AT&T PHONE: 206-818-9995
760 ALOHA ST
SEATTLE WA 98109
SUBDIVISION: Block: Lot: TX 1+
PARCEL NUMBER: 801181001 Section: 18 Township: 28 N Range: 01 W
CONTRACTOR: TBD PHONE: 205-807-2541
REPRESENTATIVE: CATHERINE FUNTANILLA PHONE: 206-818-9995
760 ALOHA ST
SEATTLE WA 98109
PROJECT DESCRIPTIOI' ADD 2 NEW 4' MICROWAVE DISHES ON EXISTING TOWER & 4 NEW
LINES OF COAX CABLE
TYPE OF WORK COM SQUARE FOOTAGE: COMMERCIAL:
TYPE OF IMP NEW INDUSTRIAL:
VALUATION 10,000.00 MAIN:
CODE EDITION: 2009 ADD'L: HEAT TYPE
HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: # OF STORIES:
OCCUPANCY:
OTHER:
CONST TYPE: SHORELINE:
GARAGE:
CONST TYPE: SETBACK:
DECK: BANK HEIGHT:
SEWAGE DISPOSAL: NUMBER OF EMPLOYEES:
WATER SYSTEM:
BATHROOMS:
Exist:
Prop:
Total:
Routing Date:
Type Amo_ pnt Pte__.BK - Date: Receipt: Approved/Date
Permit $181.50 LYK 02/13/12 131443 APPHUV ...°
Plan Check $117.81 LYK 02/13/12 131443 °�
State Building Code $4.50 LYK 02/13/12 131443 NDV2I 2012
Total: $303.81
Jefferson County Planning
&Building Department
i` 'ia JEFFERSON COUNTY
1, � DEPARTMENT OF COMMUNITY DEVELOPMENT
r,V 621 Sheridan Street,Pat Townsend, WA98368 I Web:www.co.iefferscn.wa.us/corrmunitydevelopment
' Tel: 360379.44501 Fax: 360.379.4451 I Email: dcd(aco.iefferson.waus
SquareONE Resource Center I Building Permits & Inspections I Development Review I Long Range Planning
March 14, 2014
1
AT&T "f ti�
760 ALOHA ST Y / '
SEATTLE WA 98109 �X° V
RE: SUBJECT: FAILURE TO RENEW
SITE ADDRESS: 2747 TARBOO LAKE RD
PERMIT#: BLD12-00043 PARCEL: 801181001
LEGAL DESCRIPTION: BLOCK: LOT: TX 1-I
PROJECT DESCRIPTION: ADD 2 NEW 4' MICROWAVE DISHES ON EXISTING TOWER
& 4 NEW LINES OF COAX CABLE
DEAR AT&T
The Community Development Office sent you a renewal notice indicating the need to either renew or
schedule a final inspection on your building permit. To date, a final inspection has not been successfully
passed nor has a renewal fee been paid.
An annual renewal fee is due unless a final inspection is passed and a certificate of occupancy is issued.
Please submit payment of $228.00 to renew your permit to 621 Sheridan St. Port Townsend, WA 98368.
If you have any questions you can contact our office at 379-4450 between 9:00 a.m. and 4:00 p.m.
Monday through Thursday.
If we do not receive payment or hear from you within thirty (30) days from the date of this notice, we will
proceed with cancelling the building permit. If the structure has not passed a final inspection we will begin
the process of placing a notice to title on your property. Once cancelled, a new permit will need to be
applied for, new fees paid, and the structure built to current building codes.
Sincerely,
‘ 771))----
Permit Technician
cc: file
• S
at&t
VINCULUMS
Authorized AT&T Wireless Services Representative
February 8, 2012 /7
Jefferson County 111� C v 4-\
Department of Community Development
IL I
�
621 Sheridan Street j FEB 1 3 2012
Port Townsend, WA 98368
' U
JEFFERSON COUNTY
DEPT Of COVMUNITY DEVFLOPRIENT
RE: AT&T building permit application for RN20 Tarboo Lake locat 274/ iarboo Lake Rd, Quilcene
To Whom It May Concern:
Please find following enclosed as submittal for a building permit to add a new 4' microwave dish on the existing
lattice tower and the addition of a new cabinet on the existing concrete pad:
• Jefferson County Master Permit Application
• Letter of Authorization from American Tower to apply for a building permit
• Copy of current lease between AT&T and American Tower, as well as the prime lease with the property
owner and American Tower
• (2) copies of structural analysis
• (3) sets of full size drawings
• (2) sets of 11" x 17"s
• Check to cover the BP fees in the amount of$525.81
Please let me know if you have any questions or need any additional information. You can reach me via email at
cfuntanilla@vinculums.com or at 206-818-9995.
