HomeMy WebLinkAboutBB10 00101 •r
CITY OF BREMERTON PERMIT NUMBER BB10 00101
M I ---
DEPARTMENT OF COMMUNITY DEVELOPMENT DATE ISSUED
` 345 - 6th Street Bremerton WA 98337
(360) 473 -5275 Fax (360) 473 -5278
ASSESSOR NUMBER 022401 -3 129 -2005 ZONING R10 SITE ADDRESS 3210 RICKEY RD NE
APPLICANT NAME HULTMAN MATT PHONE (360) 951 -2393 ADDRESS PO BOX 1229 ABERDEEN WA 98520
OWNER NAME ASSISTED LIVING CONCEPTS INC PHONE (888) 252 -5001 ADDRESS W140 N8981 LILLY RD MENOMONEE FALLS WI 53051
CONTRACTOR PHONE ADDRESS
LENDER NAME PHONE ADDRESS
SUBMITTED 02/22/2010 APPROVED 02/22/2010 EXPIRATION 08/21/2010 STATUS APPROVED
VALUATION $68 730 00 Budding Permit - No Mechanical /Plumbing
Budding Permit $74800 2211 Remove and Replace Composition Shingles on Roof
State Surcharge $450 0236 Building Code Edition
TOTAL FEES $75250 Occupancy Group
Type of Construction
Flood Zone
Setbacks
Sanitation Method
Number of Bedrooms
Square Footage Bid Price from Applicant 68 730 TOTAL
Inspection Requests FIRE Fire Inspections (360) 473 -5394
DCD Building Inspections (360) 473 -5870 HEALTH Kitsap County Health District (360) 337 -5285
L &I Department of Labor and Industries (360) 415 -4000 PW &U Public Works - Engineering (360) 473 -5270
This permit shall become null and void if the described and authorized by this permit has not commenced within 180 days from the date of issuance or if the work is suspended or abandoned
at anytime after the work is commenced for a period of 180 days It is the responsibility of the permit holder to see that the required inspections are made Failure to obtain required
inspections may result in stoppage of the work until such time that the permit holder can susbstantiate to the City of Bremerton that the concealed work meets or exceeds code
requirements Any demolition testing or financial burden shall be borne directly by the permit holder Failure to substantiate code requirements will indemnify the City against any and all
responsibility or liability connected with the construction I hereby certify that I have read and examined this permit and know the same to be true and correct All provisions of laws and
ordinances governing this type of work will be complied with whether specified herein or not The granting of a permit does not presume to give authority to violate or cancel provisions of
any State or local law regulating construction or the performance of the construction If listing the owner as general contractor I certify that I am exempt from the requirements of the State
Contractor's Registration Law under Section 3 Chapter 126 Laws of 1967 All revisions to an approved plan require DCD review and approval prior to performing work All building and tenant
occupancy permits are required to pass final inspection prior to permit expiration and obtain a certificate of occupancy prior to use or occupancy
I have read, and agree to abide by the conditions of this permit including all conditions of zoning, budding codes, and State and Federal laws
SIGNATURE OF OWNER OR
AGENT
PRINTED NAME i DATE
CONDITIONS
City of Bremerton's approval of this application pertains only to the City's regulatory jurisdiction, and thus compliance with City
regulations does not necessarily ensure compliance with federal or state laws
10 (DCD -02) DCD Validity of permit The Issuance or granting of a permit shall not be construed to be a'
permit for, or an approval of, any violation of any of the provisions of the Washington State
Building code or of any other ordinance of the City of Bremerton Permits presuming to give
authority to violate or cancel the provisions of the Washington State Building code or other
ordinances of the City of Bremerton shall not be valid The Issuance of a permit based on
construction documents and other data shall not prevent the building official from requiring
the correction of errors In the construction documents and other data The building official
Is also authorized to prevent occupancy or use of a structure where In violation of the
