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Home My WebLink AboutBLD2010-00186 *UILDING PERMIT APPLICAIN MRA O 00 15 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD10-00186 Received Date: 6/1/2010 SITE ADDRESS: 155 GYBE HO NORDLAND, 98358 OWNER: MICHAEL W BALL PHONE: 206-947-3002 6507 DIVISION AVE NW SEATTLE WA 98117-5142 ROBERT SPERRY HORT PLAT SUBDIVISION: Block: Lot: PARCEL NUMBER: 921081025 Section: 8 Township: 29 N Range: 01 E CONTRACTOR: H K CONSTRUCTION PHONE: 360-385-7351 241 CHIMACUM CREEK DR PORT HADLOCK WA 98339 Contractor's License HKCON"981 DL E res 3/13/2012 REPRESENTATIVE: SIMON LITTLE / PHONE: (360) 360-640-8814 210 N VICTORY AVE / PORT TOWNSEND WA 98368 PROJECT DESCRIPTIOI' NEW DETACHED GARDE/SHOP W/ PLUMBING STUB OUT - RID (_�t.)( I:'L TYPE OF WORK GAR SQUA FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 95,000.00 AD : % HEAT TYPE: e{eL'reAC. CODE EDITION: 2006 HAT BASE: HEAT TYPE: OCCUPANCY: dl0.tl i OCCUPANCY: NHEATED: \ # OFSTORIES: OTHER:CONST TYPE: GARAGE: \'Jjt i�� + SHORELINE: CONST TYPE: DECK: � SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT \ WATER SYSTEM: BEDROOMS: BAT OOMS: Exist: 0 Exist: 0 Prop: 91 op: .0 Total: if I otal: ,0 ( —,4 Rfoouuting Date: `---_... Type , / Amount Paid--- - Date: Receipt: Approved/Date Permit $958.75 LYK 06/01/10 117778 Plan Check $623.19 LYK 06/01/10 117778 APPROVE State Building Code $4.50 LYK 06/01/10 117778 Total: $1,586.44 SEP c93 201( Jefferson County Planning &Building Department e n C 0_,Co DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street,Port Townsend,WA 98368 Tel:360.379.4450 Fax:360.379.4451 Web:www.co.jef ferson.wa.us/communitydevelopment yS `.`p'` E-mail: dcdiz?co.jefferson.wa.us CERTIFICATE OF OCCUPANCY PERMIT #: BLD10-00186 APPLICANT: MICHAEL W BALL PHONE: 206-947-3003-EV 6507 DIVISION AVE NW SEATTLE WA 98117-5142 SITE ADDRESS: 155 GYBE HO Issue Date: 09/20/2010 NORDLAND, 98358 Final Date: 8/14/2015 SUBDIVISION: Block: Lot: PARCEL NUMBER: 921081025 Section: 8 Township: 29 N Range: 1E PROJECT DESCRIPTION: SFR W/ATT GARAGE & A/G 250 GAL PROP TANK THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2006 EDITION. OCCUPANCY GROUP: R-3 TYPE OF CONSTRUCTION: 5N SPRINKLER SYSTEM yes no THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 8/14/2015 \\tidemark\data\forms\F_BLD_Occupancy.rpt 8/20/2015 2,,0-5°'`. go 4SG� `0,2 JEFFERSON COUNTY :- DEPARTMENT OF COMMUNITY DEVELOPMENT S,J �i Gl / t Date: -] , Time Received: am/Pni Mon. Tue. Wed. Thur. Fri. Date: BLD: ,/")—/6.40 Contact Name: Owner: Contact Number: 360 Address: A �^ ../// `,e HP 206 '-7 0 Notes:.. t Foundation Plumbing Framing Propane Tank P Mechanical Setbacks Under-ground Framing Underground Furance Footing Rough In Air Seal Above ground Gas Stemwall Hydronic Exterior shear Exterior lines Straps Hot Water Htr Interior shear Oil Interior lines Ducts Post Hole Ventilation Appliance Underfloor Gas/Wood stove Man-Homes Insulation Setbacks Final Inspection Floor Foundation Wall Block&Tile Address Posted Ceiling �gSD" `.06. JEFFERSON COUNTY = DEPARTMENT OF COMMUNITY DEVELOPMENT Date: '?f( Time Received: /Q5 am rr7 Mon. Tue. Wed. ay Fri. Date: Vi-7 BLD: A9 - lgC, Contact Name: Owner: Contact Number: 360 Address: j 53' VI Je-ltn 206 4q7 ?ODZ Notes: Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under ground Framing Under ground Furance Footing Rough In X 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 Rlork tL Tile _ _ __ __ Ceiling SUS r ��.F GL JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT $ Date: 3/27 Time Received: Z • 32— am4g, Mon. Tue. Wed. Thur. Fri. Date: 3/ BLD: I6 - (70(f3e, Contact Name: Owner: Contact Number: 360 Address: 155 BE Po ' 206 q41 - 3130Z Notes: 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 . if =a • 1132 - Date (� time received a1 ' r� Pm Mon. Tues. :Weda Fri. BLD: 'Q — 1g'L• Date: 7/l i • OWNER: ,l - Contact Name: ADDRESS: SS �?�� ' ' `" Contact Number 360 54 20'6 'j y ,i . - r` Notes: Foun__ d n Plumbing - Framinq' . 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 y Interior shear Interior lines — Ducts #_ Past Hole Ventilation Appliance • Underfloor Gas/wood stove Man-Homes . • Setbacks. • Insulation. - Final Inspection_ •i. • • Foundation,—. . ' Block&Tie floor wall ceiling. . Address Posted �<SON wee °ya JEFFERSON COUNTY ,9aHI NC�ni DEPARTMENT OF COMMUNITY DEVELOPMENT Date: --t a_Time Received: 1 Z q amAC Mon. Tue. Wed. Thur. Cri: Date: Y'- ! 