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HomeMy WebLinkAboutBLD2003-00618 UILDING PERMIT APPLICA N MLA03-00551 ReviewType:I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD03-00618 Received Date: 9/30/2003 SITE ADDRESS: 2277 DUCKABUSH RD BRINNON, 98320 OWNER: TIMOTHY J EDGREN PHONE: (360) 796-4716 KATHERINE EDGREN 2277 DUCKABUSH RD BRINNON WA 98320-9624 SUBDIVISION: Block: Lot: PARCEL NUMBER: 502083017 Section: 8 Township: 25 N Range: 02 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTION ROOF OVER EXISTING DECK TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ALT MAIN: 160 VALUATION 500.00 ADD'L: HEAT TYPE: CODE EDITION: 1997 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: PARCEL TAGS: YES NO BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA Exist: Exist: Wetland Erosion Prop: Prop: Seismic Streams Total: Total: Flood Way Floodplain Routing Date: 3 F&W Landslide q(50 tioZj Shoreline Aquifer Forest: Commercial Rural Type Amount Paid By: Date: Receipt: Approved/Date Permit $38.75 MZL 09/29/03 60093 Plan Check $25.18 MZL 09/29/03 60093 State Building Code $4.50 MZL 09/29/03 60093 Total: $68.43 Jefferson Count apartment of Community Deuelo mei ,¢,�ozv nG p �� 6 621 Sheridan Street,Port Townsend WA 88368[3601370-44t o 4 ------. i Perm ot A ppGc© o IU �s N L } . Project Description: t Buildinge: t Type: Project Type: Frame Type; ❑ Single Family ❑ New '1 r � ,� �--� ��Wood r.LV_Et.OPNEi; ❑ Garage Attached/Detached fg Addition (CoWE&f,�1G r=X I i1. ?�Y_� ❑ Steel . ❑ Modular ❑ Alteration/Remodel u` / ❑ Concrete ❑ Commercial ❑ Repair ❑ Masonry ❑ Multi-family/#of Units ❑ Demolition ❑ Other: ❑ Industrial L Other: Co v-i-A7.. :12) be C K. Bathrooms: Bedrooms: Type of Sewage Disposal: Type of Heat: fi� Choose one: Existing: ____f___ Existing: 4G.' ❑ Sewer ❑ Community System PrElectricity ❑ Oil Proposed: Proposed: ,yy Individual System ❑ Woodstove ❑ Propane Total: Y' Total: Y 0 If not sewer,fill out the following: ❑ Heat Pump VConventional ❑ Alternative ❑ Other Permit# SEP /--CI is S'f Water Supply: • ❑ Private well f l° Two P. Well❑ Public:Name of water system: Square Footage: For Office Use Only II v af1" Main Floor �� Consistency Review •3 ' 2No Floor Base fee "r 3 o'15- St D 3rd Floor Plan Check fee 63•2I 25. Is, 3; ,03 Htd Basement State Surcharge fee 4•s Unhtd Basement t i` Subtotal „ ,1 - 6 ,4-3 Garage/Carport 101111 Pot Water Review fee '-P. IIIMII Decks 6(ove4.6-9 /60 SO F- 41 / i-+ ��� I 911 Rd Approach fee , Commercial TOTAL 94 ,1Ifflara q .0 11 Industrial Receipt# , 0()• 3 Other Cash/Check# (o Total Valuation: Initials •Pk-e7 „,i. Or /s ` Date 411, (J Estimated Cot $ S-O O. O 0 ` If within 200' ofthe-Shoreline, � -- - Distance to Bank or Ordinary High Water Mark ft. Bank Height ft. By signing the application form,the applicant/owner attests that the information provided herein is true and correct to the best of their knowledge. Any material falsehood or any omission of a material fact made by the applicant/owner 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 it's employees,representatives or agents for the purpose of application review and any required later inspections. Access and right of entry to the applicant's property or structure shall be requested and shall occur during regular business hours. Signature: ' •l• , 4,_ Date: 9,z9,,O J3 �/ OVER ► H:HOME\PLNCNTR\INFOBLDG\FORMS\BLDpermitApplication 11-8-01 "-` ,� ,. Made in Canada Innovation in too From•the workbench Af: ; r , ! . -; " .,. r ,. • . . . t t,:`�- !!! ,r a f!!e r Y !� v .. . .... ! , Date: r At-6.A .t. P.I.6k! ! .. A-N P.�..P WZik.-c.. 1 r .÷..."' e.x,s.,404.:: (A.)4-I :., '.., elm' :.' :* ,:. ...: .,.; ..: 3, 34,,,,/,171'.,it.:. DZ 't -**-----H,:ve.„...• ..:9_!-1,: 197,Lir::".... ;:"c4L-4:: ' ... -••"' 4 iit,e.s , ,....„,„......... ... k 4 t+ . ‘C.,C) . " • t ittc1V,414V,`,,'::, a •AI ,,:.. fk • C 1,2tin,ta�• ,+_,.��tz> : l;rt�c'C1Wk Q RPp2ax. i6 y0 SgFr: OH ^4: • �� 4 • • fib = • « R •E JIVE . 41'4 4 4• ••• (•.4•7-• SEP'i2.9'' ' ' . JE'FFERSON:G0UN.TY• • D PT::F COMMUNITY DEVELOPMENT • • C VEa,El) PC Rza,5'5c-T' 77.tX PAic4i-: Sot Q ' -0(7 , !TMEC2 60) 7• i6y7r .• •. .C • r.:2.7.7r.P cxeus f D .'G 4-$ ' I"'� fo •_ .B q„i , u3 4 q$3 20 :Ac:tze- Ge ,s- A . i . /\ ! r' ',, � *1 r ED6