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Home My WebLink AboutBLD2010-00014 'BUILDING PERMIT APPLICA•N MA e0 000 14 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: SITE ADDRESS: BLD10-00014 20 APPALOOSA PL Received Date: 1/13/2010 BRINNON, 98320 OWNER: TODD K PETERSON PHONE: 360-796-2947 JACKI V STRATTON PO BOX 430 BRINNON WA 983200430 LAZY C RANCH DIV 1 SUBDIVISION: Block: Lot: 4 PARCEL NUMBER: 966900004 Section: 34 Township: 26 N Range: 02 W CONTRACTOR: TIMBER IRON ERECTORS PHONE: 360-670-6227 DAVID RICHARDSON PO BOX 516 CARLSBORG WA 98324 Contractor's License TIMBEI952QC Expires 11/3/2009 REPRESENTATIVE: DAVID RICHARDSON PHONE: 360-670-6227 TIMBER IRON ERECTORS PO BOX 516 PROJECT DESCRIPTIOI■ NSFR REPLACEMENT ON EXISTING FOUNDATION TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 784 VALUATION 95,621.00 ADD'L: 392 HEAT TYPE: WOD CODE EDITION: 2006 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: SHORELINE: CONST TYPE: DECK: 308 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: OTHER BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 1 Prop: 1 Total: 1 TotalY :---� Routing Date: - - t3-Ib Type Amount Paid By: Date: Receipt: Approved/Date Permit $965.75 LYK 01/13/10 113642 AP®®®�, `Et Plan Check $627.74 LYK 01/13/10 113642 1� ( � V State Building Code $4.50 LYK 01/13/10 113642 AP? 5 2QWU Potable Water Application $98.00 LYK 01/13/10 113642 Total: $1,695.99 Jefferson County Plannin g &Building Department �,ON c ,, DEPARTMENT OF COMMUNITY DEVELOPMENT a 621 Sheridan Street,Port Townsend,\X'?r 98368 Tel:360.379.4450 I Fax:360.379.4451 Web:www.co.jefferson.wa.us/communitydevelopment �-q Ok E-mail: dcdaco.jefferson.wa.us SfI1 NCI' , CERTIFICATE OF OCCUPANCY PERMIT#: BLD10-00014 APPLICANT: JACKI V STRATTON PHONE: 360-796-2947 20 APPALOOSA PL BRINNON WA 98320-0430 SITE ADDRESS: 20 APPALOOSA PL Issue Date: 04/5/2010 BRINNON, 98320 Final Date: 9/23/2015 SUBDIVISION: 9669- LAZY C RANCH Block: Lot: PARCEL NUMBER: 966900004 Section: 34 Township: 26 N Range: 2W PROJECT DESCRIPTION: NSFR REPLACEMENT ON EXISTING FOUNDATION 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 THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 9/23/2015 \\tidemark\data\forms\F_B LD_Occupancy.rpt 10/1/2015 .c,goN e `, °G. DEPARTMENT OF COMMUNITY DEVELOPMENT ,.^ 621 Sheridan Street,Port Townsend,WA 98368 Tel:360.379.4450 I Fax:360.379.4451 /� 101ethb. Web:www.co.jef ferson.wa.us/communitydevelopment '16'F/I N 0' E-mail:dcd@co.iefferson.wa.us 20 Appaloosa PI., Brinnon mot_ f y 7.:,1. , i Ili .t y i �t -. ,.71' ! a w . "�` . .. i II : .. II • ._ - . 111111a,.. 4'4.,; Ili • k�4sON roG JEFFERSON COUNTY A DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street I Port Townsend,WA 98368 I Web: www.co.jefferson.wa.us/communitydevelopment qsx o Tel:360.379.4450 I Fax:360.379.4451 I Email:dcd @co.jefferson.wa.us Building Permits&Inspections/Development Consistency Review/Long Range Planning J Watershed Stewardship Resource Center TODD K PETERSON PO BOX 430 BRINNON RE: Building Permit No. BLD10-00014 Dear TODD K PETERSON, It has come to our attention that your building permit No. BLD10-00014 has been expired since . As you may know, our department offers renewal of building permits for an annual fee of: $228. Once your permit is renewed, you are again eligible to receive County inspections with the goal of completing the building review process over a one-year time period. As of January 1, 2013, if your permit is less than five years old, additional renewals may be approved. Any permits older than five years must have their work finalized by our inspectors one year from your renewal date, or your permit will be cancelled. Having your building receive and pass all of its required inspections is