7 BLD: i Q •- I 1•, Contact Name: Owner: Contact Number: 360 Address: , `i-`i- &, sie I-o 206 cjLi-7300'2. II Notes: I 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 S- Setbacks Floor Foundation Wall Address Posted Block &Tile Ceiling I • Date — .i CJ time received:35 7 am 1C C; Tues : / B Wed. Thur. -Fri. BLD: — /&6 Date: � Zz--- . OWNER: Contact Name: ADDRESS: /SS " - L'e° /4 Contact Number:380 Notes: //C�}T �'u, S zos 94'7:3�Z Foundation plumbing • Framing Propane Tank Mechanical Setbacks _ Under-ground Framing Underground Furnace _ • Footing Rough In Air seal Above ground _ Gas Stemwail __ Hydronic Exterior shear Exterior lines Oil Straps Interior shear interior lines Ducts V _ Post Hole _ Ventilation _ Appliance _ Underfloor Gashvood stove Man-Homes Setbacks ' Insulation. Final Inspection ; Foundation V Bieck&Tie floor wall ceiling to — 9 Address Posted _ i - A. J e''�3 ' "_ gill • , u Date/."I z time received'/ p' (/ am 1 pm Mon. Tues. Wed. Thuurr.. Pri. BLD: 1° dr ! 0 4 Date: ' -3/ / OWNER: / ContactNarne: ADDRESS: ! '. S C1-12-t (c/ Contact Number 360 " 206 / �2' 3a, s Notes: /�// AO6- / Y,„)- 3063 Foundation Plumbing • Framing ropane Tank Mechanical Setbacks _ Under-ground_ Framing _�Under ground _ Furnace Footing Rough In Air seal Above ground _ Gas _ Stemwall _ Hydronic Exterior shear _ Exterior lines _ Oil Straps Interior shear Interior lines Ducts . . Post Hole Ventilation Appliance — Underfloor _ Gas/wood stove Man-Homes Setbacks Insulation. Final inspection Foundation _ . Block&Tie _ floor _wall ceiling Address Postd _ 1 1 'u.. Date 7 .-/D -/)time received 3�' 0 " am 1 I Mon. ue ,Wed. Tour. -Fri. BLD: / 6 ^ /f'b . Date: 11-- / 7 OWNER: 8 r-.>, 4 Contact Name: ,___1.ADDRESS: / . Coy ALP Contact Number:360 .3 dl .3p 0 206 Notes: ///cS 4 . Q. Foundation Plumbing - Framing ,Propane Tank Mechanical Setbacks Under-ground Framing _e// Underground _ Furnace _ Footing Rough In Air seal Above ground _ Gas _ Stemwall _ Nydronic Exterior shear Exterior lines Oil Straps Interior shear Interior lines _• Ducts _ _ Post Hole _ Ventilation Appliance _ Underfloor Gas/wood stove Man-Homes Setbacks _ Insulation. Final Inspection Foundation Block&Tie _ floor wall ceiling Address Postb'd . .4. JEFFERSON COUNTY 1 DEPARTMENT OF COMMUNITY DEVELOPMENT SH C:G�` I Date: t4 k/ O (5 Time Received: 2:G ) am el) Mon. Tue. W-d. Thur. Date: 1 5 ?O BLD: l •ia ( Contact Name: filiti. gJ.' i Owner: M1 P Contact Number: 360 Address: _: �� C�) 0 i Notes: 144 7 Uf 4 4 %iltif) 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 x Setbacks Floor Foundation Wall Address Posted Block&Tile Ceiling 7 t 1 ' iritrtirrrar 4 i 13— Date time received tt��\ ' �am !� s Mon. ;Tuess.. .. Thur. -Fri. BLD: I/ U 1 ^Y5 Date: /^ r r OWNER: 1 V Contact Name: 77 p /� ADDRESS: S a Contact Number.360 7o v 2CZ 206 Notes: n.' Foundation Plumbing Framing Propane Tank Mechanical Setbacks _ Under-ground_ Framing Underground - Furnace _ Footing Rough in Air seal // Aboveground Gas Stemwall , Hydronic Exterior shear V Exterior lines _ Oil _ Straps ,`;`L Interior shear - interior lines - Ducts Post Hole _ r,r, ' Ventilation Appliance — Underfloor Gas/wood stove Man-Homes - -f• ;tbecks Insulation Final Inspection .°t,. r-"0,0, datlon r i, r. &Tie floor wall ceiling Address Posted rip 4-, ..,...,- „ \Y : r iI 11IIaER` Date 1I- 7 timereceivedd� % ^� am /. Mon. Tues. Wed. , Fri. b BLD: D r- ' Date: l ..` 1 G OWNER: 7 Contact Name: ADDRESS: 6S ..'e .I 0 t(z j ■ Contact Number:360 l l� t ` �,250 Notes: 206 Foundation Plumbing Framing Propane Tank Mechanical Setbacks Underground_ Framing _ Underground Furnace — Footing Rough in V Air seal Above ground Gas Stemwall _ Hydronic Exterior shear Exterior lines _ Oil Straps Interior shear Interior lines _ Ducts _ Post Hole Ventilation Appliance _ Underfloor Gas/wood stove Man-Homes Setbacks Insulation Final Inspection Foundation P Bieck&lie floor_wall ceiling Address Posted • AI S I. ' 1 Date I Y — 1 1 r '- imereceived `1 ti / pm Mon. Tues. Thur. Fri. BLD: 3,; I .-(l Date: \\ OWNER: Contact Name: ADDRESS: J v Contact Number.360 SEA-32 go col• No C Ok (L�_ 206 Notes: v�. Foundation Plumbing - Framing Propane Tank Mechanical Setbacks Under ground— Framing __ Under ground Furnace _ Footing Rough in Air seal Above ground — Gas Stemwall __ Hydronic Exterior shear Exterior lines Oil — Straps Interior shear Interior lines Ducts Fast Hole Ventilation — Appliance _ Underfloor Gas/wood stove Man-Homes Setbacks Insulation Final Inspection Foundation Block Brie floor _wall ceiling Address Posted i I 47°3; gi MOIU Date /0 25 time received g‘110 am /1; ..) Mon. Wed. Thur. Fri. BLD: I D 151 Date: /0 °'.