HomeMy WebLinkAboutBLD2013-00029 110
BUILDING PERMIT APPLI•ION MLA13-60019
Review Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD13-00029 Received Date: 1/24/2013
SITE ADDRESS: 20 HERON RD
PORT LUDLOW, 98365
OWNER: DONALD S CLARK PHONE:
ANITAJ CLARK
20 HERON RD
PORT LUDLOW WA 98365-9300 LUDLOW BAY VILLAGE
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 968600023 Section: 16 Township: 28 N Range: 01 E
CONTRACTOR: WARREN ENTERPRISES PHONE: 360-871-9388
PO BOX 626
CHIMACUM WA 98325
Contractor's License WARREE*947BR Expires 2/13/2014
REPRESENTATIVE: MICHAEL WARREN PHONE: 360-981-9388
PO BOX 626
CHIMACUM WA 98325
PROJECT DESCRIPTIOI DECK ADDITION
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP DEK MAIN:
VALUATION 650.00 ADD'L: HEAT TYPE: UH
CODE EDITION: 2009 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: GARAGE: SHORELINE:
CONST TYPE: DECK: 20 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL:
WATER SYSTEM:
BEDROOMS: BATHROOMS:
Exist: Exist:
Prop: Pro
Total: otal:
Routing Date:
Type Amount Pai• = Date: Receipt: Approved/Date
Permit $152.00 LYK 01/24/13 139934 APPROVED
Plan Check $98.80 LYK 01/24/13 139934
State Building Code $4.50 LYK 01/24/13 139934 MAR 2 8 2013
Total: $255.30 Jefferson County DCD
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JEFFERSON COUNTY
' DEPARTMENT OF COMMUNITY DEVELOPMENT
i- `4 621 Sheridan Street • Port Townsend • Washington 98368
360/379-4450 • 360/379-4451 Fax
4' Q'. www.cojefferson.wa.us/commdevelopment
�ZIN q
Master Permit Application MLA: t t
Project Desciption(include separate sheets as necessary):
T1 -/Vc uh on
Tax Parcel Number: C-i(oWncyz-,Q:213 Property Size: '3 r 5 e)1 •51-i (acres/square feet)
Site Address and/or Directions to Property:
" ed. P .
Property Owner(s)of Record: PDe1\1 C'.1_AAe <
Telephone: iss/tq Fax: IS/yr email: N
Mailing Address: t7•b• 3 016 fat.
Applicant/Agent(if different from owner): i r o\ t 3 Ckt-r to
Telephone: (3(0(3, 4 iS i --9 3 $$ Fax: email: tWi Wct'relA tg(oba,
Mailing Address: i? . 13c (,24 Ch;tMncrumt W Or G$325 live-- ccrw
What kind of Permit? (Check each box that applies ❑ Lot or Road Segregation
building ❑ 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 0 Discretionary"D"or Unnamed Use Classification
I 0 Commercial* ❑Special Use(Essential Public Facilities)`*
0 Change of Use El Boundary Line Adjustment
El Address 0 Road Approach 0 Short Plat**
❑ Home Business ❑Cottage Industry ❑Binding Site Plan * ^� I LG
❑Propane 0 Long Plat*e \`
I , (///'���-� I /J --�
El Sign - • 0 Planned Rural Re'siyientlal-Developrri=• -J-/=c 7: „ments**
❑Allowed"Yes" Use Consistency Analysis ❑ Plat Vacation/Alt riation'* ii j I
❑Stormwater Management ❑ Shoreline Master Program ExeTption/Per, 11,,Revisio s"*
❑Site Plan Approval Advance Determination(SPAAD)* 0 Shoreline Manage ment' Subbfthtia (D4vel' ritent''t
❑Temporary Use ❑Shoreline Management Variance ) !� 1
❑Wireless Telecommunication* ❑Comprehensive Plan/UbefEend-Use-District Men a dment
❑ Forest Practices Act/Release of Six-Year Moratorium 0 Jefferson County Shornel(4e(> aJt #tr6glsiWt Amendme t
*May require a Pre-Application Conference ❑Tree Vegetation'RequestNP Ct'mMUN1n DPVELOPMENT
**Requires a Pre-Application Conference
Please identify any other local,state or federal permits required for this proposal, if known:
•
n DESIGNATION OF AGENT
I hereby designate 1 r li I /�/ ' • to act as my agent in matters relating to this application for permit(s).