Washington State Building code or of any other ordinances of the City of Bremerton r i
10 (DCD -01) DCD Prior to performing any renovation or demolition work, Puget Sound Clean Air Agency f�
(Clean Air Agency) and Washington Department of Labor and Industries (L &I) regulations
require an asbestos survey be performed to determine whether there are asbestos -
containing materials in the work area or structure The asbestos survey must be
conducted by and EPA - certified (AHERA) building Inspector (except renovation or owner -
Page 1 of 2
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CITY OF BREMERTON PERMIT NUMBER BB10 00101
DEPARTMENT OF COMMUNITY DEVELOPMENT DATE ISSUED
345 - 6th Street Bremerton WA 98337
' (360) 473 -5275 Fax (360) 473 -5278
ASSESSOR NUMBER 022401 -3 129 -2005 ZONING R10 SITE ADDRESS 3210 RICKEY RD NE
APPLICANT NAME HULTMAN MATT PHONE (360) 951 2393 ADDRESS PO BOX 1229 ABERDEEN WA 98520
OWNER NAME ASSISTED LIVING CONCEPTS INC PHONE (888) 252 5001 ADDRESS W140 N8981 LILLY RD MENOMONEE FALLS WI 53051
CONTRACTOR PHONE ADDRESS
LENDER NAME PHONE ADDRESS
SUBMITTED 0212212010 APPROVED 02/22/2010 EXPIRATION 08/21/2010 STATUS APPROVED
occupied single family residences) DCD For more Information, please contact Clean Air
Agency through their web site at www cleanair org or by phone at 800 - 552 -3565 or 206-
689 -4058 The L &I web site can be found at www Ini wa gov /p -ts /asbestos /asbestos htm
10 (DCD -47) DCD Reinspection Fee All approved plans, the printed building permit, and the permit /
Inspection placard, are required to be on -site for Inspection purposes, and work to be
Inspected shall be complete and ready for inspection If an Inspection Is called for and
plans are not available on site, or the work is not ready for Inspection, approval will not be
granted In addition, a re- inspection fee will be charged and must be collected by the
Department of Community Development prior to any further Inspections being performed or
approvals granted (/
10 (DCD -50) Final Inspection Required All building permits shall have a final inspection performed and '
approved by the City of Bremerton Department of Community Development prior to permit
expiration The failure to request a final Inspection or failure to obtain final approval prior to
expiration may require a reactivation fee, or a new permit application If more than a year
has passed with no activity
11 (DCD -14) DCD Approved Plans, Engineering, Site Plan, Permit, and Conditions shall remain On site
and be available for Inspection
12 (DCD -32) Changes to Plans Any changes to plans shall be approved before construction is
performed Architect or engineer of record shall approve the change before submitting a
revision A revision Is subject to a revision fee and additional fees for plan review and
Inspections
MINIMUM INSPECTIONS REQUIRED
To request an inspection, please call (360) 473 -5870 and be sure to provide your permit number, name on permit, site address, contact
phone number, and inspection type
Final Inspection - Building
Page 2 of 2
Letter of Transmittal (
December 20, 2010 � �� Washington State Department of
DEC 2 0 2010
Construction Review Services
Department of 310 Israel Rd SE
Community Development Tumwater, WA 98501
PO Box 47852
Olympia, Washington 98504 -7852
www doh wa gov /crs
tel 360 - 236 -2944
E
fax 360 - 236 -2901
Project Info:
CRS# 60190314 Project 3210 Rickey Rd NE
Albright House location Bremerton, WA 98310
Chapter 388 -78A WAC Boarding Homes
Fire Sprinkler Pipe Replacement Local Permit #
Key People:
Assigned DOH Richard M Swanson, RA
Reviewer rchard swanson @doh wa gov
Facility Albright House Facility Contact Albright House
Administrator Gail Holtznagel Alan Flippo
3210 Rickey Rd 3210 Rickey Rd NE
Bremerton, WA 98310 Bremerton, WA 98310
(360) 373 -0553 (903) 521 -7723
gholtznagel @alcco com aflippo @alcco corn
Architect / N/A Local AM City of Bremerton
Engineer Curt Hogenson