( OWNER: -EA-LA- Contact Name: ADDRESS: 1 SS (9 Contact Number l 2-7S 7 Notes: I b 5 � Foundation Plumbing Framing Propane Tank Mechanical Setbacks Under-ground Framing Under ground Furnace Footing Rough in Air seal Above ground _ Gas _ Stemwall ^ Hydronic Exterior shear_ Exterior lines _ Oil _ Straps Interior shear — Interior lines Ducts Post Hole _ Ventilation Appliance __ Underfloor Gas/wood stove_ Man-Homes Setbacks Insulation Foundation Block&Tie _ floor wall ceiling Final Inspection Detailed uote Carl's Building Supply . "'ti" 10733 Rhody Drive �l�igat d Port Hadlock,WA 98339 360-385-2111 www.m2o.com Project Information Project: Eva/sliding patio door Project ID: 44 Sales Rep: Administrator Quote Date: 06/17/2010 Delivery/Pickup: Delivery Print Date: 06/16/2010 Customer: 0000000042 PO: Terms: Est Delivery: Comments: (After Receipt of Order) Billing Information Shipping Information Contact: Contact: Address: Address: Phone: Phone: Fax: Fax: Manutecdrrer: Milgard Item: 0001 Location: °4-'��;� (kientity: 1 WoodClad,3626, PSD4,RO 142 1/8"x UF:0.34,SGC:0.24,VLT:0.44 0 4723.71 6-9/16"Jamb Extender V 83.54 Gas Filled Argon 55.35 Brushed Chrome Interior Handle Finish 64.57 Brushed Chrome Exterior Handle Finish 64.57 Item Total: $ 4991.74 I Fin Placement:1 3/8"Nail Fin Setback;Sliding Direction:OXXOR; Item Quantity Total: $ 4991.74 Exterior Finish:Matte Black;Interior Finish:Unfinished Vertical Grain Douglas Fir;Glazing:Dual Glazed(Insulated Glass);Energy Package: No;Tempered All;Outer Glass Ute Option:SunCoat Low-E;Inner Glass Lite Option:Clear;Glass Thick 1:1/8";Glass Thick 2:1/8"; EdgeGardMAX:Yes;Gas Filled:Argon;Hardware:Single Point Lock; Extension Jamb:6-9/16";Screen:Sliding Screen;Interior Handle Finish: Brushed Chrome;Exterior Handle Finish:Brushed Chrome; For safety purposes,3 and 4 panel doors may require field glazing. Line Item Comments: Customer Approval: Initials Other Charges: SUBMITTED BY: SUB TOTAL(taxable):$ 4991.74 ACCEPTED BY: SUB TOTAL(non-taxable):$ 0.00 ----- TAXES( 0.000 %):$ 0.00 DATE: GRAND TOTAL:$ 4991.74 Quote 10: 44 1 Of 2 06/16/2010 - --1-.-b vo S 0 ss uott ��-�.v�e� aro, rt. 1 . 4"a e- 324 MA 'J = ir—�I d -6•rki- 601...0.1 wi,i,s - ----t rizo (Rh ot;kisr Fz.o-- tketr ) le_ lb W , I.J.Dcu)S : . 6 N '`A'' ''13 >S1(911m-S . c•,), ofe-1.11611 • 1 -T 0-01+ s\laL■f$5 dooes v4)\Sie 11F4irs • 1-1, 4 '5k-ilk e.00m . II(wht 4 2 u 24 illilig Kt44n - & Seme I 1 % a,� � epo •fitt, opr - cast nee ' 4' 'I ?lac 3c) Y. ICILDING PERMIT APPLICA•N MRLA1100-00p215 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD10-00186 Received Date: 6/1/2010 SITE ADDRESS: 155 GYBE HO NORDLAND, 98358 OWNER: MICHAEL W BALL PHONE: 206-947-3003-EVA 6507 DIVISION AVE NW SEATTLE WA 98117-5142 ROBERT SPERRY SHORT PLAT SUBDIVISION: Block: Lot: PARCEL NUMBER: 921081025 Section: 8 Township: 29 N Range: 01 E CONTRACTOR: H K CONSTRUCTION PHONE: 360-385-7351 241 CHIMACUM CREEK DR PORT HADLOCK WA 98339 Contractor's License HKCON*"981 DL Expires 3/13/2012 REPRESENTATIVE: SIMON LITTLE PHONE: (360) 360-640-8814 210 N VICTORY AVE PORT TOWNSEND WA 98368 PROJECT DESCRIPTIOI SFR WI ATT GARAGE LAA� �(� `�^ I TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 450; VALUATION 95,000.00 ADD'L: 199 HEAT TYPE: EEE CODE EDITION: 2006 HEAT BASE: HEAT TYPE: RAD OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: CONST TYPE: 5N OTHER: , - SHORELINE: CONST TYPE: GARAGE: 1,441 SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: 05783 BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 1 Pfop 1 Total: 1 Total: 1 Routinq�yDate: Type AmounfPaid By: Date: Receipt: Approved/Date Permit $958.75 LYK 06/01/10 117778 Plan Check $623.19 LYK 06/01/10 117778 State Building Code $4.50 LYK 06/01/10 117778 Renewal-2011 $213.00 LYK 09/27/11 128177 Permit $74.00 LYK 02/28/12 131503 Plan Check $74.00 LYK 02/28/12 131503 Poliabia\nIarerAppIication $6a 00 LYK 02(28/17 1'11F03 Total: $2,011.44 AIIIIIIIIIIII 1 '' t" No F ' T—b 73 -1 ' — --I -U o 1 0 z II _ 85- H 1 v, I 1 ® z° 90__ o f fp p tom. 0 i I 'k::' M ,'"° 0 ; z , . H z c �'_ I II z-� r n rn1 1. Fn 6 C I 1 2 ( - rn I I 95J1 C < 1 , " n 1 I pilgg o 2 _I cl: ITI G■ A >---I --t 1-0 .3 '8) t6' u p (5) --I § 4 -..-...2C------------------_____________L. f- .6.' ' P 6-- ni 1 1 -23!1 1-- '? !Ai V �� 11 1 I CD p 1 1 p A 0 1 '1 SC s- �,/ \ II y �a I I rn r ccc1� i; n to z c - ® v I tarn dt' I i -D /1 ra/iiH /�_ r i 0 1 / :4, i ; N .. rn 2HH v9N n-I t is- . F I 1 r m R s I to / `` . l7 0 ` ' Q \ ' r . lei Nis% t.. .40, ///1\ : i ' .I�' P/� opro 0 � N � - it ``= a Io . .1 ,.... , _ :_ sik, 1 ,,. __J \ , '/ 3":*" r -\ ' , 1 . IVA PROPERTY LINE 21.1.86' 1 m i I ADJACENT LAND USE: $ RESIDENTIAL I rn 7 �� _\\ \ A Ns — lu }i1 til tit �� r \�O\, \ < ,ta N to YJ 0 ' iR \\s \\\ z r, 1 ° -Its z \ 'P '\\PQ� "' *` tom- S n 7 7' ;{ CSI t(1 p .Q r 'U 70 \ '\\ � [ N �n z k i m r `v� lid 11 rn # ® — ice--- CI ? o V_ri — 11 L' b I 0 73 , __ o _ So,"� 0 I ill I I y I 85-- 1 air zM I I k� I . ' a wr-tti 8 U ° 1 � ,io ° 1 M4 j _ Z o ttzt C I1 , aC qp �` " C rn rn I 1 ZM n (1 A z , 11 f� 5 I � 6 —{ r-- I 11j d I1 0 N ! w - rn tii 11 . C IP' A igirl gz p I rn 1 -� �- --i x Q rn iali%hiQN� + i ' L g � � - ij' A ' -i ��R o.4 I 2 : - Z ? 71 I �� A�, � . y rn i 0 I q 8 II f\NN.....,.."/ ? A T Ci ,' '� I cr 1 s- 10 D -{ m 401 1 ® � 9-:� I I 6 z � z =z _F p 73 ri)..P, w 1 /t � F D }-p L 1§ I ,�- o. I , r I (1 �2 v 9 ) (l-Q1 s T If 5'1-0' / C!? -h ‘* i > D -)-1). 2 r (5) A `$ q\'�. '/ / Oh d '3' b I I ,. 