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Home My WebLink AboutBLD2019-00079 - 01 PERMIT APPLICATIONDEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street, Port Townsend, WA 98368 Tel: 360.379.4450 | Fax: 360.379.4451 Web: www.co.jefferson.wa.us/communitydevelopment E-mail: dcd@co.jefferson.wa.us CERTIFICATE OF OCCUPANCY BLD19-00079 04/17/2019Issue Date: PORT LUDLOW, 98365 SITE ADDRESS: PERMIT #: APPLICANT: 1ERange:28Township:8Section:990600206PARCEL NUMBER: Lot:Block:9906 - PORT LUDLOW NO. 2SUBDIVISION: N 2020-01-08Final Date: 90 RAINIER LN GRAHAM HATCH 90 RAINIER LN PORT LUDLOW WA 98365-9651 PHONE:561-345-0249 PROJECT DESCRIPTION:ENCLOSE AN EXISTING COVERED PORCH- FOR LIVING SPACE THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2015 EDITION. OCCUPANCY GROUP: TYPE OF CONSTRUCTION: SPRINKLER SYSTEM No THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 2020-01-08 R-3 Acting Building Official, Patty Charnas \\tidemark\data\forms\F_BLD_Occupancy.rpt 2020-01-13 a JEFFERS.N couNrY e DEPARTMENT OF COMMUNIry DEVELOPMENT 621 Sheridan Street I Port Townsend, WA 98368 360-3794450 | email: dcd@co.jefferson.wa.us www. co. jefferson.wa. us/com mdeve lopment BU!LDING PERMIT PERMIT #: SITEADDRESS: OWNER: SUBDIVISION: PARCEL NUMBER: BLD19-00079 90 RAINIER LN PORT LUDLOW, 98365 GRAHAM HATCH 90 RAINIER LN PORT LUDLOW WA 98365-9651 9906 - PORT LUDLOW NO. 2 990600206 Section: 8 Received Date: lssue Date Expiration Date PHONE: 561-345-0249 Township: 28 N Range: '1E 3t712019 4t17 t2019 4t17t2020 CONTRACTOR PI BUILDING & DESIGN LLC 708 S MADISON ST TACOMAWA 98405 PHONE: 253-363-1089 Contractor's License PlBUlBD820D3 PROJEGT DESCRIPTION: ENCLOSE AN EXISTING COVERED PORGH- FOR LIVING SPACE TYPE OF WORK TYPE OF IMP VALUATION CODE EDITION: OCCUPANCY: OCCUPANCY: CONST TYPE: CONST TYPE: SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: Exist: Prop: Total: RES NEW 20,000.00 2015 R-3 BATHROOMS: Exist: Prop: Total: SQUARE FOOTAGE: MAIN: 208 ADD'L: HEAT BASE: UNHEATED: OTHER: GARAGE: DECK: HEAT TYPE: HEAT TYPE: # OF STORIES: SHORELINE: SETBACK: BANK HEIGHT: EEE Type Amount Paid Bv: Date: Receipt Permit Plan Check Scanning Fee State Building Code Tech Fee Total: $368.00 $184.00 $23.00 $6.50 $29.08 SRE SRE SRE SRE SRE 03t07t19 03t07t19 03t07t19 03t07t19 03t07119 1 83570 1 83570 1 83570 1 83570 1 83570 $610.58 R105.5 Expiration. Every permif issued shall become invalid unless the work authorized by such permit is commenced within 180 days after its issuance, or if the work authorized by such permff is suspended or abandoned for a period of 180 days after the time the work is commenced. HEALTH DEPARTMENT AND PUBLIC WORKS APPROVAL BEQUIBED}RIOR ]OEINAL 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. Final lnspections require 24 hour notice. Office Hours 9:00 am - 4:30 pm MONDAY - THURSDAY HOT LINE AVAILABLE 24 HOURS A DAY o Jefferson County DCD Building Division Correction Notice o PERMIT NU OWNER JOB LOCATION lnspection of this structure has found the following violations: When ns have been made, call for inspection. S Date lnspector Building Division (360) 379-4450 lnspection Hotline (360) 379-4455 THIS NOTICE MUST BE KEPT WITH APPROVED PLANS ON SITE. l1rt4,/ / I;r.. (' You are hereby notified additional work shall not be done upon these premises untilthe above violations are corrected, unless othenarise noted. Jefferson County Building ion Permit N BLD19-00079 Applicant: HATCH BUILDING PERMIT INSPECTION APPROVALS Appticabte Code: 201s tnternationat Buitdins 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 & lndustries. The electrical permit must