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HomeMy WebLinkAboutBLD2003-00642 4111 BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD03-00642 Received Date 10/10/2003 SITE ADDRESS: 2364 ELKHORN LN Issue Date 11/7/2003 QUILCENE, 98376 APPLICANT: MARTIN C SAUNDERS PHONE: (360)698-6653 7375 BRIDLEVALE BLVD NW BREMERTON WA 98311-8914 SUBDIVISION: Block: Lot: T 4 PARCEL NUMBER: 802272003 Section: 27 Township: 28 N Range: 02 W CONTRACTOR: INNOVATED FIRE SPRINKLERS SYS PHONE: (360)452-7583 VINCE BETTGER 81 NEW HAVEN LN PORT ANGELES WA 98362 Contractor's License: INNOVFS044DR Expires: 08/12/2004 LOAN LENDER/ BOND HOLDER: PROJECT DESCRIPTION: NO MLA REQ -FIRE SPRINKLER SYSTEM REQUIRED INSPECTIONS: [ ] SETBACKS: [ ] UFFER: [ ] Footing: [ ] Foundation: [ ] Underground Plumbing: [ ] Underground Insulation: [ ] Shear Wall : [ ] Framing: ( 1 Plumbing: ��i�'lb.) �Z �.y`''Y�? ,mac L /< ////�3 T-4444, rt.-sr el( 7' [ ] Propane Tank/ Lines: [ ] Insulation: ( 1 Sheetrock: [ ] Septic Sytem Final Approval: 1 Zoning Final Approval: [ ] Final/Occupancy Approval: /0-L0-05 HEALTE PARTMENT 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. 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 •UILDING PERMIT APPLICA VN BLD03-001 27 Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD03-00642 Received Date: 10/10/2003 SITE ADDRESS: 2364 ELKHORN LN QUILCENE, 98376 OWNER: MARTIN C SAUNDERS PHONE: (360)698-6653 7375 BRIDLEVALE BLVD NW BREMERTON WA 98311-8914 SUBDIVISION: Block: Lot: T 4 PARCEL NUMBER: 802272003 Section: 27 Township: 28 N Range: 02 W CONTRACTOR: INNOVATED FIRE SPRINKLERS SYS PHONE: (360)452-7583 VINCE BETTGER 81 NEW HAVEN LN PORT ANGELES WA 98362 Contractor's License INNOVFSO44DR Expires 3/13/2001 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP NO MLA REQ - FIRE SPRINKLER SYSTEM TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 3,450.00 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 F&W Landslide Routing Date: lotc.- ( ? cpess.3 Shoreline Aquifer Forest: Commercial Rural Type Amount Paid By: Date: Receipt: /�11 PP • t /E Permit $97.25 KAS 10/10/03 60259 Plan Check $63.21 KAS 10/10/03 60259 NOV -- 7 2003 State Building Code $4.50 KAS 10/10/03 60259 Total: $164.96 Jefferson County Planning & Building Department ecsaiLrr -'6ryNg1214, JO i Jefferson Camtyletment of Co mmdty Development ��' r r ° 621 Sheridan Street,Port Townsend WA 88368[360]378 A450 - - A 0 _ _ �. ��rm ? 0 ,p, i, ,caTo on ,,s,iiit,G,,, . . Project Description: Building Type: Project Type: Frame Type: _g Single Family X New 15K Wood ❑ Garage Attached/Detached 0 Addition 0 Steel ❑ Modular ❑ Alteration/Remodel ❑ Concrete • ❑ Commercial ❑ Repair 0 Masonry O Multi-family/#of Units ❑ Demolition 0 Other: O Industrial O Other: ..re,.. , p.', 1:iC t Bathrooms: Bedrooms: Type of Sewage Disposal: Type of Heat Choose one: Existing F.'risting. 0 Sewer 0 Community System ❑ Electricity 0 Oil Proposed: Proposed: ❑ Individual System 0 Woodstove ❑ Propane Total: Total. If not sewer,fill out the following: ❑ Heat Pump 0 Conventional 0 Alternative ❑ Other Permit# SEP Water Supply: "�:,.Private well ❑ Two Party Well 0 Public:Name of water system: Square Footage: For Office Use Only Main Floor :.r' / t Consistency Review 2ND Floor Base fee t7•25 3rd Floor Plan Check fee—65% (.3.2{ Htd Basement State Surcharge fee .14'.SO Unhtd Basement Subtotal 1(:).-i: qio Garage/Carport Pot Water Review fee -! Decks 911/Rd Approach fee CP Commercial TOTAL 16 y'-q G Industrial Receipt# 6,&Z5 9 Other Cash/Check# n?32 7 Total Valuation: i--i � Sp✓:'�c1C 1•e o"J' Initials i"gja Or Date (Ol R°( d3' Estimated Cost >(/S ci.c ) If within 200' of the 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 attomey'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: tip. .: r9 - '' ?t:: %e -� �l %-ate•' -' . H:HOME\PLNCNTR\INFOBLDG\FORMS\BLDpern itApplication 11-8-01 �v'1o's 4[o q'p 4" '✓t7 ,' �� G'o". .� 5'0" I Lo'(o" �jro - ------ A o . \ PoR� ►t . 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