\\OWNER SIGNATURE -' t .ii Date: 1 — 7.:4 - 7_v13 --
✓ :uu irnn•
rr F.
By signing this application for, • e 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 feel ' ed la r inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the ap•,Irp••, ' Jth-/ e • e wants prior notice.
Signature: (//r it i/! Date: 1 2_' ' 2_013
/p IVr'
The action • .• i. 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 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)eve, if ou are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual
and non-trans • :•t.,espo sibility for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below.
Signature: ,/ � / Date: I — Z`f — ? r3
t i'
Y • f
• •
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: PHCNE: FAX:
ft (C.:0\teSp>Zs ( ) ( )
MAILING ADDRESS: EMAIL:
CONTRACTOR'S LICENSE WAINS
NUMBER: NUMBER
ARCHITECT/ENGINEER: PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
New ❑ Wood Existing: C. Sewer
Addition C Steel Proposed: Bank ❑ Community System
C Alteration/Remodel C Concrete Total: _ Height: 0 Individual System
o Repair C Masonry SEP Permit# _
Bedrooms: Water Supply:
Demolition Other: Existing: Setback: Pp Y
0 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 Propane Tank and/or Appliance Installation permit,mark all items below that apply:
j Underground Tank I Above ground Tank Size of Propane Tank:
1 Heat Stove I Cook Stove I Woodstove j Fireplace Insert I Hot Water Tank I Pellet Stove 1 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 and septic system components,
including the reserve area.
Square Footage Current Proposed For Office Use Only Amount . Revision
Main Floor Heated EH Bld App Review: -------
2"°
-----2"°Floor Heated Consistency Review: ^ .r��p
Other Heated Base fee: o!v(O
Mezzanine Ajjiegal SeeNop
532,..„
Heated Basement Plan Check fee: Et)
Unheated Basement State Surcharge fee:
Other Unheated Pot Water Review fee:
Garage/Carport SUBTOTAL
Decks (30911/Rd Approach fee:
Other TOTAL: $ ( 015 3e
Receipt Number: )3 Ct Q 3c(
�_________„„ Cash/Check Number: 50
7 I
' STIMATED COST(REQUIRED) Date: �
• . .matepals foundation to finish I 1-5-. I!(
R, ,d 5 0 • ff Initials:
Contractors or Tradespeopl inter Friendly Page Page 1 of 2
General/Specialty Contractor
A business registered as a construction contractor with LEI 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 WARREN ENTERPRISES UBI No. 601736829
Phone 3609819388 Status Active
Address P 0 Box 626 License No. WARREE*947BR
Suite/Apt. License Type Construction Contractor
City Chimacum Effective Date 1/19/2006
State WA Expiration Date 2/13/2014
Zip 98325 Suspend Date
County Jefferson Specialty 1 General
Business Type Individual Specialty 2 Unused
Parent Company
Other Associated Licenses
Specialty Specialty Effective Expiration
Status
License Name Type 1 2 Date Date
WARREE*000PW WARREN Construction ENTERPRISES Contractor General Unused 10/16/2000 12/14/2003 Archived
Business Owner Information
Name Role Effective Date Expiration Date
WARREN,MICHAEL Owner 01/19/2006
Bond Information No records found for the previous 6 year period
Assignment of Savings Information
Savings Assignment of Savings Account Number Effective Date Release Date Assignment Type Impaired Date Amount Received Date
1 21322486 1/19/2006 Until Bond $12,000.00 1/19/2006
Released
Insurance Information
Insurance Company Name Policy Number Effective Date Expiration Date Cancel Date Impaired Date Amount Received Date
5 Omega U 5 0US002000824 04/07/2011 04/07/2013 $300,000.00 04/04/2012
Insurance Inc
4
Omega US Ins 0US002000545 04/07/2009 04/07/2011 $300,000.00 03/12/2010
CAPITOL
3 SPECIALTY INS C500337139 01/30/2008 01/30/2009 $300,000.00 02/08/2008
CORP
CAPITOL
2 SPECIALTY INS CS00337139 01/30/2007 01/30/2008 $300,000.00 02/07/2007
CORP
Summons/Complaint Information
Cause County Complaint Judgment Status Payment Paid By
09-2-00264-8 Date: 07/02/2009
Date: Date:
GROVES 8 CO INC JEFFERSON Amount: $3,585.55 Dismissed
Amount: $0.00 Amount:
InterPlead: No Savings:21322486
https://fortress.wa.gov/lni/bbip/Print.aspx 1/24/2013
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FOR INFORMATIONAL PURPOSES ONLY-
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BUILDING PERMIT
EXPIRATION NOTICE
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA
98368
(360)379-4450 FAX (360)379-4451
PERMIT#: BLD13-00029
SITE ADDRESS: 20 HERON RD Date Issued: 3/28/2013
PORT LUDLOW, WA 98365 Date Expires: 3/28/2014
APPLICANT: DONALD S CLARK
ANITA J CLARK
20 HERON RD
PORT LUDLOW WA 98365-9300
SUBDIVISION: LUDLOW BAY VILLAGE BLOCK: LOTS:
Section: 16 Township: 28N Range: 01 E
PARCEL: 968600023
According to our records, YOUR BUILDING PERMIT HAS NOT PASSED A FINAL INSPECTION
AND WILL EXPIRE ON 3/28/2014.