be signed off by the State lnspector prior to the County's Framing lnspection lnspection ltem Date Approval Signature Notes Foundation Footing Footing Drains Foundation Stem Wall Under Floor Framing -ftq Framing fuo lnsulation: Walls lnsulation: Floors Wallboard Nailing Smoke & CO final inspection will not be scheduled until the following are completed and signed off by the applicable Department; o Building Permit Conditions dre met t Septic Permit Final/Complete for any building containing plumbing o Land Use Conditions met ond signed ofi o Public Works Permit Finol (where applicable) FINAL INSPECTION t/,/ TION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR F!NAL INS lrr,t, NG PERM.T APPr-rcflg*BLD19-00079 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: SITEADDRESS: OWNER: SUBDIVISION: PARCEL NUMBER: BLD19-00079 90 RAINIER LN PORT LUDLOW, 98365 GRAHAM HATCH 90 RAINIER LN PORT LUDLOW WA 98365-9651 990600206 Section: Received Date: 31712019 PHONE: 561-345-0249 9906 - PORT LUDLOW NO.2Block: Lot: 8 Township: 28 N Range: 1E CONTRACTOR: REPRESENTATIVE: PI BUILDING & DESIGN LLC 708 S MADISON ST TACOMA WA 98405 Contractor's License PlBUlBD820D3 PHONE: 253-363-1089 Expires 312312020 PHONE: PROJECT DESCRIPTION: ENCLOSE AN EXISTING COVERED PORGH- FOR LIVING SPAGE TYPE OF WORK TYPE OF IMP VALUATION CODE EDITION: OCCUPANCY: OCCUPANCY: CONST TYPE: CONST TYPE: SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: Exist: Prop: Total: RES NEW 20,000.00 2015 BATHROOMS: Exist: Prop: Total: SQUARE FOOTAGE: MAIN: 208 ADD'L: HEAT.BASE: UNHEATED: OTHER: GARAGE: DECK: Type HEAT TYPE: HEAT TYPE: # OF STORIES: EEE SHORELINE: SETBACK: BANK HEIGHT Amount Paid Bv: Date: Receipt Permit Plan Check Scanning Fee State Building Code Tech Fee Total: $368.00 $184.00 $23.00 $6.50 $29.08 SRE SRE SRE SRE SRE 03t07t19 03t07t19 03t07t19 03t07t19 03t07t19 1 83570 1 83570 1 83570 1 83570 1 83570 Approved/Date APPROVED AFR I 7 201s J&rson CountY DCL $610.58 o |n -occsci DEPARTMENT OF COMMUNITY DEYELOPMENT 621 Shcridrn Strcct, Port'I'orvnscnd, W.\ 98368 'l'cl: 360.379.4450 | liax: 360.379.4-+5i \{'cb: I i-mail: dcd@co.Lc ffcrson.wa. us PERMIT APPLI Steps in the Permit Process: -Review application checklist to ensure all information is completed -Make sure septic has been applied for and water availability has been proven. -Make an appointment to meet with the Permit Technician by calling 360-379-4450. -This is not a standalone application; it must be accompanied by a project specific supplemental application. -Fees will be collected at intake. Additionalfees may apply after review and payment is required before permit is issued. For Department Use Only Related Application #s: Building Permit # MLA# Site lnformation Assessor Tax Parcel Number: Site Address and/or Directions to Property: Access(nameofstreet(s)) fromwhichaccesswill begained: ./.,; !,1, ,., .) ., _, Present use of property: Description of Work (inclu I l de proposed USES r ,_,< t,n1 Wastewater - Sewage Disposal , This property is served by Port Townsend or Port Ludlow sewer system? lf not served by sewer identified above, identify type of septic system below -rYES Tyoe of Sewage System Serving Property: _ Septic Septic Permit #: _ Community Septic Name of System: Are other residences connected to the septic system? Additions or repairs to sewage system: ls it a complete or partial system installation: Has a reserve drainfield been designated? Date of Last Operations & Maintenance check: Describe or attach any drainfield easements, covenants or notices on title, which may impact the property: Case #: Attach last report to