5,- 0, HP -U i i I - / 11 b � . I+ �\ 0 E V 9� rn I.�: - ..... . PROPERTY LINE 219.86' �7 \ c. -C ;` rn C g g ig 1,I ' ADJACENT LAND USE: -pG��'X g RESIDENTIAL c �� _ I f 2> \ \tc1/4‘ \\.‘ 0 -,,,,#' \ \ d N � r � Q g oo --7 .____> . { FROOZiR `Z''\,, \f `i1 ' -7' n N. H K CONSTRUCTION • Page 1 of 2 Home Inicio en Espanol Contact Search L81 5t`' A-Z Index Help My Secure L&I Safety Claims&Insurance Workplace Rights Trades&Licensing 0 Washington State Department of Labor & industries H K CONSTRUCTION Owner or tradesperson 241 CHIMACUM CREEK DR PORT HAOLOCK.WA Principals 360-385-7351 KATSIKAPES,HAZLI H,PRESIDENT JEFFERSON County KATSIKAPES,ANN EVELYN,SECRETARY Doing business as H K CONSTRUCTION WA UM No. Business type 601 745 435 Corporation License Verify the contractor's active registration/license/certification(depending on trade)and any past violations. Construction Contractor Expired. License holder did not renew. License specialties Suspend date GENERAL 01/30/2013 License no HKCON**981 DL Effective—expiration 03/13/2002—03/13/2014 Bond No current bond account.See the bond history. Bond history Insurance ................... No current insurance account.See the insurance history. Insurance history Savings Savings history Lawsuits against the bond or savings No lawsuits against the bond or savings accounts during the previous 6 year period. L81 Tax debts No L&I tax debts are recorded for this contractor license during the previous 6 year period,but some debts may be recorded by other agencies. License Violations ........................................ No license violations during the previous 6 year period. Workers' comp Do you know if the business has employees?If so,verify the business is up-to-date on workers'comp premiums. L&I Account ID Account Is closed. 550,481-02 Doing business as KATSIKAPES ENTERPRISES INC Estimated workers reported NIA https://secure.lni.wa.gov/verify/Detail.aspx?UBI=601745435&LIC=HKCON**981DL&SAW= 8/19/2015 1 H K CONSTRUCTION Page 2 of 2 L&l account representative T5 DALILA MEANS(360)902-4735-Email: MEAE235 @Ini.wa.gov Workplace safety and health Check for any past safety and health violations found on jobsites this business was responsible for. Washington State Dept.of Labor&Industries.Use of this site is subject to the laws of the state of Washington. https://secure.lni.wa.gov/verify/Detail.aspx?UBI=601745435&LIC=HKCON**981DL&SAW= 8/19/2015 • JEFFERSON f1NTY � DEPARTMENT OF O COMMUNITY DEVELOPMENT 621 Sheridan Street• Port Townsend •Washington 98368 1 , . 360/379-4450 360/379-4451 Fax At asp www.co.jefferson.wa.us/cornmdevelopment Master Permit Application MLA: 10 R;) Project Description(inchVe spa�rate Veets as n ary): S�,op �;Ghrk AO �, r I 1.,10)1 4f1Ljf 4 Co4c. s Tax Parcel Number. 12/• OA - 025 Property Size: 3.5 7 Ac rP (acres/square feet) Site Address and/or Directions to Property: ' o. r��a b n Y•N,cr�1 155 6 f� R 1\14 1.441 „ 17+- -Tk Property Oer(s) of Record: M;Cn o,r.� � r 11 , E v- c 1„r , 1 Telephone:706.-41 7" 3o0Z Fax 06- g - 5 emaiil: l iC/Irt bkII7l o ti i(•c Mailing Address: 63D7 1YlviSien it . .G) Seh f rr q 117 Applicant/Agent(if different from owner): Sint o/t t Telephone: •o-6 0- :: Fax email: 5■mbo (Z)s)-,,L0-s1-1.t e r, Mailing Address:2 0 6P otJ . , ' - . i F; What kind of Permit?(Check box that applies ullding ❑Critical Areas Stewardship Plan Demolition Permit ❑Variance(Minor,Major or Reasonable Economic Use) ❑Single Family 150arage Attache Detach ❑Conditional Use[C(a),C(d),or C] ❑ Manufactured Home ❑ Modular ❑ Discretionary'D"or Unnamed Use Classification ❑ Commercial* ❑Special Use(Essential Public Facilities)" ❑ Change of Use ❑Boundary Lire 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 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: L._ U DESIGNATION OF AGENT I hereby designate S. - , rTZc to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Date: f/a a_ / e 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 fad 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 iabilities,judgments,court costs,reasonable attorney's fees and expenses which may in any way accrue against Jefferson County as a result of or it 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 requi _ later in .