valuable to you as it is your assurance that your building meets adopted standards for quality and safety. Additionally, having documentation that your building has passed required inspections may be required from lenders or buyers if you ever decide to sell or re-finance your building. To take advantage of this renewal, we must receive your full payment of$228 by May 31, 2013. Please make your check or money order payable to: Jefferson County DCD and include your building permit number on your check. You may also pay at our office with check, money order, cash, or credit card. http://www.co.jefferson.wa.us/commdevelopment/Credit%20Card.htm This is the only notice you will receive. If we do not receive your full payment by the due date, your permit will be cancelled. Once cancelled, if you later decide to renew your permit, you will have to apply for an entirely new building permit, pay all associated fees, and comply with current building and zoning code requirements. In the event that your building permit is cancelled and your construction is not finalized by the building inspectors, the County may choose to record a "Notice to Title" on the property, to document the property is out of compliance with the County's development codes. If you have any questions about this offer, you may call our office at: (360) 379-4450 and ask for a Permit Technician. I hope you will take advantage of this offer! Sincerely, �� // Carl Smith, Director 130N c- JEFFERSON COUNTY �4w °� DEPARTMENT O 621 Sheridan 5treei� Pori Townsend,F WA 983681 Web: www.clo.lefferson.wa.us/comLmunitydevelopment Tel:360.379.4450 Fax:360.379.4451 Email:dcd@co.iefferson.wa.us 16.4, N 66) Building Permits&Inspections 1 Development Consistency Review Long Range Planning J Watershed Stewardship Resource Center RESIDENTIAL FINAL INSPECTION LIST, INCLUDING BUT NOT LIMITED TO: ➢ One complete and operational bathroom; All bathroom fans and whole house fans must be operational. Y The cooking appliances and hood fan to be installed and operational. ➢ Fan in laundry room to be installed and operational. ➢ Sheetrock must be taped and sealed. ➢ All plumbing lines must be in and approved; Hot and cold on correct sides; Dishwasher to be provided with air gap. ➢ Septic system to be finaled by Environmental Health Department. ➢ Heating system must be operational. ➢ All electrical outlets must be covered. No exposed wires. ➢ Stairways and decks must be equipped with handrails and guardrails. ➢ Smoke detectors must be operational and interconnected. ➢ Drainage system must be operational with downspouts tightlined in. (unless approved alternate method is to be used). ➢ Siding must be on and painted if not treated. ➢ Garage door must be installed. ➢ 911 placard (address) must be posted. Y Manuals must be available with permanent appliances. Y Waterlines in unheated spaces must be insulated. ➢ Hotwater pressure relief valve vented to exterior with elbow pointed down at end. ➢ Firewall between house and garage with 20 minute rated door. ➢ Any holes in firewall/sheetrock where pipes, wires or ducting penetrate are to be sealed with approved materials. Y Crawl space and attic access sealed with weather stripping and insulated. Y Attic access in garage must be fire rated. ➢ Provide insulation certificate verifying R-values. ➢ Exterior doors must be tight fitting and threshold checked for airleaks. ➢ All glass in hazardous locations must be tempered. Masonry fireplaces must have glass doors installed. err,soN co JEFFERSON COUNTY ° DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street I Port Townsend,WA 98368 I Web:www.co.Jefferson.wa.us/communitvdevelopment ySxro Tel:360.379.4450 I Fax:360.379.4451 I Email:dcd@co.jefferson.wa.us Building Permits&Inspections/Development