application Complete_ _Partial _ Yes_ No_ @ NO oo The authorized agent/representative is the primary contact for all project-related questions and correspondence. The County will mail / e-mail requests and information about the application to the authorized agent/representative and will copy (cc) the owner noted below. The authorized agent/representative is responsible for communicating the information to all parties involved with the application. lt is the responsibility of the authorized agent/representative and owner to ensure their mailbox accepts County email (i.e., Cou email is not bl 'il" By signing this appllcation form, the owner/agent attests that the information provided herein, and in any attachments, is true and correct to the best of his or her 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 making any issued permit null and void. lfurther agree to that all activities I intend to undertake or complete associated with this permit will be performed in compliance with all applicable federal, state and county laws and regulations and I agree to provide access and right of entry to Jefferson County and its employees, representatites or agents for the sole purpose of application review and any required later inspections. Applicant may visits related to this application and subsequent permit issuance. : 6 r^ l.- ^ €- ll4.lrl^' Date: Lt ffL tg request notice of the County's intent to qnter upon the property for' ./ ( ///.r14-Signalure: L-* C ' y'</t).i Print Name Applicant/Property Owner !nformation Address: 1o Painie. lo^o- e) L,)lot hJA Note: For projects with multiple owners, attach a separate sheet with each owner(s) information and signatures. t0t 3qsozltl E-mailAddress: ea I Agent/Representative with project info. (select only one ). Pro E ll^J "l^ctg36S Please contact Au Owner /-, Property Owner: Name: (r ro h ^. .^n Date: t-l D EC- t/ Phone #: Applicant: Authorized Agent/Representative (lf otherthan owner) Name: Address: Phone #:E-mail Address: Professional:ls this an for this project?NO YES 7 Engineer Architect Su rveyor Contractor X _ Consultant ptFurDDfZ@3Name: Address: Phone #: License # 4H*a <420 a/"rlh T.^r*,, A,o.T;o/u UA253 7a7 lo g 1 E-mailAddress: -)W\e Professional:ls this an Authorized for this project?NO YES Engineer Architect_ Surveyor _ _Contractor License # Consultant Name: Address: Phone #:E-mail Address Professional:for this project?NO YES Engineer Architect _ _ Surveyot _ _ Contractor License # Consu ltant Name: Address: Phone #: re: )a*teS Ko >-e-l;- ls this an Authorized E-mail Address: PI BUILDING & DESIGN LLC o Washington State ilepartment of Labor & lndustries Home Espaflol Contact Search L&l A-Z Index Help Myt&I Safety & Health Claims & lnsurance Workplace Rights Trades & Licensing a Page I of2 PI BUILDING & DESIGN LLC License Veri! the contractor's active registration / license / certification (depending on trade) and any past violations. Constructlon Contractor Actlve. Moets curreot requlrements. License specialties GENERAL License no. PIBUIBD820D3 Effective - expiration 03/23/20 I 8- 03 I 23t 2020 Bold Wesco lnsurance Go Bond account no. 46W8058791 $ 12,000.00 Owner or tradesperson Principals KOZAK, JAMES THOMAS JR, PARTNERYMEMBER Doing business as PI BUILDING & DESIGN LLC WA UBI No. 604 110 880 Received by L&l 03t23t2018 lliqrance Securlty National lnsurance Policy no. NA104713300 Received by L&l 01t17t2019 708 S MADTSON ST TACOMA, WA 98405 253.363-1089 PIERCE County Business type Limited Llabllity Company Effective date o3t23t2018 Expiration date Untll Canceled $1,000,000.00 Effective date 02t0'U20't8 Expiration