-. ors_ Staff's access and right of entry will be assumed unless the applicant informs the County in writing at the time of the appl'- ` that he or- ,wants prior notice. Signature: ��■ -�� Date: a�! �l/Zdly 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 lake"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 and non-transf ble resp si "ty#er adhering to and complying with the ESA. The Applicant has read this disdanner and signs and dates it below. Signature: Date: o /7//t a(O G:\PeanitCentcr\###DORMS###\DRD FORMS\Master Pemst Application 5-29-08.doc 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: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER:FR: PHOta: `18371 FAX: ✓a-AJ; KA--,�k4PO (36v)3o1-32:0 ( ) MAILING ADDRESS: Zd Lt • CONTRACTOR'S LICENSE rkccv.. Creak n�,I. ... Q. r vi E AIL K i I,g C 4. t1•c-(. C c r-r NUMBER: GC. 01 �K L Ol,) * 1 0 i b L NUMBER ARCHrTECT/ENGINEER: PPSS 377 I O 2 i �r� �t?5t�►1, �a $aT l,,y� 11 PHONE (360) / l 6 FAx:( ) MAILING ADDRESS: G)3 O N E �,`1d�1\/ikt 11 g C P her4On W� (�o e S i I,, Project Type: Framer MMM� I E nit d'l u rl l fan C./1 e New yam' Bathrvpms: Shoreline: Type of Sewage isposal: Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: 0 H ht: jlndividual System CI Repair ❑ Mason IN R SEP Permit# ❑ Demolition U Other. Bedrooms: Water Supply: Existing: Setback: ❑ Private well ❑ Two Party Type of Het: Proposed: }.� Public thIll tfeA Total: ---F-- I `A Name of System: If this is a Commercial Project you must answer the following: Number of Parking Spaces: Current Proposed_ NtmberofADA Parking Spaces: Number of occupants(includes owners,tenants,employees,etc) Current Proposed IBC Occupancy: IBC Type of construction: Will you have Food Service? Yes / No If this is a Propane Tank and/or Appliance Installation permit.mark all items below that apply: I Underground Tank I Above ground Tank Size of Propane Tank I Heat Stove I Cook Stove I Woodstove I Fireplace Insert i Hot Water Tank T Pellet Stove I Other Is this appliance being installed in a Manufactured/Mobile Home? Yes / No When applying for a permit to install a propane tank you must also submit a site plan showing all of the buildings,all property lines,tank location and size,distances from the propane tank to all property lines,buildings a tem com nents including the reserve area. IS po •uare Foota.e Current " Fy E a ' Main Floor Heated _$` } E B Rz =", f t. .� �� EH Bkf App Review: 2 "'mss`�` 2M1°Floor Heated� _ Consistency Review 7 J.v O I � �, .A' / Other Heated "' '*. ' 8ase fee: 2`c:15 .'15 rlt-I ' O l Mezzanine :: Additional Section: Heated Basement 3 Plan Check fee: J . ,- COa3 . 19 7�.. Unheated Basement fate Surduarge fee: `u. 1 ' 24^47' .. ''�_,.,- V Other Unheated trr t - = Pot Water Review fee: • �€ ► ' ` 03 Garage/carport � .d SUBTOTAL Decks ._ I• � / ,z1 911/Rd Approach fee: 0.A .-� jS- o' TOTAL: $ '1493Llrt lA° -t- R eceept Number. 1- -7-12- ; r 3x,,. Cash/Check Nmber. G. ci ESTIMATED. (REQUIRED ) Date: , - market value of all r and materials foundation to fni a0-1—[ n f 1` 5'7 , 20 Initials: ' - G:\PcmitCcnt r\###FORMS###\DAD FORMS\Master Pemut Applicn io 5.29-t .do ■ • 0 CC N- H CO CO CT LL .a 2 LL \ O I-I O CO I-I O N O -- •• CO -- O 0 4- a) — N 't 7 Z /'� t i O 0 0 C J -O 1 X X -0 -I-, (.0 C U O J I- N W 0 O 2 +-I 'O I-I CA 0) Q -• 7 - - t U f~ Q J C.) U U <C Z 0 3 15 J 0_ 0_ X 1 10 U I- I- O CD 0) a) a) Q a) _ = 0 Cr U CC I- F-- -O CV W Q C 3 1- a I- J LU CO \ O O CO O_ U J U C) U) -O 2 3 I C X - I- CL I-I 2 I` -- CC CO 3 3 >- CV C) W .- I- CO = Z CO 7 O -O CC O CO LU LU CO Q 01 C LI-I 0- 3 J W J W 0_ CO >- O CO CC J 2 O O CC - J ¢ O Q C) Q .- cc .— c W x C) CO I-I 3 CO O_ CU W m Q Q Q O O 0_ _ = F- X H C) J CU CO CO U W 7 X Q I-I I- J H W U W 'O I- M X W W O J CC U CC I- CD J Q I- W 0) 0- 2 I` I- CI CO I- J O CO X U O Q a) O O J 7 0_ O I-I LID W C) Cr J Q ++ \ U M CO CO CO CO - -F+ 0 U) O U) 7 CV LID O .- CU O C) J J CU ¢ 0) O) CO O O N O O .- .- O O O -0 L .- O .- U a) N CO 7) IT C O J a) L 3 L J C — a) O •+ a) Q a) a) 7) a) -- 7) CO S a) 0 CO a) U > CO 0 L C Cl - 0 CO 0_ C 0 (O X +, U -O X (O F- I- X 4 I- CO CO 4- X X F- Contractors or Tradespeople Peer Friendly Page Page 1 of I IP General/Specialty Contractor A business registered as a construction contractor with L&I 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 H K Construction UBI No. 601745435 Phone 3603857351 Status Active Address 241 Chimacum Creek Dr License No. HKCON"981DL Suite/Apt. License Type Construction Contractor City Port Hadlock Effective Date 3/13/2002 State Wa Expiration Date 3/13/2012 Zip 98339 Suspend Date County Jefferson 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 HKCON"087J1 H K Construction General Unused 4/21/1992 1/6/1997 Archived Construction Contractor KATSIEI033CJ Katsikapes Construction Carpentry/Framing Roofing 2/11/1997 3/12/2004 Inactive Enterprises Inc Contractor Business Owner Information Name Role Effective Date Expiration Date Katsikapes, Hazli H ' President 03/13/2002 Katsikapes, Ann Evelyn Secretary 03/13/2002 Bond Information Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date 1 CBIC SH1336 01/30/2007 Until Cancelled $12,000.0001/30/2007 Assignment of Savings Information Savings Assignment of Savings Account Number Effective Date Release Date Assignment Type Impaired Date Amount Received Date 1 20756674 1/31/1997 Until Bond 56,000.003/12/2002 Released Insurance Information Insurance Company Name Policy Number Effective Date Expiration Date Cancel Date Impaired Date Amount Received Date B CBIC C115H1336 01/30/2007 01/30/2011 51,000,000.0012/22/2009 7 UMIALIK INS CO GL1000131 02/11/2006 02/11/2007 03/28/2007 $1,000,000.0002/09/2006 AMERICAN 6 010E330767-8 02/11/2005 02/11/2006 02/11/2006 $300,000.0002/18/2005 STATES INS CO 5 AMERICAN 010E3307677 .02/11/2004 02/11/2005 5300,000.0001/27/2004 STATES INS CO Summons/Complaint Information No unsatisfied complaints on file within prior 6 year period Warrant Information No unsatisfied warrants on file within prior 6 year period https://fortress.wa.gov/lni/bbip/Print.aspx 6/2/2010 10/17/2010 17:34 3603731417 PRODESIGN PAGE 01101 10--17-10 • Q, . 