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HomeMy WebLinkAboutBLD2006-00288 BUILDING PERMIT 1-SSuci N.(rh:t- p , rzQA Jeffersor>lunty Department of Community Dopment 621 Sheridan Street, Port Townsend, WA 98368 fio D _Q Chaa (360)379-4450 FAX (360)379-4451 t °` (1c K, V) (} cl$38 9 PERMIT #: BLD06-00288 Received Date 05/24/2006 SITE ADDRESS: 35 RANDOLPH ST Issue Date 06/16/2006 PORT HADLOCK, 98339 APPLICANT: JOHN 0 SHOLD PHONE: LIFE ESTATE FOR DIANNE STEELE SUMAS WA 982959314 SUBDIVISION: SHOLD'S ADDITION Block: 3 Lot: 4-5 PARCEL NUMBER: 994800302 Section: 2 Township: 29 N Range: 01 W CONTRACTOR: BELFOR PHONE: 206-632-0800 3826 WOODLAND PARK N SEATTLE WA 98103 206-632-5484 Contractor's License: BELFOUG99OBJ Expires: 12/14/2006 PROJECT DESCRIPTION: REPAIR FIRE DAMAGE -NEW TRUSS, ROOF, DRYWALL& REPLACE SOME INTERIOR WALL CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT. SETBACKS: MIA. UFFER: N/A Footing: u/A Foundation: /Y-#1 Stormwater FINAL Approval: NA Underground Plumbing: N/A Underground Insulation: A/° Shear Wall : Sheathing: Framing: ( `�- j)'1 at-oc.44 STI'' Sa-FITS =AtEVsyl-p.)�� U r Plumbing: g 4/a ju7liv Propane Tank/Lines: 27 Insulation: fj/Accs OK ?Er 3-e ('Eiu,os DK /ys-Ai Sheetrock: INC PER 'IC 5/7 07 Septic Sytem Final Approval MUST e obtained before final of structure can be attempted. Road Approach Final Approval: Zoning Final Approval: Final/Occupancy Approval: D, -00+' +afros-I j44-fr7 HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL REQUI ED PRIOR TO FINAL INSPECTION THIS PERMIT IS VALID FOR ONE YEAR OR IT MUST BE PROPERLY RENEWED BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS. Office Hours 9:00 a.m. -4:30 p.m. HOT LINE AVAILABLE 24 HOURS A DAY SPECIAL CONDITIONS APPLY -SEE REVERSE SPECIAL CONDITIONS FOR CASE t BLD06-00288 PEWIT # BID O 02 P ' 1.) Environmental Health approval is for existing footprint of residence-no enclosure of carport other than roof or increase in square footage or plumbing fixtures is approved�i [RJON COIB using the existing onsite sewage system. U JEFFERSON COUNTY BUILDING DEPARTMENT i/b 379-4450 RAPID EVALUATION SAFETY ASSESSMENT FORM BUILDING DESCRIPTION OVERALL RATING: (Check One) Owner's Name: e '1 `I elLGT Mailing Addr : 3S / fuljvLp ' INSPECTED (Green) ❑ Phone : . 3 .- 3 j4- '7 3 2� _ Exterior only Site Addr Exterior & Interior • No. of Stories : I LIMITED ENTRY (Yellow) 0 Basement: Yes, ' No El Unk 0 UNSAFE (Red) Section Township Range Parcel No. INSPECTOR: q 4Se4 1/v Inspector ID Primary Occupancy: Dwelling . Affiliation CO Other Residential ❑ Commercial ❑ Office ❑ Industrial 0 Public Assembly 0 School 0 INSPECTION DATE: 5- Government 0 Emer. Serv. 0 Historic 0 Mo/day/year Other _ Time t.( ;t) ,4-n('\ am pm Instructions: Review structure for the conditions listed below. A "yes" answer to 1, 2, 3 or 5 is grounds for posting entire structure UNSAFE. If more review is needed, post LIMITED ENTRY. A "yes" answer to 4 requires posting AREA UNSAFE and/or barricading around the hazard. Hazards such as a toxic spill or an asbestos release are covered by 6 and are to be posted and/or barricaded to indicate AREA UNSAFE. More Review Condition Yes No Needed 1 . Collapse, partial collapse, or buiding off foundation .'Q ❑ 0 2. Building or story noticably leaning ❑ ❑ ❑ 3. Severe racking of walls, obvious severe damage & distress ❑ 0 ❑ 4. Chimney, parapet or other falling hazard -0 El ❑ 5. Severe ground or slope movement present ❑ 0 ❑ 