Sincerely,
6/ (L
Catherine Funtanilla
enc
z ,�N cad JEFFERSON•COUNTY
\ lA DEPARTMENT OF COMMUNITY DEVELOPMENT
v *4 621 Sheridan Street• Port Townsend •Washington 98368
360/379-4450 • 360/379-4451 Fax
4S�N(3,0p www.co.jefferson.wa.ustommdevelopment
MLA: I -aL
Master Permit Application
Project Description(include separate sheets as necessary):
kicktc n r r L�., + dtshe; on e>i st i Y�' jeveF2 tine C
(New C 1-
Tax Parcel Number: 80 I I Co t Property Size: (acres/square feet)
Site Address and/or Directions to Property:
a14- 1 Ta2boC) LY--- Pct , Qvticone
•
Property Owner(s)of Record: Po r;U4„QCC'S `'10 C icior piic 12 e tM2tt' M f)m-i
Pe
Telephone: Fax: email:
Mailing Address: IC\2`-tom 10-h Ave lam- , tv,,tM j vin (I0'}'1c,
Applicant/Agent(if different from owner): Cixtme\ri 1 - C\- )t 1tet •
Telephone: 2-0f. <612 ���
Fax: Z�- 17- �C2l� e m il:C�1L L
U11lick 6.-,. Vim. C(i-
Mailing Address: '1I I) 11000C 5r t f.(111%€, V,..i'rl cfsd; l
What kind of Permit?(Check each box that applies
Zit uilding ❑ Critical Areas Stewardship Plan
Varian Min • :. •••' se)
❑ Demolition Permit ❑ ( or,-Mat •
❑Single Family ❑Garage Attached/Detached ❑ConditionaC e C(a,j co 7g
❑ Manufactured Home ❑ Modular ❑Discretionant Uhetlai ' -
Zf Commercial" ❑Special Use(Essential Public Facilities)"
❑ Change of Use ❑Boundary Line Adjustment
;
❑ Address ❑Road Approach 0 Short Plat.. , , F F R 1 ,' 212
❑Home Business CI Cottage Industry ❑Binding Site Plan"
❑Propane ❑Long Pla f#
❑Sign ❑Planned ural `• •: 1�t + , •i 1: --RD)/• endments"
❑Allowed"Yes" Use Consistency Analysis ❑Plat Va tion! .• r,,,,1„ l,, \ll "
❑Stormwater Management ❑Shorelin -Me r I'r=_ - :-, "•''_°• -: ':ions
❑Site Plan Approval Advance Determination(SPAAD)" ❑Shoreline Management Substantial Development"
❑Temporary Use ❑Shoreline Management Variance
District Map Amendment
El Comprehensive Plan/UDC/Land Use p
❑Wireless Telecommunication P
❑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
permit(s).
11 relating to this application for ( )
1 �,(,Rt rvn� f', T Vh�IU.�11,�t to act as my agent In matters relate g pp Pe
I hereby designate
p f
OWNER SIGNATURE V�� tt (�""Ct�i''~' Date: Io 11 -
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
in consequence of the granting of this permit.
against Jefferson County as a result of or q 9 9
,expenses which may in any way accrue ago n ty
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
9
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 applict n that he she w is prior notice. r -I 1
Ir
1
Signature: G ti. Date:
.
The action or actin s 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 a e in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual
and non-transferable onsibi' for ad n e and complying with the ESA. The Applicant has read this disclaim a signs and dates it below.
Signature: /. , ( Date: 9- I 0—
G:\PerrnitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.dee
• •
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 aassumingtthee respp-onnsiibilityy of the General Contractor for the proposed project.