345 6th St, Ste 600
Bremerton WA 98337
(360) 473 -5275
curtis hogenson@ci bremerton wa us
Sprmkler / Patriot Fire Protection, Inc Fire Alarm N/A
Contractor Dan Labelle Contractor
2707 70 Ave E
Fife, WA 98424
(253) 926 -2290
DanL @patriotfire com
Other N/A Other N/A
Copies To
® Local Building Official City of Bremerton ❑ DOH Child Birth Center Licensing
❑ Architect / Engineer N/A ❑ DOH Office of Accommodations & Res Care Survey
❑ Sub - Contractor N/A ❑ DOH Office of Investigations & Inspections
® Sub - Contractor Patriot Fire Protection, Inc ❑ DSHS, Div Of Alcohol and Substance Abuse
® Other Dan Labelle ® DSHS, Jennifer Brascher, Aging & Adult Services Administration
❑ Washington State Patrol, Fire Protection Bureau ® L &I, Bill Eckroth, Electrical Section
® CRS File ❑ L &I, John Harvey, Factory Assembled Structures
Page 1 of 6 Plan Review Comments for Project #60190314
Albright House
Chapter 388 -78A WAC Boarding Homes
Fire Sprinkler Pipe Replacement
Memo:
- Authorized to Begin Construction -
The construction documents have been reviewed per Chapter 388 -78A WAC Boarding Homes (BH) and
found acceptable The stamped approved copy of the documents shall be kept and available for the licensing
staff on site Please note the following
• The local building official is responsible for building construction permitting and occupancy.
Installation may begin upon receipt of permits as required by the local building official.
• Any changes /deviations (incl. change orders or addenda) from the approved documents must be
submitted to the Department for review and approval. Please include your CRS number on all
communications to Construction Review Services.
• You must notify the department when construction is complete, either by the included
notification of construction complete (pink card) or by completing the form on the CRS
website. Additional instructions may be printed on the pink card. When we receive
notification, we will notify Department of Social & Health Services (DSHS) Boarding Home
licensing that you have completed the review process and are ready for licensing.
• Final licensing approval is subject to a site inspection by DSHS Boarding Home Licensing and
the Office of the State Fire Marshal to verify compliance with Boarding Home regulations and
your approved documents. If stamped approved plans are not available, the site inspection may
be terminated until such time they are available as determined by the licensing
inspector /surveyor.
If you have any questions please feel free to contact Construction Review Services You can monitor project
status and fill out our online survey at v` ww doh wa gov/cr
Page 2 of 6 Plan Review Comments for Project # 60190314
Facility Data Certificate:
Facility Name: Albright House Licensee UBI #: 601587134
Site Address: 3210 Rickey Rd NE Critical Access Facility: ❑ Yes ❑ No
Bremerton, WA. 98310
Estimated Date of Occupancy: currently occupied
Occupancy R2 Construction 5 -B Applicable Code
Group Type 2009 IBC
V)
Number of Current Added Removed Total
>+ Beds
}, Automatic Fire Sprinkler System ® Yes ❑ No Type 13
a Automatic Fire Alarm System ® Yes ❑ No
� Compartmentation req'd ®Yes ❑No Smoke Control System Provided ❑ Yes ®No
w
a Special Delayed Egress Control ® Yes ❑No Location
Q
Certificate of Need Required ❑ Yes ❑No CON Approval Granted ❑ Yes [
CON Number
Number of units Private occupancy Two person occupancy
,4 Based on size of rooms used for sleeping Residents
U O Based on size of common rooms Residents
Q v'
F, N Maximum allowable licensable beds
A W Qualifies for Assisted Living Funding Program ❑ Yes ❑No Number of qualifying units
W � U
�4 w
W
Ey
O
z
The data above is based on the information presented to CRS. Any change in the facility or facility program that
causes the above information to be incorrect is subject to review by CRS. Approval for construction is not
approval for licensure. A copy of the facility data certificate will be sent to the licensing agency.