2q,) 0 '04, � , i�' e 4 A°.g 4 Q6:2� • ' - / tip' sSrONAL O� ' 6x6 POST w/ SIMPSON COL BASE „.. EXPIRES 5-17--2012 C HOLD COL DOWN TO BELOW COL BASE FURNISHED HOUR BALANCE WITH FLOOR 4 #4 `BERT HOOK 12"0 OR 10" SQ IN FTG, EXTEND TO / 2" BELOW TOO'' OR SLAB SEE PLAN FOR SIZE & REINF n_ w CL ... SOIL BEARI\G SPREAD FOOTING w/CO\C CCL REVISED FOOTING SECTION FOR GYBE HO SHOP FOR PRODESIGN PLANS 52 OF 4-30-10 INTERIOR COLS. SUITABLE BEARING SOIL FOUND TO BE SEVERAL FEET BELOW SLAB ELEVATION. DETAIL IS ACCEPTABLE FOR UP TO 6' BURY HEIGHT. SEE 52 FOR FOOTING SIZE AND COL BASE CALLOUT NO TIES REQUIRED IN COLUMN. PERMIT NUMBER BL1 D-00186 DCD FAX 360-379-4451 4 IV 7/ 35, .. 11" A / 32 - 11" I v -0„ / 20' -O / /3' - 11/2" }' - 10` I- -1 I L r - - 17 I I O .. .._.� ..a ... .�.. µms,ff�. � ...a{ N '2—" ge ` v Aug I.. _ 1 rn Hh :N � // II v>>� � rn � 3 , z o � G // z T$ ® 71 to , (^1 8 c , —' z \ / Cl i ^ Q1 III -- — — -- 7 1 tA O / �t z � NO r 1— \ rfi0 ( oo-n JI v I / I � rng Az �- - - - I 7 k . US CP / II , L___I i \rt-- E / \ I 3-1 xr z irn n r u / \ m o $ rn / Z ) / ri \ A ' p (\ \ I is I . O -� 0, O j � rnis, O 3_u v d 0 2. • Ali 0 H e rn 0 rn N CQ 0 y 0 ■ + m I1Si me O a 0 CO O i -* (N m X V g 14• 14.OAi.DOOR I I I I / 4' - 111/2' / j I I I J • Jefferson County DCD Building Division Correction Notice PERMIT NUMBER JO ' 4061 S i OWNER BpGtL JOB LOCATION /4'5 Y& tyO Inspection of this structure has found the following violations: 1> �A3 5T4Lt 5i4p5 Af2 e 6.1.51 A Le- R,qu (i Pfr r cT1 ) 1ti<P14 (7 SN,,k6/Lo PZer sera es Krre J4 - AJ)Z 57-vv6" f aii eili-nZ, ,461) 0111 - ILkk (?( 14° I You are hereby notified that no more work shall be done upon these premises until the above violations are corrected, unless noted otherwise. When corrections have been made, call for inspection. Date /vf/I- Inspec BUILDING DIVISION(360)379-4450 INSPECTION HOTLINE(360)379-4455 THIS NOTICE MUST BE KEPT WITH APPROVED PLANS ON SITE ani Jefferson County Building D sion Permit Nun ': BLD10-00186 Applicant: BALL BUILDING PERMIT INSPECTION APPROVALS applicable Code: 2006 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 Setbacks Erosion Control Foundation Footing !(j`-l E1G ! , r5 Footing Drains //- Foundation Stem Wall AY-NJ_ / /("T-37 Underground Plumbing I, Ig_IU Straps(hold downs) 3/i7/14 Ext. Shear Wall Nailing 3 t I Rough-in Plumbing 3/2-7/r 4 Framing 3/2 1 I r# sLa p r e_q_ aJ T -4 1/-( 2_ Blocking 3)17//if Wallboard Nailing S1-G/_ i L-- 7 4 /9 '�' W=r ROW l /N� �ti rz�rQCZs � ; f` �9 �• Drywell/Alt Drainage Address Posted (? s la rk Ex r 7//03 /3 g ,,.('AS V cc n1` h /r 4 Sirop6(14cid o ) 3A7/1 4 X 11RP,cyS 7/1 /3 3 )3H 7//05 PP. 'r1, 5 r5"10 7/i//3 GRSCrixS & 1q j/3 IV FINAL INSPECTION h �Iiy p 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 #: BLD10-00186 Received Date: 6/1/2010 SITE ADDRESS: 155 GYBE HO Issue Date 9/20/2010 NORDLAND, 98358 Expiration Date 9/20/2011 OWNER: MICHAEL W BALL PHONE: 206-947-3003-EVA 6507 DIVISION AVE NW SEATTLE WA 98117-5142 ROBERT SPERRY SHORT PLAT SUBDIVISION: Block: Lot: PARCEL NUMBER: 921081025 Section: 8 Township: 29 N Range: 01 E CONTRACTOR: H K CONSTRUCTION PHONE: 360-385-7351 241 CHIMACUM CREEK DR PORT HADLOCK WA 98339 Contractor's License HKCON**981DL Expires 3/13/2014 PROJECT DESCRIPTION: SFR W/ATT GARAGE TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 450 VALUATION 95,000.00 ADD'L: 199 HEAT TYPE ff:ca CODE EDITION. 2006 HEAT BASE: HEAT TYPE: RADFr OCCUPANCY. R-3 UNHEATED: #OF STORIES: OCCUPANCY: CONST TYPE: 5N OTHER: 0 SHORELINE: CONST TYPE: GARAGE: 1,441 SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: 05783 Type Amount Paid By: Date: Receipt: BEDROOMS: BATHROOMS: Permit $958.75 LYK 06/01/10 117778 Exist: 0 Exist: 0 Plan Check $623.19 LYK 06/01/10 117778 Prop: 1 Prop: 1 State Building Code $4.50 LYK 06/01/10 117778 Total: 1 Total: 1 Renewal-2011 $213.00 LYK 09/27/11 128177 Permit $74.00 LYK 02/28/12 131503 Plan Check $74.00 LYK 02/28/12 131503 Potable Water Application $64.00 LYK 02/28/12 131503 Total: $2,011.44 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# :BLD10-00186 1.) The minimum daily design flow per residence is 240 GPD. Therefor this building approval accounts for 240 GPD of septic system capacity. As designed and approved septic permit SEP97-34 has a capacity for 360 gpd. An Accessory Dwelling Unit(ADU) is not allowed on this septic system. 