6. Other hazard present ❑ 0 0 Recommendations: ❑ No further action required ❑ Detailed Evaluation required (circle one) Structural Geotechnical Other ❑ Barricades needed in the following areas: • ❑ Other: Posted at this Assessment: ❑ Yes NNo ?aL o(Joc- Comments: Fir-UT OS t1.L CILG H:\home\pincntr\f orms\sef ety.frm S ILDING PERMIT APPLICATA BLD06-00288 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD06-00288 Received Date: 5/24/2006 SITE ADDRESS: 35 RANDOLPH ST PORT HADLOCK, 98339 OWNER: JOHN 0 SHOLD PHONE: LIFE ESTATE FOR DIANNE STEELS SUMAS WA 982959314 SHOLD'S ADDITION SUBDIVISION: Block: 3 Lot: 4-5 PARCEL NUMBER: 994800302 Section: 2 Township: 29 N Range: 01 W CONTRACTOR: BELFOR PHONE: 206-632-0800 3826 WOODLAND PARK N SEATTLE WA 98103 Contractor's License BELFOUG99OBJ Expires 12/14/2006 REPRESENTATIVE: BELFOR RHONE 206.632=09®6 3826 WOODLAND PARK AVE N SEATTLE WA 98103 PROJECT DESCRIPTIOI` REPAIR FIRE DAMAGE -NEW TRUSS, ROOF, DRYWALL & REPLACE SOME INTERIOR WALL TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP REP MAIN: 740 VALUATION 61,000.00 ADD'L: 740 HEAT TYPE: CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: OCCUPANCY: UNHEATED: # OF STORIES: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: 336 SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: 2 Exist: 2 Prop: 0 Prop: 0 Total: 2 Total: 2 Routing, (Date: - _ T efl c Type Amount Paid By: Date: Receipt: Approved/Date Permit $720.75 LYK 05/24/06 83414 APPROVED Plan Check $468.49 LYK 05/24/06 83414 State Building Code $4.50 LYK 05/24/06 83414 Total: $1,193.74 JUN ��') Jefferson County Planning wilding Department PERMIT # f ED 0288 irrrrpnns' minor.- Mete 4Q 06 09: 36a MARV I•OLEVER 253-863.739 P• 2 `—_____, r.a..SON*-- 4r' cob JEFFERSON COUNTY 'ii a 2,.:1 DEPARTMENTOFCOMMUNITYDEVELOPMENT '' 621Sheridan Street• Port Townsend •Washington 98368 360/379-4450 • 360/379-4451 Fax\s 360/37 _Jeffers• 360/us/com 1 Fax opment Master Permit Application MLA: NO i-AL_ 'f Q t ) Project Description(include separate sheets as necessary):R f P/,</R f//l f_ 19,,m ,4-6, ,V,r.- 7//vfff yr/t°of carry 0,-.p 4 1 /EPu/4 /.: 54,Al/ /A/75/?ffi.7 Property /4,/4 4-v Tax Parcel Number L/ t 7 f UG -5p2 Size: /ZO.X/ft7 /$JG6: (acre squaref) Site Address and/or Directions to Property: 3. - P/9HD6L fN/ • Property Owner(s)of Record:- P/1 L E S7Of_L C Telephone: 1-3Gi.- 3/? 73 Zg Fax: email: Mailing Address: cf 3/5 5—WA NSAri' AO s 6•4A S iA,A. ' - Z lS Applicant/Agent(if different from owner): DE=L/wfl Telephone: ZL'[c 43 Z. 6$C'O Fax: Zc ‘ G 3 L ..r e. 'Y email: Mailing Address: What kind of Permit?(Check each box that applies) Building 0 Variance(Minor,Major or Reasonable Economic Use) 0 Demolition Permit 0 Conditional Use(C(a),C(d),or C)" ta'Single Family O Discretionary"D"or Unnamed Use Classification 0 Garage Attached I Detached 0 Special Use(Essential Public Facilities)** 0 Manufactured Home 0 Boundary Line Adjustment 0 Modular 0 Short Plat" 0 Commercial* 0 Binding Site Plan 0 Change of Use ❑Long Plat" 0 Address 0 Road Approach 0 Planned Rural Residential Development(PRRD)/Amendments•• ❑Propane 0 Plat Vacation/Alteration" 0 Allowed"Yes"Use Consistency Analysis 0 Shoreline Master Program Exemption/Permit Revisions" 0 Stormwater Management 0 Shoreline Management Substantial Development" ❑Site Plan Approval Advance Determination(SPAAD)` 0 Shoreline Management Variance ri Temporary Use a Comprehensive Plan/UDC/Land Use District Map Amendment 0 Wireless Telecommunication* 0 Jefferson County Shoreline Master Program Amendment 0 Forest Practices Act/Release of Six-Year Moratorium May require a Pre-Application Conference "Requires a Pre-Application Conference Please identify any other local,state or federal permits required for this proposal, if known: X. 