Consistency Review/Long Range Planning/Watershed Stewardship Resource Center July 17, 2013 TODD K PETERSON AND JACKI V STRATTON PO BOX 430 BRINNON WA, 98320-0430 RE: Building Permit No. BLD10-00014 Dear TODD K PETERSON AND JACKI V STRATTON, It has come to our attention that your building permit No. BLD10-00014 has been expired since 4/5/2010. As you may know, our department offers renewal of building permits for an annual fee of: $228. These annual fees owed accumulate each year. Since your permit has been expired since 4/5/2010, your total renewal fees owed are: $222. However, to encourage you to renew your permit and continue with required inspections of your building, our Department is offering to renew your permit for the single-year amount of$228. Once your permit is renewed, you are again eligible to receive County inspections with the goal of completing the building review process over a one-year time period. Having your building receive and pass all of its required inspections is valuable to you as it is your assurance that your building meets adopted standards for quality and safety. Additionally, having documentation that your building has passed required inspections may be required from lenders or buyers if you ever decide to sell or re-finance your building. The reverse side of this letter lists the typical items required for a final inspection approval. To take advantage of this offer, we must receive your full payment of$228 by March 30, 2013. Please make your check or money order payable to: Jefferson County DCD and include your building permit number on your check. You may also pay at our office with check, money order, cash, or credit card. http://www.co.jefferson.wa.us/commdevelopment/Credit%20Card.htm This is the only notice you will receive. If we do not receive your full payment by the due date, your permit will be cancelled. Once cancelled, if you later decide to renew your permit, you will have to apply for an entirely new building permit, pay all associated fees, and comply with current building and zoning code requirements. In the event that your building permit is cancelled and your construction is not finalized by the building inspectors, the County may choose to record a "Notice to Title" on the property, to document the property is out of compliance with the County's development codes. If you have any questions about this offer, you may call our office at: (360) 379-4450 and ask for Permit Technician Lisa Keller. I hope you will take advantage of this offer! Sincerely, �► Carl Smith, Director „sox JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street I Port Townsend,WA 98368 I Web:www.co.jefferson.wa.us/communitydevelopment �qso Tel:360.379.4450 I Fax: 360.379.4451 I Email:dcd@co.jefferson.wa.us Building Permits&Inspections/Development Consistency Review Long Range Planning I Watershed Stewardship Resource Center RESIDENTIAL FINAL INSPECTION LIST, INCLUDING BUT NOT LIMITED TO: D. One complete and operational bathroom; All bathroom fans and whole house fans must be operational. D. The cooking appliances and hood fan to be installed and operational. ➢ Fan in laundry room to be installed and operational. ➢ Sheetrock must be taped and sealed. ➢ All plumbing lines must be in and approved; Hot and cold on correct sides; Dishwasher to be provided with air gap. ➢ Septic system to be finaled by Environmental Health Department. ➢ Heating system must be operational. ➢ All electrical outlets must be covered. No exposed wires. ➢ Stairways and decks must be equipped with handrails and guardrails. ➢ Smoke detectors must be operational and interconnected. ➢ Drainage system must be operational with downspouts tightlined in. (unless approved alternate method is to be used). ➢ Siding must be on and painted if not treated. ➢ Garage door must be installed. ➢ 911 placard (address) must be posted. ➢ Manuals must be available with permanent appliances. D. Waterlines in unheated spaces must be insulated. ➢ Hotwater pressure relief valve vented to exterior with elbow pointed down at end. ➢ Firewall between house and garage with 20 minute rated door. ➢ Any holes in firewall/sheetrock where pipes, wires or ducting penetrate are to be sealed with approved materials. ➢ Crawl space and attic access sealed with weather stripping and insulated. ➢ Attic access in garage must be fire rated. ➢ Provide insulation certificate verifying R-values. ➢ Exterior doors must be tight fitting and threshold checked for airleaks. D. All glass in hazardous locations must be tempered. ➢ Masonry fireplaces must have glass doors installed. I e 'c c. DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street,Port Townsend,W-' 98368 Tel:360379.4450 I Fax:360 379.4451 ty Web:www.co.jefferson.wa.us/community development 9SF7/N�ytO E-mail.dcd@co.jefferson.wa.us May 20, 2015 TODD K PETERSON JACKI V STRATTON 20 APPALOOSA PLACE BRINNON WA 98320 RE: BLD10-00014 for a new single family residence on existing foundation at 20 Appaloosa Dr Dear Mr. Peterson and Ms. Stratton: It has come to our attention that the above-named permit expired on April 5, 2015 and did not received final inspection. Please submit payment for a 6-month renewal in the amount of$117 along with a letter pursuant to JCC 15.05.060 (4) providing justifiable cause for extension prior to June 19, 2015. After approval of renewal, your permit will be required to receive final inspection prior to October 5, 2015.To schedule an inspection, please contact our inspection hotline at 360-379-4455 and have your approved permit and plans available on-site. Failure to comply with the above requirements will result in your permit being cancelled. Should your permit be cancelled, in order to receive final inspection, you will need to reapply for a new building permit, new permit fees, and construct the building to current code. Please be aware that occupancy of the single family residence is not authorized prior to final inspection. We look forward to assisting you in completing your building inspections. Sincerely, £LWLL ,rvt2 Elizabeth Williams, Administrative Clerk Sent by USPS Certified Mail:7014 0510 0002 0498 2519 SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY • Complete items 1,2,and 3.Also complete A. Si ture . _8 r item 4 if Restricted Delivery is desired. X (/ Q -� Et • Print your name and address on the reverse 1J El A re .ee so that we can return the card to you. B. Received by(Printed N me) 'G._-.Date`of D-every • Attach this card to the back of the mailpiece, ( C..� cY� �t(„ .: or on the front if space permits. V �t )l TTT"A Ic D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES -r - •-' __ - '• ToaA �elea-�on r� E c E oV JacAe �S�+rra�� ; , I g.0 ap.pa1 U l-La & 3. S rvice Type `—•••-- g r;n \I ' UON ci g 3 Certified Mail® ❑Priority Mail Tpt f ' Regi I ipt for Merchandise ❑ Insured Mail Coli1/4ctp`n R y6ry:r 4. kestcioted-Delivery?-(ExhaJ- -LIT-es 2. Article Number 7014 0510 0002 0498 2519 (Transfer from service label PS Form 3811,July 2013 Domestic Return Receipt U.S. Postal Service,. CETIFIED MAIL RECEIPT g.. (Domestic Mail Only;No Insurance Coverage Provided) inFor delivery information visit our website at www.usps.come ru ,t"taa qt 1 # E r4.