2.) VOLUNTARY MEASURES OF COASTAL &AT RISK SIPZ: Water conservation measures: 1. Roof and other intercepted precipitation shall be routed to on-site detention ponds and/or other approved means and allowed to be released to the soil slowly. 2. Water collected from Storm water and roof catchments may be used for watering lawns and gardens. Unless catchment water has been treated to meet drinking water standards, there shall be no cross connections allowed between the potable supply and impounded water. 3. Water withdrawn from wells on each property shall not be used for watering of lawns and/or gardens. 4. Ground water withdrawn from each property shall be restricted to a rate of three (3) gallons per minute. 5. Installation of water conserving fixtures such as low flow toilets, faucets and shower restrictors and other water saving plumbing fixtures. 6. Landscaping plan (xeriscaping, native vegetation with minimal amounts of irrigation). Please NOTE that the above listed measures are not intended to be exhaustive, but rather is intended to be illustrative of the types of water conservation measures. 3.) VOLUNTARY MEASURES OF COASTAL & AT RISK SIPZ: 1. Installation of a flow meter. 2. On-going well monitoring for chloride concentration. 3. Submittal of monitoring data to County. 4.) MANDATORY MEASURES FOR COASTAL SIPZ: 1. For proof of potable water on a building permit application, applicant must utilize DOH-approved public water system if available. 2. If public water is unavailable, a qualifying alternative system may be used as proof of potable water or an individual well may be used as proof of potable water subject to the following requirement: a. Chloride concentration of a laboratory-certified well water sample submitted with building permit application. 3. If public water is unavailable, a qualifying alternative system may be used as proof of potable water. 5.) The applicant shall fully adhere to all conditions and requirements of the eagle habitat management plan. 6.) 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. 7.) A Stormwater Plan has been submitted and approved by the Department of Community Development. Once the subject permit has been issued the applicant shall fully implement the provisions of the submitted plan and contact the Jefferson County Department of Community Development to arrange a schedule to inspect the property for plan compliance. A Certificate of Occupancy will not be issued until the Department verifies plan compliance. No clearing for roadways or utilities shall occur on the project site until clearing necessary for the installation of temporary sedimentation and erosion control measures have been completed. 8.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 9.) Not more than 2 unlicensed vehicles hall be stored on any lot unless totally screened from view of neighboring dwellings and rights-of-way. Such screening shall meet all applicable performance and development standards specific to the district in which the storage is kept, and shall be in keeping with the character of the area. Screening shall meet the requirements of Chapter 18.30 JCC. Outdoor storage of 3 or more junk motor vehicles is prohibited except in those districts where specified as an automobile wrecking yard or junk (or salvage) yard and allowed as a permitted use in Table 3-1 or Chapter 18.18 JCC, and such storage shall meet the requirements of JCC 18.20.100, Automobile wrecking yards and junk (or salvage) yards. In no case, shall any such junk motor vehicles be stored in a critical area. 10.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 11.) The building height is not to exceed 35 feet. 12.) Building setback from Gybe Ho Road is no less than 20 feet. Side setbacks are no less than 5 feet. Building setback from SR 116 Flagler Road is no less than 30 feet. 13.) The potable water to serve the single family residence proposed with this revised plan is to come from the Quimper public water supply serving the parcel. The existing 2 party well on an adjacent parcel is not approved. 