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HomeMy WebLinkAboutBLD2003-00680 II BUILDING PERMIT APPLIcir ION BLD03-00680Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD03-00680 Received Date: 10/28/2003 SITE ADDRESS: 71 SIMCOE RD PORT TOWNSEND, 98368 OWNER: MICHAEL M HENERY PHONE: (360) 379-0646 JANE A HENERY 71 SIMCOE RD PORT TOWNSEND WA 98368-9657 SUBDIVISION: Block: Lot: PARCEL NUMBER: 001324011 Section: 32 Township: 30 N Range: 01 W CONTRACTOR: J D G CONSTRUCTION INC PHONE: PO BOX 2073 PORT TOWNSEND WA 98368 Contractor's License JDGCOI*044BJ Expires REPRESENTATIVE: PHONE: "" ' � ' -� PROJECT DESCRIPTIOF ROOF - REPLACE EXIS G & ROOF STRUCTURE NO MLA REQ 2evrtvdft S - TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ALT— MAIN: VALUATION 20,000:00 ADD'L: HEAT TYPE: CODE EDITION: 1 1997 �, OCCUPANCY: / �� HEAT BASE: HEAT TYPE: OCCUPANCY: �f ,`7{ UNHEATED: #OF STORIES: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: 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: F&W Landslide 10 �� (o3 W Shoreline Aquifer Forest: Commercial Rural Type Amount Paid By: Date: Receipt: L!k_to pr ve t Permit $321.25 KAS 10/27/03 60292 AP H MI..; Plan Check $208.81 KAS 10/27/03 60292 State Building Code $4.50 KAS 10/27/03 60292 DEC - it 2003 Total: $534.56 Jefferson County Planning &Building Department t,ViitaW. Y • g, ON co Jefferson Cou rt of sty Development �� , i 0,E 621 Sheridan Strad,Port Townsend WA 0 E360J 378-4450 iZi `N o 4- '-''. * Prmot o0 O ppliOcacnOn ezeDF- Project Description: . 6rE .#z�Ko M43--. i`(JF �-� Building Type: Project Type: Frame Type: g Single Family ❑ New 0 Wood ❑ Garage Attached/Detached ❑ Addition ❑ Steel ❑ Modular Alteration/Remodel ❑ Concrete • ❑ Commercial Repair ❑ Masonry ❑ Multi-family/#of Units ❑ Demolition ❑ Other: 0 Industrial 0 Other. Bathrooms: Bedrooms: Type of Sewage Disposal: Type of Heat: Choose one: Existing Existing. ❑ Sewer 0 Community System 0 Electricity ❑ Oil Proposed: Proposed: ❑ Individual S stem Total: Total: y 0 Woodstove 0 Propane If not sewer,fill out the foll 0 Heat 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 Consistency Review 2ND Floor Base fee 31 I./.a..5321,2-s- eip, 3rd Floor Plan Check fee—65%o�LS`&•'3 1 2b�• o l L TS•,4 Htd Basement State Surcharge fee 4-SC) g Unhtd Basement Subtotal 31-1-.5' Garage/Carport Pot Water Review fee Ck Decks 911/Rd Approach fee Commercial TOTAL 1-- 153L(:S Industrial Receipt# %0Za Z. Other ,Q47`/`' 41:0111/f7 Cash/Check# ti -5 -' Total Valuation: Initials rOr A5 `' Date e0 2- Estimate cost: / A. If within i` -. --the-Sn©reline, 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: Date: OVER H:HOME\PLNCNTR\INFOBLDG\FORM\BLDpernutApplication 11-8-01 # • BUILDING PERMIT II Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD03-00680 Received Date 10/28/2003 SITE ADDRESS: 71 SIMCOE RD Issue Date 12/4/2003 PORT TOWNSEND, 98368 APPLICANT: MICHAEL M HENERY PHONE: (360) 379-0646 JANE A HENERY 71 SIMCOE RD PORT TOWNSEND WA 98368-9657 SUBDIVISION: Block: Lot: PARCEL NUMBER: 001324011 Section: 32 Township: 30 N Range: 01 W CONTRACTOR: J D G CONSTRUCTION INC PHONE: 425-881-9663 PO BOX 2073 PORT TOWNSEND WA 98368 Contractor's License: JDGCOI*044BJ Expires: 11/14/2005 LOAN LENDER/ BOND HOLDER: PROJECT DESCRIPTION: REPLACE EXISTING & ROOF STRUCTURE AND REMODEL EXISTING BATHROOM REQUIRED INSPECTIONS: ( ] SETBACKS: [ ] UFFER: [ ] Footing: ( ] Foundation: [ ] Underground Plumbing: [ ] Underground Insulation: [ ] Shear Wall : ( ] Framing: C. /-3-01 1-44000 i a)wx1. `j evrsr Bu.ek+Az.ok. 41Agicl 1 Plumbi -fd'O [ ] Propane T nk/ Lines: [ ] Insulation: 1 !,42Q-04 [ 1 Sheetrock. , /aZ,—�'-D - [ ] Septic Syt m Final Approval: [ 1 Zoning Final Approval: [ ] Final/Occupancy Approval:T5Pnik giteriC. L.k)t OP hOr1S.,2,� OK >-7-A.� HEALTH DEPARTMENT APPROV L 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 rn X II _ L IT - G) _ 1 CO —1 73 O�0 z broom books L — m N N X X Z X rt /� � CD 00 = . O © pT O 01 O O ..A.O n , ft Cr. 1'-78" / / amn Cu n \ 1".' * W — — W \ -D.- F� ,,art co II oai= 51 - - II Z \ -• V tH— - G) -I _— — — - 00 --_-_ - coin, V n - 0' - ._ kb CJJ ..4.I.-, z z � � O L - jbroom ca. C7 booksL - — 4 / 4T_95It__-/ 8 8 D T F2 6 Remodel for: Shearwater Services, Inc. 4873 GISTERED z o R iECT z Mike &Jane Henery PO Box 53261 Bellevue, WA 98015 t �r W c " N O rn o o / cA " LLEN WVD 71 Simcoe Road (206) 949-5033 rallen@shearwaterserv.com STATE OF WASHINGTON Port Townsend, WA 'A'6