Page 3 of 6 Plan Review Comments for Project # 60190314
Albright House
Chapter 388 -78A WAC Boarding Homes
Fire Sprinkler Pipe Replacement
� b
Q
The following is the plan review comment
a
O 0. O
U ¢ z
1 El Construction and renovation may create conditions that compromise the health and safety
of residents, staff, and visitors Facility planning must include provisions for infection
control and safety of the facility's occupants during any renovation or new construction
Excerpt from facility Fare Safety letter
We are planning for the residents to remain at the facility during the project
With an extra staff member dedicated to "Fire Watch" during this project
there will not be added danger to the residents
In addition to providing a fire watch, provide information on steps that will be taken to
mitigate potential infection control issues caused by airborne contaminates generated by
the work WAC 388 -78A- 2850(3)
Response received 11109110 — Fare watch and infection control shall be
provided by the owner of the facility
Not Approved 12/01/10 - Provide steps that will be taken to mitigate potential infection
control issues caused by airborne contaminates generated by the work
ALC response received 11122110 — The contractor will use the attic access areas
in room 121 and the maintenance room for the workmen to enter the attic Unit
121 is vacant Workers and stall will monitor to assure that the doors to these
areas are closed when the access doors are open
Access for pipe and materials will be the attic access in 121, the SE gable, and
SW gable Workman will temporally remove a small section of vinyl siding and
subsiding, install a " p oly curtain " in the SE and SW gables and use the window
in unit 121 to access materials for this project
The listed areas will not interfere with any of the emergency exits
The access areas used by the workman to "load" materials in the attic will be
cordoned off from the public, staff, and residents using signs and construction
tape
Approved 12/14/10 — Per the response the accesses to the attic will be monitored by
the workmen and facility staff to assure the doors are kept closed whenever accesses
to the attic are open. All material to be transported through temporary openings
into the attic through SE & SW gables and window in unoccupied Room 121 &
Page 4 of 6 Plan Review Comments for Project # 60190314
maintenance.
Facility to monitor residents for disturbance by noise and potential airborne
contaminants generated by movement above the ceiling. Residents shall be
temporarily relocated to other portions of the facility if noise is too distracting.
Facility to monitor clean up after work has been completed. Entire facility to be
thoroughly cleaned with special attention being given to Room 121.
2 ❑x Two sets of sprinkler system working plans shall be submitted for review and approval
before any equipment is installed or remodeled The department reserves the right to
defer plan review and inspections to the local authority having junsdiction (AHJ)
Deviation from approved plans will require permission Plans and specifications,
including hydraulic calculations that are incomplete or are not stamped by a Washington
State Licensed Fire Sprinkler Contractor, will be returned without review
Section 903 1, International Fire Code
Fare sprinkler documents developed by Patriot Fare Protection Inc were
received on 09124110
Not approved 10/26/10 based on fire sprinkler plans received 9/24/10 Plans must be
stamped and signed by a Washington Licensed Fire Sprinkler Contractor Provide a
detail for protecting the wet sprinkler pipe from freezing Section 8 15 12 2, NFPA 13
Response received 11109110 — Attached are (2) copies of the stamped drawings,
along with 2 stamped hydraulic calculations, drawing now indicate a tenting
detail for the wet sprinkler piping in the attic space, As your request indicated
Approved 11/12/10 based on revised fire sprinkler plans received 11/9/10. Items
addressed on revised plans. rb
AL response received 11122110 — Included are two sets of "Sealed" drawings
with the CRS project # 60190314 attached
ALC will hire an insulation contractor to "tent" the lines with poly to trap
ambient heat and apply 12 " blown fiberglass to prevent freezing as similar to
the existing "wet" lines
The insulation contractor will use the same access points as the Fare sprinkler
contractor
Sprinkler plans received 11/22/10 were approved 11/22/10. Only revision noted was
on Sheet FP -1 showing tenting of the water lines.