date 02t0112020 9eY!rs: No savings accounts during the prevlous 6 year period. t"awsqits agtnt! !h9 hgnd o.1saylngp No lawsuits against the bond or savings accounb during the prevlous 6 year period. L&l Tax debts No L&l tai debts are recorded for thls contractor license durlng the prevlous 6 year period, but some debts may be recorded by other agencles. License Violations Xo ticense vtotations durlng the prevlous 6 year perlod. Help us improve 31712019https://secure.lni.wa.gov/veri$/Detail.aspx?UBI:604110880&LIC:PIBUIBD820D3&SAW= PI BUILDING & DESIGN LLC Workers'comp o Do you know if the business has employees? lf so, verify the business is up-to-date on workers' comp premiums. L&l Account lD Account ls closed. 639,29!{:r Doing business as PI BUILDING & DESIGN LLC Estimated workers reported N/A L&l account contact T5 / JAVIER PAREDES (360)9024639 - Emall: PAJB235@lnl.wa.gov Public Works Strikes and Debarments Verify the contractor is eligible to perform work on public works projects. Contractor Strikes xo Ctrikes trive bCen lssued against this contractor. Contractors not allowed to bld fo aeUaments have bCen lsiued against this contractor, a Page2 ofL No inspections during the previous 6 year period. @ Washington State Dept. of Labor & lndustries. Use of this site is subjecl to the laws of the state of Washington Help us improve 317120t9https://secure.lni.wa.gov/veriff/Detail.aspx?UBI:604110880&LIC=PIBUIBD820D3&SAW: Workplace safety and health DEPARTMENT OF COMMUNITY 621 Sheridan Streeg Port Townsend, WA 98368 ^f el: 360.379.4450 | Fax: 360.379.U51 Web : www.co. iefferson.wa.us /communitvdevelopment a MAR 0 5 20tg E-mail: dcd@.co.iefferson.wa.us ,jEFFERS ON COUNTY SUPPLEMENTAL APPLICATION RESIDENTIAL OR COMMERCIAL BLDG PERMIT off! For Related #: Enter the square footage (sq/ft) that applies in each field Supplemcntal SFR 1 Site lnformation Owner Name:6 1,.^r" l-jr"*"k AssessorTaxParcel#: 1q CI-A0A-Z06 Type of Building New Addition T--1+ Replacement Repair Relocated Demolition * *A separate permit is required Select One: Single Fami ly Residence Modular Other list # new bedrooms # new bathrooms existing existing total bed total bath Heat Source Select allthat apply Heat Pump X Electric Heating Oil Wood Propane Structure Existing Sq/Ft Proposed Sq/Ft ICC Valuatioh (ffice use) Residential / Commercial Main Floor \r tu F,7(fi Residential / Commercial Second Floor Additional Floors - heated / unheated Basement - unfinished I Basement - finished space or habitable I Detached Garage - heated / unheated Attached Garage - heated / unheated DU, Garage 2nd fl- unfinished storage Garage 2nd fl- finished space or habitable t Carport - 2 walls or less Deck - uncovered Covered porch Other (shed, barn, pole bldg,etc.) tbz J Estimated Cost of Project (Required): S 2 O, : .:-: O rm value of project Receipt #:Date:Use Only Proposed Building/Project Number of ftoors I s o o u mobile ot 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 or her 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 making any issued permit null and void. Signature ,Date: !t:Dic tg Building Permit Fees Buiiding Base Plan Check Review Land Use Review Septic Review Potable Water Technology/Scan State Fee Other Fees Shoreline Exemption - ot)L*q7,D Zoning Zoning Other New Address Technology Fee-5% Total Fees Rpceint # f)ate: ulD'se The signer of this statement certifies 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. trSignature(-{nt Na Date: 4 Dec-B lbq 'oo \srr6pd b6 s23.oo Su 50 zq- o8 S*crieoenlai SFF- 2 Cash/Check/CC: Use Hour"-9;^- l, {--.^^ r l, Pr.r,\e ^ "-t--J Builders Jse Onty it:rd