` •sl' a• 47",t, , S es co E' Postage $ ° Certified Fee Postmark ° Return Receipt Fee Here ° (Endorsement Required) ° rc ted Delivery Fee - (Endorsement Required) L7 Total Postage&Fees ° Sent To r R Street,Apt No.; p or PO Box No. rN- City,State,ZIP+4 PS Form 3800,August 2006 See Reverse for Instructions JEFFERSON COUNTY NO. 15 257 .s DATE /RECEIVED FROM Jade). S7lizt--/�� DESCRIPTION BARS# y •AAMM�/OUNT CURRENCY /`l/1 /� Ai fAl r J / o 00 COIN �YAL�/LT / C ga OW/ r J/18 ,¢J- RECEIVED BY 4 10-14"24---) TOTAL / • Bw10-- Cl4 01--e-Ate ail/re t„,191ait, ./1._ a deti .1,0-/- .42,66/-caL .261-e-- 6-1-zade-L, /a-e---"ise---/6 42a,fite , 44- JW d , a 63 ,/- el c--iltijz-r -k AaJ ,0,-v--4. a i(di ci-kd wa,EL/L-, - -/Lt re2-7- 4 cd-- v--4( 'Ll/K--, •- ,er, a} `--/I-t: 4 ti. 1.i.) ey-bca Z,e)--2 e -4 Le (#5L-g-e- 6,z_i/ p10 ' "" p lea,,az g6,6, --jiuz.jite `-fij 4 - in - r a t ri-VAP F 0 VET i r'! � J��1i9 ��1� +ll � . , , , ,„ JEFFERSON COUNTY __,OFPL OF COMMUNITY DEVELOPM, _ f a ,n. W JYvl { 'aoHa. ON ' € Cii c) _ . ,. Date (Z.-- OD received "l% � -8---m ! pm Mon. Tues. Wed./- Thur. - Fri. BLD: till I t 9 f Date: 12 -G OWNER: 4(c't_C CAA— Contact Name: ADDRESS: 20 At D c as. Contact Number:360 "IC-4,, j 7 206 Notes: 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 _ Past Hole _ Ventilation Appliance Underfloor Gas/wood stove! Man-Homes Setbacks ^ Insulation Final Inspection Foundation _ Block&Tie _ floor _wall_ ceiling Address Posted JEFFERSON COUNTY 11C'0 No. 148496 j� DATE 5-� � -/ RECEIVED FROM C JU AI4; Shy// "V DESCRIPTION BARSN AMOUNT 4 CURRENCY 4, / zY1 COIN //// ( ' IKS 6 L-ta /7 -I /25`' O n O v RECEIVED BY TOTAL (L X SP AA 1 ---#71,r-C/ rsvviyt+ ' 3/■■•7 eq . 1 i V ` .. . ..�. .. ! , �, ■_ ._ 1 of e -----1--C-- -- `'- ' .. ; 1 l 9/YY7 in' 1S/rS,`31�t�%It „ ,,,.;. . _i__ _ ___ _ , _... Z2 O 4 .... , Z I _ '. gcaa P r t o GYM. ��,�,,II 0uj Ct - k ) 0_-I i` -,► Ittij 12 wo- re 4� =u 4L--P• C: -t= -1/- - , I 3. ' i i ' A g i J. 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JEFFERSOI)UNTY I 'IAA DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street • Port Townsend •Washington 98368 • 360/379-4450 • 360/379-4451 Fax i Zinc /- ' „p wow.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: iO 4 Pro De tion(include separate sheets as necessary): Tax Parcel Number. q 6( ( ((,j')(`/ r________ Property Size: (acres/square feet) Site Address and/or Directions to Property: _ p i�1- Se co ej A ' rK�St Nlac�- i2,r, t,npf l� ( ryC,7l4 C i �� r t`} om4�0 Property Ownsr(a)of Record: far kA S1ra 0'- -4 Toc Pe-E-E.re‹hn _t 1 Telephone: '`.-2):1--.CS lo ()iJ 1 Fax email: i y nA 024 CC P �{!lt h(Q.0-fir R'`,J”" Mailing Address: Per L•13t t')et(\nc.. ,✓ 4 '"iEE3aO ApplicantlAgent(if different from owner): �)• '" {-mkt ac)Ccnra Telephone: (01C)40CL1 Fax: email: Mailing Address: What kind of Permit?(Check each box that applies ❑Building ❑Critical Areas Stewardship Plan Demolition Permit ❑Variance(Minor,Major or Reasonable Economic Use) Ccit Ingle Family ❑Garage Attached/Detached ❑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 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 ❑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: R I G DESIGNATION OF AGENT I hereby designate l�4 tie IC&Y J n to act as my agent in matters relating to this application for permit(s). r' OWNER SIGNATURE -,;,Le .-------3 Date: / 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. Staff's access and right of entry will be assumed unless the applicant informs the County in writing at the time of the apps cati h '- she wants prior notice. Signature: .r- ' � Date:, -/ /.0 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 and non-transferable adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: ,44,-,k tc o __�- Date: , G:\PermCe itnter\###FORMS###\DRD FORMS\Master Pam it Application 5-29-08.doc `�C • BUILDER STATEMENT 0 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: ',7(-'444,-�ltaCZ, Date. - GENERAL CONTRACTOR OR MANUFACTURED HOME IN TALLER: PHONE: FAX: 7/1 E 140 N -X r /0/1's (3(0) O C'.0 7 (340) 6(3— ?NI MAILING ADDR of Po do y.,_ sip G R l S jjpµ tai, EMAIL: 'l`ERE C (o J 'M)-,:c. t COIN{ CONTRACTOR'e LICENSE TT „ ,,,� WAINS NUMBER: ` +�+/16 t� S. Q ( NUMBER c� ARCHITECT/ENGINEER: f^ l ' PHONE (40S) ycl�-/.t FAX:(6—) I/7 W. !,l/ MAILING ADDRESS: P o 3 0 X 30 K l 4 4 spi 5 'o/ 'f EMAIL Project Type: Frame Type: Bathrooms: rP Shoreline: Type of Sewage Disposal: M New p Wood Existing: -10-Sewer El Addition ❑ Steel Proposed: 7 Bank ❑ Community System ❑ Alteration/Remodel ❑ Concrete Total: 1 v,� Height: V Individual System ❑ Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well ❑ Two Party Type of Heat: Proposed: t! ❑ Public Total: l Name of System: v/off E�Y 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 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 I 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 properly lines,tank location and size,distances from the propane tank to all property lines,buildings and septic system components, includin• the reserve area. S• are Foo- !e .: _. x 4,a 4:0 "0 : `T r Main Floor Heated 76fti EH Bid App Review:• Ze Floor Heated 3 (eats. ,R- q+tax1 x t 5 Consistency Review. I 5.00 Other Heated • , Base fee: 1 .i — Mezzanine '([ ' - Additional Section: Heated Basement -1 Plan Check fee: to3r1 14 Unheated Basement a,' : State Surcharge fee: - 0Re 4-Sd Other Unheated Pot Water Review fee: cx') Garage/Carport SUBTOTAL �a�i— n^ -u ' �`1 Decks 11/Rd Approach fee: D D.: Other ,t , . a�a TOTAL $POI• i:17, Receipt Number. ` l3(c42 Cash/Check Number �A.{4 l 11 I ESTIMATED COST(REQUIRED) Date: .Fair -rket value of all labor and materials . . . --r, o`�s_�_ • GAPem itCenter\###FORMS###\DRJ FORMS\Master Permit Application S-29-08.doc r lb • CC 1- H a) _ 0 LL Z W � _O H O 1- J O LO J .. .. N \ W [U — CF .— O Y CU —,-- O O O L co z O = +I CA Z 1 -0 U O 0 = H W O O CO ++ "O H O CO I 7 L L L CO ici ¢ -O 0 U CJ W Z O CC J CL CL �. 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E.T-, , .1 c-r 1 ‘e;,,er. --y.,_ , fl, I 1 a:V" mss- I 7( 1; o - . su a� q `3. _. ii, .) e_ oti ,..r., .,-... , � a ili. . --4"r.- -`'ik i I V' 4_ - - ._ t I , ,1 i Fcci Ran 1 1 i... ,_____ _____ ._, ____ .. `' _∎∎0 014 v \ '' . `? ' Troo N .0 lir / l ,L s e- i - , 1 ,. . -- o I '' 1 • f L.er y 4 : -44t LAz. `c` fa-A�' '"� s E . f '-I Lk ReAtmeel.uvv tn- y Airs.e. 5-013 0074'5,' piksAA .- an se,Lxirr, 14, --wok Zc. -tea VO-11760: . Untitled Page Page 1 of 2 • • General/Specialty Contractor A business registered as a construction contractor with Lai 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 TIMBER IRON UBI No. 600567825 ERECTORS Phone 3606706227 Status ACTIVE Address P 0 BOX 516 License No. TIMBEIE952QC Suite/Apt. License Type CONSTRUCTION CONTRACTOR City CARLSBORG Effective Date 11/3/2005 State WA Expiration 11/3/2011 Date Zip 98324 Suspend Date County CLALLAM Specialty 1 GENERAL Business Type Individual Specialty 2 UNUSED Parent Company Business Owner Information Name Role Effective Date Expiration Date RICHARDSON, DAVID P OWNER 11/03/2005 Bond Information 3 and Bond Effective Expiration Cancel Impaired Bond Received Bond Company Account Date Date Date Date Amount Date Name Number AMERICAN Until 3 CONTRACTORS 100034033 10/31/2007 Cancelled $12,000.00 10/03/2007 INDEM CO 2 PLATTE RIVER 41090028 10/31/2006 Until 12/18/2007 $12,000.00 11/01/2006 INS CO Cancelled ACCREDITED Until 1 SURETY a CAS 10042939 10/31/2005 Cancelled 11/04/2006 $12,000.0011/03/2005 CO Insurance Information Insurance Company Policy Effective Expiration Cancel Impaired Amount Received Name Number Date Date Date Date Date UNDERWRITERS https://fortress.wa.gov/lni/bbip/Detail.aspx 1/13/2010 Untitled Page Page 2 of 2 • • 5 AT LLOYDS PFK042754 10/31/2009 10/31/2010 $300,000.0010/13/2009 4 UNDERWRITERS PFK040386 10/31/200810/31/2009 $300,000.00 10/28/2008 AT LLOYDS 3 UNDERWRITERS PFK037934 10/31/200710/31/2008 $300,000.00 10/19/2007 AT LLOYDS 2 UNDERWRITERS PFK034221 10/31/2006 10/31/2007 $300,000.00 10/26/2006 AT LLOYDS 1 UNDERWRITERS PFK029909 10/31/200510/31/2006 :$300,000.0011/03/2005' AT LLOYDS https://fortress.wa.gov/lni/bbip/Detail.aspx 1/13/2010 P • onLA to--4 A V LDR dr-,.