'Y6O i 1p SIGNATION OF AGENT I hereby designate g U to act as my agent in matters relating to this application�for permit(s). OWNER SIGNATURE ci&lat_ Al O�L 06...1 Date: CX I v, -e-e6 y . \j 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 ifs 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.Access and right of entry to this property shall be requested and shall occur only duringri regular business hours igna.Signature: 1 /` F7 /J{i4PG� Date: ' '"` AU/ 06 S 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'NM beundertaken because this peinii'( has been issued will not violate the ESA. Any individual,group or agency can file a lawsuit on behalf of aril 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 responsibility for adhering to c mptying with the ESA. The Applicant has read this disclaimer And signs a tes it below. �_ / ? ( ' QF.L/-�/t; Date: ,f Yt `WQN Signature: �L-v>%'� � �Y and f G:\PrnnitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05.doc Tj NOTICE:Plans are approved excepting any errors or omissions. All work must pass inspection in conformance with o all applicable codes and regulations. fi hi 4 - l r 24. a) -o ; 1I ii.IH ci K.a ( C `� N � a E o- aa)) wc• coo I � • �. � Cl) m •,cna) 773 M .Ca) a) � p IMMO - T.) ra V) 7 cc) : ' ` o E � Om 438No3 coj R C a) co a) O z O 70 a) O C U O 411 tie d' F- � co sFr j 1-zr— —1r— > N Q j N O N a) t rnm ,e � tt...;.. - O o C C t r 1 P ce _M a) cn O. O_ / 1A` Co N O _O O le >7 N a) C to 0 0 to �. a) Q t _C Jr i9 .T• ci O .� M C v) 3 �: IX C N its\... c Q E E � �. iuiii VI VL_____ ; N 0 C• ON h• 4 e 2r Crq ld 1 Co act the Building Depart, ie, t at 9-4450 prior to ma co ea or revisions to the approved ages �, s • a c� c C\I a JEFFERSON COUNTY % C . o. tt � �N Q a CO o �s Q co-4 t © APPROVED AS SUBMITTED ``o V r LW Lim AS NOTED W �. LAW ri LE �' i 0 REJECTED Date,,.,.-.- - Reviewer • • x Y l7 r 0 n (II w H co co L . li 1 m II ,, , fli '' '"' --': • 0,=.1...-',-,-:,• , ' g11 a; 1-- r6 41 - r z.-a I. II ' er v O 3.3. 1 S.fi. LA O, . O O ON b I aa I -311r I-j tr 11' 1 24. _ Alitilk 41 Cr. el#% S®• .4 30N o /w,rS , r,� JEFFERSO�OUNTY • ' /i y DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street • Port Townsend •Washington 98368 ViA fr . .y, 360/379-4450 • 360/379-4451 Fax �q<9NG�O www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: Project Description (include separate sheets as necessary): _g F_PA{//? P//I F_ DANAt6 F /1./,G rev 7/I GSf' yr/t oaf pf,e y 14—4�C Property Tax Parcel Number: el 00 Z 9/ '� Size: /Zv. /fa /'6iejt,;- (acre square f f.) Site Address and/or Directions to Property: 3.S" /?/4 if/QOL PN Property Owner(s)of Record: P/4 t, 5 r,E/cL 5 Telephone: / -/Cc- 3/7 77 Z$ Fax: Mailing Address: C/3/S s—frvA/V S,--.1% //15 jy,,/9D 5 L'A 9 , Z email: Applicant/Agent(if different from owner): /31t Foil Telephone: ZG G 6 3 Z G $'4-71.% Fax: Z"‘ (!7Z- S 4sy email: Mailing Address: What kind of Permit?