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Home My WebLink AboutBLD2021-00192 - RE ROOFDEPARTMENT 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 RE-ROOF APPLICATION Site Information Assessor Tax Parcel Number: Site Address and/or Directions to Property: Access (name of street(s) from which access will be gained: Property Owner Name: Address: Phone #: Email Address: Applicant / Contractor: Authorized Agent/Representative Name: Phone #: Email Address: License #: Expiration Date: Work Proposed On Single Family Residence Accessory Structure Accessory Dwelling Unit Commercial Building Garage / Shop Codes Referenced: 2015 IBC 1510 and IRC R908. Last Updated 01/02/19. Required Submittal Items – If work does NOT include structural change, or load bearing capacity Re-roof application Permit Fees based on valuation, minimum base fee of 2 hours Exemptions: If the scope of work does not change the load bearing capacity OR the original structure AND is less than 200 sq. /ft., a permit is not required. Emergency Damage Repair: If the work is to repair a roof damaged by sudden, unforeseen events such as storm damage, roofing permits will be issued over-the-counter for minor repairs. Rebuild involving structural repair will require wet stamped engineered plans within 30 days of the emergency issuing AND the applicant will need to schedule inspections per the building permit process. Temporary, emergency repairs such as tarps and tarp tie-downs do not need a building permit. Is this application for use in a Mobile / Manufactured Home? * If Yes: A permit from Washington State Department of Labor and Industries, not Jefferson County, is required for appliances installed within a mobile/manufactured home. L&I: (360) 417-2702 * If No: Complete this form and make an appointment to submit to Jefferson County Permit Tech (360) 379-4450 ✔ 969700009 234 Camber Ln Port Ludlow, WA 98365 David and Vicky Grauberger 234 Camber Ln Port Ludlow, WA 98365 (360) 301-6145 Integrity Rooﬁng & Construction (360) 900-7663 INTEGRC841J1 ✔ baywatcher234@gmail.com trisha@integrityrc.com 04/21/2022 DocuSign Envelope ID: 1415FD6D-FE05-4EE0-8491-443618514BCD Description of Work ICC Valuation (Office Use) Estimated Cost of Project (Required): $ $ 1.Is the original roof sheathing & underlayment being removed? 1a. If yes, type of roof materials to be removed: (IRC 2015 R908 Reroofing) 2.Are you replacing with the same material? 2a. If no, type of roof materials to be used (Roof materials must comply with IRC 2015 R901 General) Yes No 3.Does the scope of work increase the pitch or square footage of the original roof? 3a. If yes, are you adding dormers? 3b. If yes, are you increasing the living or heated space of the house? Yes No Yes No Yes No 4. If you answered “YES” to 3a or 3b, a floor plan and a fee of $141.00 is required for an Environmental Health Review. (JCC 8.15.90) 5.If you answered “YES” to 3a or 3b AND the project is located less than 150 feet from a marine or river shoreline or 100 feet from a lake shoreline THEN submittal of a site plan and fees in the amount of $679 are required. (JCC 18.25) 6.Any additional information: Builders Statement 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. Signature: Print Name: 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 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: Print Name: Date: Receipt # Date: Cash/Check/CC: OFFICE USE ONLY Building Permit Fees Re-Roof Permit Fee $194.00 Environmental Health Review ($141.00) Land Use Fee ($679.00) Project Scanning Fee $24.00 State $6.50 Subtotal Technology Fee – 5% of