14.) Approval of this permit does not provide any assurance of future approvals for onsite sewage disposal on the property or use of any existing septic systems. Actions taken to date and proposed as part of this project may limit or prevent future development of an onsite sewage system. Future proposals must meet current code at the time of application. - 0 BUILDING PERMIT IP Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD10-00186 Received Date: 6/1/2010 SITE ADDRESS: 155 GYBE HO Issue Date ; 9/20/2010 NORDLAND, 98358 Expiration MM. , 0/2011 OWNER: MICHAEL W BALL ° 0 :2 -947-3003-EVA 6507 DIVISION AVE NW SEATTLE WA 98117-5142 ROBERT EI,'-I°SHORT PLAT SUBDIVISION: Lot: PARCEL NUMBER: 921081025 Section: 8 ownship: 29'• Range: 01 E 1 CONTRACTOR: H K CONSTRUCTION ,I PHONE: 360-385-7351 241 CHIMACUM CREEK DR IJ PORT HADLOCK WA 98339 Contractor's License HKCON"981 DL Expir 3/13/2012 PROJECT DESCRIPTION: NEW DETACHED GARAGE/SHOJ-V I PLUMBING STUB OUT W/ HTD WORKSHOP TYPE OF WORK GAR SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 320 VALUATION 95,000.00 ADD'L: HEAT TYPE: EEE CODE EDITION: 2006 HEAT BASE: HEAT TYPE: OCCUPANCY: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: 199 SHORELINE: � G�R A(�F: 1,441 CONST TYPE: �ECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: Type Amount Paid By: Date: Receipt: BEDROOMS: BATHROOMS: Permit $958.75 LYK 06/01/10 117778 Exist: 0 Exist: 0 Plan ck $623.19 LYK 06/01/10 117778 Prop: 0 Prop: 0 St uilding Code $4.50 LYK 06/01/10 117778 Total: 0 Total: 0 Total: $1,586.44 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# :BLD10-00186 1.) VOLUNTARY MEASURES OF COASTAL &AT RISK SIPZ: Water conservation measures: 1. Roof and other intercepted precipitation shall be routed to on-site detention ponds and/or other approved means and allowed to be released to the soil slowly. 2. Water collected from Storm water and roof catchments may be used for watering lawns and gardens. Unless catchment water has been treated to meet drinking water standards, there shall be no cross connections allowed between the potable supply and impounded water. 3. Water withdrawn from wells on each property shall not be used for watering of lawns and/or gardens. 4. Ground water withdrawn from each property shall be restricted to a rate of three (3) gallons per minute. 5. Installation of water conserving fixtures such as low flow toilets, faucets and shower restrictors and other water saving plumbing fixtures. 6. Landscaping plan (xeriscaping, native vegetation with minimal amounts of irrigation). Please NOTE that the above listed measures are not intended to be exhaustive, but rather is intended to be illustrative of the types of water conservation measures. 2.) VOLUNTARY MEASURES OF COASTAL &AT RISK SIPZ: 1. Installation of a flow meter. 2. On-going well monitoring for chloride concentration. 3. Submittal of monitoring data to County. 3.) MANDATORY MEASURES FOR COASTAL SIPZ: 1. For proof of potable water on a building permit application, applicant must utilize DOH-approved public water system if available. 2. If public water is unavailable, a qualifying alternative system may be used as proof of potable water or an individual well may be used as proof of potable water subject to the following requirement: a. Chloride concentration of a laboratory-certified well water sample submitted with building permit application. 3. If public water is unavailable, a qualifying alternative system may be used as proof of potable water. 4.) The applicant shall fully adhere to all conditions and requirements of the eagle habitat management plan. 5.) 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. 6.) A Stormwater Plan has been submitted and approved by the Department of Community Development. Once the subject permit has been issued the applicant shall fully implement the provisions of the submitted plan and contact the Jefferson County Department of Community Development to arrange a schedule to inspect the property for plan compliance. A Certificate of Occupancy will not be issued until the Department verifies plan compliance. No clearing for roadways or utilities shall occur on the project site until clearing necessary for the installation of temporary sedimentation and erosion control measures have been completed. 7.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 8.) Not more than 2 unlicensed vehS shall be stored on any lot unless totally signed ' from view of neighboring dwellings and rights-of-way. Such screening shall meet all applicable performance and development standards specific to the district in which the storage is kept, and shall be in keeping with the character of the area Screening shall meet the requirements of Chapter 18.30 JCC. Outdoor storage of 3 or more junk motor vehicles is prohibited except in those districts where specified as an automobile wrecking yard or junk (or salvage)yard and allowed as a permitted use in Table 3-1 or Chapter 18.18 JCC, and such storage shall meet the requirements of JCC 18.20.100, Automobile wrecking yards and junk (or salvage)yards. In no case, shall any such junk motor vehicles be stored in a critical area. 9.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 10.) The building height is not to exceed 35 feet. 11.) Building setback from Gybe Ho Road is no less than 20 feet. Side setbacks are no less than 5 feet. Building setback from SR 116 Flagler Road is no less than 30 feet.