-r ljS� JEFFERSON COUNTY PERMIT CENTER APPLICANT NAME II Drid CQ j2.tsOf e M'ID PHONE: 34:040-10-10357 SITE ADDRESS: ApaD` L - DATE: I- (3-10 nncn r HEALTH APPROVAL 0,. 7P PERMIT # SEP 82-I L45 WATE- FOOD SERVICE 2. SHORELINE BANK HEIGHT SETBACK 3. FLOOD ZONE 4. FOREST PRACTICE APP (CLASS ) 5. PLANNING APPROVAL 4 •ERITICAL AREA REVIEW . ZONING 8. HEIGHT 9. LOT COVERAGE 10. ADDRESS 11. FEE NTRACTOR'S LICENSE 4 ERGY SHEET 14. BOND HOLDER/LENDER 15. NTT 16. SETBACKS 17. PROVIDE WA STATE ENGINEER STAMP/ARCHITECT'S STAMP 18. STORMWATER SITE PLAN 19. D.O.T. ACCESS APPROVAL 2¢ FIRE FLOW FOR COMMERCIAL STRUCTURES OCCUPANCY: 4 ..r N REVIEW �j�97C� �7%f� C9(/ TYPE OF CONST: 23. EXPOSURE: 24. WIND: 25. SNOW: 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 3 . 37. 38. 39. H'.\HOMEIP LNCNTRIIN FO B LGIBLBCKLIS12/2000 Jefferson County Building Divi. Permit NumberiLD10-00014 Applicant: PETERSON 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 TZ-k Erosion Control Foundation Footing �QZr0-e(12_,) fl Footing Drains Foundation Stem Wall Underground Plumbing Under Floor Framing Straps(hold downs) Ext. Shear Wall Nailing f 47-70 Rough-in Plumbing 0 Framing 7 l.■q 11D FAN Blocking Y FL( iro Airseal I t �o ,,t /_% Insulation:Walls - _Z A O Insulation: Floors Insulation: Ceiling Int. Shear Wall Nailing Wallboard Nailing Ci --"1„0-10 Gas Line: Interior 0 ✓/1 Gas Line: Exterior Propane Tank Heat/Chimney Clearance Drywell/Alt Drainage Address Posted g ra is- FINAL INSPECTION (41.-31(y 1)3._ 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 #: BLD10-00014 Received Date: 1/13/2010 SITE ADDRESS: 20 APPALOOSA PL Issue Date 4/5/2010 BRINNON, 98320 Expiration Date 4/5/2011 OWNER: TODD K PETERSON PHONE: 360-796-2947 JACKI V STRATTON PO BOX 430 BRINNON WA 983200430 LAZY C RANCH DIV 1 SUBDIVISION: Block: Lot: 4 PARCEL NUMBER: 966900004 Section: 34 Township: 26 N Range: 02 W CONTRACTOR: TIMBER IRON ERECTORS PHONE: 360-670-6227 Tiered DAVID RICHARDSON PO BOX 516 CARLSBORG WA 98324 Contractor's License TIMBEI952QC Expires 12/3/2010 PROJECT DESCRIPTION: NSFR REPLACEMENT ON EXISTING FOUNDATION TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 784 VALUATION 95,621.00 ADD'L: 392 HEAT TYPE: WOD CODE EDITION. 2006 HEAT BASE: HEAT TYPE: OCCUPANCY. R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: SHORELINE: CONST TYPE: SETBACK: DECK: 308 BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: OTHER Type Amount Paid By: Date: Receipt: BEDROOMS: BATHROOMS: Permit $965.75 LYK 01/13/10 113642 Exist: 0 Exist: 0 Plan Check $627.74 LYK 01/13/10 113642 Prop: 1 Prop: 1 State Building Code $4.50 LYK 01/13/10 113642 Total: 1 Total: 1 Potable Water Application $98.00 LYK 01/13/10 113642 Total: $1,695.99 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# :BLD10-00014 1.) THE WATER LINE MUST BE RE-ROUTED 10 OR MORE FEET FROM THE EXISTING SEPTIC TANK AS SHOWN ON PLOT PLAN.. VERIFICATION REQUIRED... call 360-385-9444 48hr in advance to arrange inspection. 2.) NEW HOME MUST BE 10 FEET FROM DRAINFIELD EDGE OR 11.5 FEET FROM THE 4" LATER PIPE THAT HAS BEEN LOCATED 3.) 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. 4.) The project shall comply with Construction Stormwater Pollution Prevention (SWPP) Elements#1 through#12 of the Department of Ecology's Stormwater Management Manual for Western Washington 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.