Subtotal $11.23 (only if no EH and/or LU fee; otherwise 5% of subtotal) Total Fees Additional fees may apply $235.73 Yes No 40,050.00 ✔ ✔ Trisha Huckabee 03/30/2021 ✔ ✔ ✔ DocuSign Envelope ID: 1415FD6D-FE05-4EE0-8491-443618514BCD David & Vicky Grauberger 3/30/2021 BUILDING PERMIT JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street | Port Townsend, WA 98368 360-379-4450 | email: dcd@co.jefferson.wa.us www.co.jefferson.wa.us/commdevelopment BLD2021-00192 4/6/2022Expiration Date 4/6/2021Issue Date 3/31/2021Received Date: PORT LUDLOW, 98365 SITE ADDRESS: PERMIT #: OWNER: 1ERange:28Township:17Section:969700009PARCEL NUMBER: 9697 - LUDLOW POINT VILLAGE DISUBDIVISION: DAVID K GRAUBERGER VICKY SUE GRAUBERGER 234 CAMBER LN PORT LUDLOW WA 98365-8782 PHONE: N 234 CAMBER DR CONTRACTOR:INTEGRITY ROOFING &CONSTRUCTION LLC KEYPORT WA 98345 P.O. BOX 163 PHONE:360-535-3888 Contractor's License INTEGRC841J1 Expires 4/21/2022 PROJECT DESCRIPTION:RE-ROOF TYPE OF WORK DECK: # OF STORIES: CONST TYPE: CONST TYPE:GARAGE: UNHEATED:OCCUPANCY: OCCUPANCY:HEAT BASE:2018CODE EDITION:ADD'L:VALUATION TYPE OF IMP REP MAIN: SQUARE FOOTAGE:RES OTHER: SETBACK: BANK HEIGHT: HEAT TYPE: HEAT TYPE: SHORELINE: SEWAGE DISPOSAL: Exist: Exist: BATHROOMS:BEDROOMS: WATER SYSTEM: Prop: Total:Total: Prop: Amount PaidType By:Date:Receipt: $194.00Permit MSP 04/02/21 196243 $6.50State Building Code MSP 04/02/21 196243 $24.00Scanning Fee MSP 04/02/21 196243 $11.23Tech Fee MSP 04/02/21 196243 $235.73Total: R105.5 Expiration. Every permit 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 permit is suspended or abandoned for a period of 180 days after the time the work is commenced. 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. Final Inspections require 24 hour notice. Office Hours 9:00 am - 4:30 pm MONDAY - THURSDAY HOT LINE AVAILABLE 24 HOURS A DAY Jefferson County Building Division BUILDING PERMIT INSPECTION APPROVALS Permit Number: Applicant: Applicable Code: BLD2021-00192 2018 International Building Codes GRAUBERGER 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 NotesApproval SignatureDateInspection Item Miscellaneous RE-ROOF FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR FINAL INSPECTION A fnal inspecton will not be scheduled untl the following are completed and signed of by the applicable Department : ·Building Permit Conditons are met ·Land Use Conditons met and signed of ·Septc Permit Final/Complete for any building containing plumbing ·Public Works Permit Final (where applicable) CONDITIONS for Building Permit # : \\tidemark\data\forms\F_BLD_Permit_Bldg.rpt 4/6/2021 Date: 4/2/2021 Invoice ID: 2021BLD2021-00192 JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan Street | Port Townsend, WA 98368 360-379-4450 | email: dcd@co.jefferson.wa.us www.co.jefferson.wa.us/commdevelopment Invoice Date Due: 5/2/2021 REMIT TO: BILLING ADDRESS: Please return the above portion with your payment Permit 194.00 State Building Code 6.50 Scanning Fee 24.00 Tech Fee 11.23 $235.73Total Amount Due: Jefferson County DCD 621 Sheridan St. Port Townsend, WA 98368 DAVID K GRAUBERGER 234 CAMBER LN PORT LUDLOW WA 98365-8782 VICKY SUE GRAUBERGER Permit Number: BLD2021-00192 Permit 194.00 State Building Code 6.50 Scanning Fee 24.00 Tech Fee 11.23 Total Amount Due:$235.73 Payment is accepted by cash, check, debit or credit card (Visa, Mastercard, Discover). To pay by credit card, go to http://www.co.jefferson.wa.us/617/Credit-Card-E-Check-Payments-for-Permits, and click on the "Online Credit Card & echeck Payments" link on the left side of the page. For questions: call 360-379-4450.