Compliance with the comments above provided by the Department of Health, Construction Review Services, are necessary for this facility to meet
the requirements of the applicable licensing regulations found in the Washington State Administrative Code and associated references These
comments do not relieve the facihty from the responsibility to meet the requirements of any other applicable federal, state or local regulations
In the event of conflicts between otherjurisdictions and these written comments, the most stringent shall apply
Page 5 of 6 Plan Review Comments for Project # 60190314
FIL
BUILDING PERMIT 3210 RICKEY RD NE
INSPECTION Remove and Replace
CARD Composition Shingles on Roof
} e 4
E� €
Building Plumbing Mechanical Alarm /Sprinkler
This Placard must be posted on or near building and the Permit & "Approved" plans must be at the sit
Permit # BB10 00101 POST ON SITE
Call the following Agency Telephone Numbers for inspectio - Propertylines shall be properly identified and marked before
Budding Department Inspections Call (360) 473 -5870 foundation footing inspection Setbacks are measured to the
WATER - Public Works -Water (360) 473 -5927 finished wall structure
- Reinspection fee maybe assessed if inspection has been
PW - Public Works - Engineering (360) 473 -5270 requested when not readyor corrections are not completed
HEALTH - Kitsap Co Health District (360) 337 -5285 - Permit, approved plans, engineering, and inspection card shall
Fire - Fire Department (360) 473 -5394 be on site during construction or Remspection Fee may be
L &I - Dept of Labor and Industry (360) 415 -4000 assessed
Inspection A ppro ed Date Notes
Final Inspection - Building f2 _ Z l)
FINAL BUILDING (360) 473 -5870
All of the above must be approved
Occupancy approval for SFR only - Commercial
structures require a separate Certificate of Occupancy
DO NOT OCCUPY BUILDING WITHOUT BUILDING DEPARTMENTAPPROVAL
PROTECT THIS CARD FROM THE WEATHER
13 1 0001
PERMIT CENTER �2 - 1 0
COMMERCIAL V/
• • Building Permit Application
Department of Community Development * 345 - 6th Street, Suite 600 * Bremerton, WA 98337 -1873
.[ y1pa� (360) 473 - 5275 * Fax (360) 473 * www ci bre w us
................... Apo ---
�4 Ati{{{RiH R � R'kili Ri dC i:A{R �,fli .
Business Name 2 F y h cqS c- (4 V
Site Address �a /O •� /� ,f�� )L X A i•° e
To apply for a property address, contact Public Works at (360) 473 -5270
CONTRACTOR. GQ t OWNER A�
Address P C- /6-/r /.Z- z y Address 3� X-C L Xq ,r�
Clt , State ZI p Ci!y State Zip ,e
License#&Exp Date 4rAV5 S Phone #
Contact Name 1 Authorized Agent Name:
Contact Phone # 3�G c'S /- 0 �PS Address
Email address City, State Zi
Tax ID/Parcel #. ot - aaos Phone # ( )
❑ Sewer ❑ Septic Email address
t Is ft app lication NO. Please oh"M 0 Nays AR0066 A l -00
❑ NEW COMMERCIAL ❑ TENANT IMPROVEMENT WITH WORK
❑ COMMERCIAL REMODEL ❑ TENANT IMPROVEMENT WITHOUT WORK
❑ COMMERCIAL ADDITION ❑ NEW SIGN
❑ COMMERCIAL REPAIR ❑ GRADING (Cubic Yards )
❑ NEW MULTI - FAMILY Lei REROOF
❑ DEMOLITION Interior Exterior " Foundation Wall ** Roof! Section"
** Separate demolition permit and fees required
Contact Public Works for sewer cap permit (473 -5270) Sewer must be capped pnor to demolition permit issuance
0 OTHER
IS THIS PROPERTY WITHIN 200 FEET OF A SHORELINE? YES ❑ NO [
Scope of work proposed � Q G j� GUS Ag &k
Square Footage" Building Construction Type
Valuation Plan Review Fee Permit Fee T surcharge Total Fees
A-7-2, o Lf 5�_ a
Application for which no permit is issued within 180 days following the date of application shall expire by limitation, and plans and other data
submitted for review may thereafter be returned to the applicant or destroyed by the building official The building official may extend the time
for action by the applicant for a period not exceeding 180 days on request by the applicant, showing the circumstances beyond the control of the
applicant have prevented action from being taken No applicant shall be extended more than once In order to renew action on an application
after expiration the pplicant shall resubmit plans and pay a new plan review fee
Applicant's Signature Date
Rev July 2008
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