If you do not complete the project or renew the building permit prior to expiration, you will
need to reapply for the shoreline exemption approval and pay for permit review fees. Please
note we have a new Shoreline Master Program (SMP) approved effective February 21,
2014. Any application received after that date shall require compliance with the new SMP.
To keep your building permit active you must pay a $228 renewal fee. This will keep your
permit active for one year after the date of expiration.
If renewal fee is not paid by time of expiration, no more inspections can be performed until
received.
Please contact our office if you have any questions.
Sincerely,
Permit Technician
\\tidemark\data\forms\F_BLD_Permit_Exp_Ntc.rpt
SENDER: COMPL 2TE THIS SECTION
COMPLETE THIS SECTION ON DELIVERY
A. Sigpature ❑Agent
■ Complete items 1,2,and 3.Also complete r 1 ,�
tPrint4 if Res ',1 endDeliverydre is desired. VIl -t .(Lf"L ,I lddressee
• Print your��eand address on the reverse ,� C
so that we ca turn the card to you. eceived by/f'' e Name) I C. Dat el Y
• Attach this"dais:to the back of the mailpiece, tl n �O� l /
or on the front if space permits. D. Is delivery add ifferentfrom item 1? 0 Y s
1. Article Addressed t & an ita If YES,enter delivery address below:
Cl No
ana ..------
„':;r--) `L ui-I .-:-'1::'._11.—\\1\1.-1 1-T.-1.-1 \ 1
3. nr.•.
., 0 Prl tyiMaril Fx{5ress”` ;
ftr4- /��I /� El Reg
Mail ❑Collect on Deli' El,
(� 4. Restricted Delivery?(Extra Fee) .❑,Ys
2. Article Number 7012 3460 0001 6300 2951
(Transfer from service label)
PS Form 3811,July 2013 Domestic Return Receipt
•
UNITED STATE$ ,�STQ�,SERVICE 1 11 11 1
p First-class Mail
1� I Uos ge&Fees Paid
NC� Permit No.G-10
• Sender: Please print your name, address, and ZIP+4®in this box*
, DEPT COMMUNITY DEVELOPMENT
f l JEFFERSON COUNTY
621 SHERIDAN ST.
9SH Gl° PORT TOWNSEND, WA 98368
=i 4 :s" 21 'lijiiiH'1111'11111111"
- 1
st ,ON O
44.`c, U DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street,Port Townsend,WA 98368
Tel:360.379.4450 I Fax:360.379.4451
tp Web:www.co.jefferson.wa.us/communitydevelopment
�SkI NO- E-mail:dcd(&,co.jefferson.wa.us
FINAL NOTICE
December 12, 2014
Donald and Anita Clark
20 Heron Rd
Port Ludlow WA 98365
RE: BLD13-00029 for a deck addition at 20 Heron Rd.
Dear Mr. and Ms Clark:
It has come to our attention that the above-named permit expired on March 28, 2014 and did not
receive any inspections. Please submit your renewal payment in the amount of $228 prior to
December 31. 2014 and schedule your first inspection no later March 28, 2015.
If you do not comply with the above requirements, your building permit will be cancelled. Should your
permit be cancelled, in order to move forward with your project, you will need to reapply for new
building and shoreline permits,which will be required to adhere to the new Shoreline Master Program
and pay new permit fees.