(Check each box that applies) Building ❑ Variance(Minor, Major or Reasonable Economic Use) ❑ Demolition Permit ❑ Conditional Use[C(a), C(d),or C]** 'Single Family ii Discretionary"D"or Unnamed Use Classification ❑ Garage Attached/Detached ❑ Special Use(Essential Public Facilities)** ❑ Manufactured Home ❑ Boundary Line Adjustment ❑ Modular ❑ Short Plat** ❑ Commercial* ti Binding Site Plan** ❑ Change of Use ❑ Long Plat** ❑Address ❑ Road Approach ❑ Planned Rural Residential Development(PRRD)/Amendments** ❑ Propane ❑ Plat Vacation/Alteration** ❑Allowed"Yes"Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions** ❑ Stormwater Management ❑ Shoreline Management Substantial Development** ❑ Site Plan Approval Advance Determination (SPAAD)* ❑ Shoreline Management Variance ❑ Temporary Use Cl Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* ❑Jefferson County Shoreline Master Program Amendment ❑ Forest Practices Act/Release of Six-Year Moratorium *May require a Pre—Application Conference **Requires a Pre-Application Conference Please identify any other local, state or federal permits required for this proposal, if known: DESIGNATION OF AGENT / I hereby designate to act as my agent in matters relating to this application for permit(s). X OWNER SIGNATURE 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 it's 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.Access and right of entry to this property shall be requested and shall occur only during regular business hours. Signature: �L ' �'G — 7 Pe' l /.1(' i /L *- /� (r Date: '' 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 responsibility for adheringin to and complying with the ESA. The Applicant has read this disclaimer d si ns and dat s it below. Signature: 41- -vG-ram' 1 v/i'�+^'C e��"7 Fe/? ,°/ 'L �c/ ���9 I` � Date:disclaimer -' �$ G G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05.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 tl;at they will be assuming the responsibility of the General Contractor for the proposed project. Signature: Date: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: ilf.4 /'O/1 ('2') (4 3 Z cI5-(;.r ( 2 ) 02- .195-/ MAILING ADDRESS: - 2 4: 144-1 2 L AA//2 P/IN? cark/f.M EMAIL: CONTRACTOR'S LICENSE 5EATrG E 1.4-/4 1l?/G 3 WAINS NUMBER: ,9 F.L.ra UG 9 9 D,C'i NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX: ( ) MAILING ADDRESS: 3 f z( 34 pi_Atvi p,t.n/(,4L4:/V 549'T7L1 EMAIL Project Type: Frame Type: Bathrooms: , Shoreline: Type of Sewage Disposal: ❑ New t Wood Existing: / L *ewer ❑ Addition ❑ Steel Proposed: Bank Height: ❑ Community System ❑ ,Alteration/Remodel ❑ Concrete Total: / t- (\/ ig,Individual System Repair ❑ Masonry SEP Permit# ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Z Setback: L I Private well ❑ Two Party Type of Heat: Proposed: AA' ublic Total: Z- 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: ❑ Underground Tank ❑ Above ground Tank Size of Propane Tank: LI Heat Stove ❑ Cook Stove ❑ Woodstove ❑ Fireplace Insert ❑ Hot Water Tank ❑ Pellet Stove ❑ 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: 741/E (�j• ov 2° Floor Heated Consistency Review: ., _ I Other Heated Base fee: a) el5 Mezzanine Additional Section: — Heated Basement Plan Check fee: -4/ Unheated Basement State Surcharge fee: 4 �Z1 Other Unheated Pot Water Review fee: j Garage/Carport SUBTOTAL �d Decks 3 �� 911/Rd Approach fee: .--- Other TOTAL: $ I ._J ) rft3 Receipt Number: t 4- Cash/Check Number: `(0 r, ESTIMATED COST(REQUIRED) Date: ,`1 v► )eke .Fair market value of all labor and materials fo dafi� r Initials: a 1,1 1 ,,u, • ___-________) 4-6117) G:\PermitCenter\FORMS\DRD FORM as er ermit Application 12-30-05.doc