Signature:PIS tS .3 r "` it t c tlCCt Ic 5 f P 47(• Date:
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
( ) ( )
MAILING ADDRESS: EMAIL:
CONTRACTORS LICENSE WAINS
NUMBER: NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
❑ New ❑ Wood Existing: ❑ Sewer
O Addition ❑ Steel Proposed: Bank ❑ Community System
❑ Alteration/Remodel ❑ Concrete Total: Height: o Individual System
❑ Repair ❑ Masonry SEP Permit#
O Demolition ❑ Other: Bedrooms: Water Supply:
Existing: Setback: ❑ Private well ❑ Two Party
Type of Heat Proposed: ❑ Public
Total: Name of System:
If this is a Commercial Project 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 Pro•ane Tank and/or A• •liance Installation •errnit mark all items below that a• • •
I Underground Tank I Above ground Tank Size of Propane Tank: t I] \
VJ I� 1
1 Heat Stove I Cook Stove I Woodstove I Fireplace Insert I Hot Water Tank I Piet Eit
Mobile Home? Yes / No I J'
in a Manufactured/Mob e
Is this appliance being installed I
the buildings,al ••-
lar wrn th � ^ rty
also submit a site s g
i When applying for a permit to install a propane tank you must p �, , g�� ��
c system com•• : ;_,
lines,tank location and size,distances from the propane tank to all property lines,bafldings and septa sys
• l
including the reserve area.
--_,r . � .. Tom' 't �P
��4 !'e� � -x' �F� rm`5rr{`. �"�'°�'73'.,,�eF'H'-'-, a •� .+-a••
Square Footage Current Proposed I. 1:-.11E r , .t- ,y �_ .7_. 4 .,,^ 'j:_ .7'.'''`' '—'-'-
Main Floor Heated y EH Bld App Review: u Oh' i v tl,M
�: �aa
2 Floor Heated �et�F-: Consistency Review:
v1-:::
Other Heated Base fee: 1 p I j
Mezzanine - . Additional Section:
Heated Basement *`II. Plan Check fee:
Unheated Basement t` State Surcharge fee:
.-,ix Other Unheated\- a 1,
Pot Water Review fee:
'2' •Garage/Carport SUBTOTAL t - 5,15� g cT
Decks - 911/Rd Approach fee:
Other -4g.,*:. Tn..: TOTAL $ H,5 .2
..
',"`ma 4 Receipt Number: F 11 I k—C
1 :
Cash/Check Number:
ESTIMATED COST(REQUIRED) Date:
air market vale of all labor and materials foundation to finish 2-13—f 2-
l0'000 10 Initials:
G:\PemutCenter\###FORMS###\DRD FORMS\Master Permit AppIic on 5-29-08.doc
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Jefferson County Building D�sion Permit Nu,: BLD12-00043
Applicant: AT&T
BUILDING PERMIT INSPECTION APPROVALS Applicable Code: 2009 International Building Codes
To schedule inspections, call (360)379-4455 no later than 7:00 AM the day of the inspection.
Requests received after 7:00 AM will not be scheduled for that 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
Miscellaneous second party verification of instatation
FINAL INSPECTION
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#: BLD12-00043 Received Date: 2/13/2012
SITE ADDRESS: 2747 TARBOO LAKE RD Issue Date 11/21/2012
QUILCENE, 98376 Expiration Date 11/21/2013
OWNER: AT&T PHONE: 206-523-1941
760 ALOHA ST
SEATTLE WA 98109
SUBDIVISION: Block: Lot: TX 1+
PARCEL NUMBER: 801181001 Section: 18 Township: 28 N Range: 01 W
CONTRACTOR: TBD PHONE: 205-807-2541
PROJECT DESCRIPTION: ADD 2 NEW 4' MICROWAVE DISHES ON EXISTING TOWER & 4 NEW LINES
OF COAX CABLE
TYPE OF WORK COM SQUARE FOOTAGE: COMMERCIAL:
TYPE OF IMP NEW IN INDUSTRIAL:
VALUATION 10,000.00 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:
BATHROOMS: Permit $181.50 LYK 02/13/12 131443
Exist: Plan Check $117.81 LYK 02/13/12 131443
Prop: State Building Code $4.50 LYK 02/13/12 131443
Total: Total: $303.81
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 7 am the day the inspection is needed.
Office Hours 9:00 am -4:30 pm MONDAY - THURSDAY
HOT LINE AVAILABLE 24 HOURS A DAY
SPECIAL CONDITIONS APPLY-SEE ATTATCHED
• •
CONDITIONS for Building Permit# :BLD12-00043
1.) The project shall adhere to the Best Management Practices (BMPs)to control stormwater,
erosion and sediment during construction. BMPs shall address permanent measures to
stabilize soil exposed during construction, and in the design and operation of stormwater
and drainage control systems.
2.) PRIOR TO FINAL-Second party verification of modifications
11tidamark\data\fnrma\F R111 Parmit Rldn rnt 1117112012