If you have chosen not to move forward with your project, please notify our office of your decision.
Sincerely,
/ , 1/ pl,zelleie
1/�LJ
Elizab-th Williams,
Administrative Clerk
Sent by USPS Certified Mail: 7012 3460 0001 6300 2951
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gLD 3— nod
Tracking Number: 70123460000163002951
Updated Delivery Day: Wednesday, December 17, 2014
Product & Tracking Information
Postal Product: Features:
Certified Mail'"'
DATE&TIME STATUS OF ITEM LOCATION
December 17, 2014, 10:09 Delivered PORT LUDLOW,WA 98365
am
Your item was delivered at 10:09 am on December 17, 2014 in PORT LUDLOW,WA 98365.
December 17, 2014, 8:11 Out for Delivery PORT
am HADLOCK, WA 98339
December 17, 2014 , 8:01 Sorting Complete PORT
am HADLOCK, WA 98339
December 17, 2014 , 6:14 Arrived at Unit PORT
am HADLOCK, WA 98339
December 17, 2014 , 3:03 Departed USPS Facility TACOMA,WA 98413
am
December 16, 2014 , 10:05 Arrived at USPS Facility TACOMA,WA 98413
pm
https://tools.usps.com/go/TrackConfirmAction?gtc_tLabels 1=70123460000163002951 12/18/2014
Ir
,,4 ON N� JEFFERSON COUNTY
r ` DEPARTMENT OF COMMUNITY DEVELOPMENT
1sHl Nei
Date:i ,12.))4 Time Received: /O.. SS am pm Date: Mon. Wed. Thur. Fri.
BLD: Contact Name:
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Owner: gPeufk_ (� ,,� Contact Number: 360 x-37 rfq?�Address: aQ IKALJan )(,1( ^ 206
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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
11,
BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD13-00029 Received Date: 1/24/2013
SITE ADDRESS: 20 HERON RD Issue Date 3/28/2013
PORT LUDLOW, 98365 Expiration Date 3/28/2014
OWNER: DONALD S CLARK PHONE:
ANITAJ CLARK
20 HERON RD
PORT LUDLOW WA 98365-9300 LUDLOW BAY VILLAGE
SUBDIVISION: Block: Lot:
PARCEL NUMBER: 968600023 Section: 16 Township: 28 N Range: 01 E
CONTRACTOR: WARREN ENTERPRISES PHONE: 360-871-9388
PO BOX 626
CHIMACUM WA 98325
Contractor's License WARREE*947BR Expires 2/13/2014
PROJECT DESCRIPTION: DECK ADDITION
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP DEK MAIN:
VALUATION 650.00 ADD'L: HEAT TYPE: UH
CODE EDITION: 2009 HEAT BASE: HEAT TYPE:
OCCUPANCY:
OCCUPANCY: UNHEATED: #OF STORIES:
CONST TYPE: OTHER: SHORELINE:
GARAGE:
CONST TYPE: DECK: 20 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL:
WATER SYSTEM: Type Amount Paid By: Date: Receipt:
BEDROOMS: BATHROOMS: Permit $152.00 LYK 01/24/13 139934
Exist: Exist: Plan Check $98.80 LYK 01/24/13 139934
Prop: Prop: State Building Code $4.50 LYK 01/24/13 139934
Total: Total: Total: $255.30
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
SPECIAL CONDITIONS APPLY-SEE ATTATCHED
Jefferson County Building•Division Permit Dumber: BLD13-00029
Applicant: CLARK
BUILDING PERMIT INSPECTION APPROVALS Applicable Code: 2009 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
Setbacks (L` t?T iL4
Erosion Control 1
Foundation Footing I)i 736 '1
Framing 1
2310
FINAL
FINAL INSPECTION 12
I,z3/iV
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
• •
CONDITIONS for Building Permit# :BLD13-00029
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.) The site plan as submitted with the building pemit application on January 24, 2013 has
been reviewed for consistency under the UDC, and has been approved by Jefferson
County Department of Community Development. Any modifications, changes, and/or
additions to the stamped, approved site plan dated March 28, 2014 shall be resubmitted
for review and approval by Jefferson County Department of Community Development.
\\tidemark\data\forms\F_BLD_Permit_BIdg.rpt 3/28/2013