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Home My WebLink AboutBLD2005-00638 • • CERTIFICATE OF OCCUPANCY Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 (800) 831-2678 PERMIT #: BLD05-00638 SITE ADDRESS: 74 WOODHAVEN LN Issue Date: 01/9/2006 PORT TOWNSEND, 98368 Final Date: 2/20/2007 APPLICANT: WILLIAM RICH PHONE: 253-630-0063 MARLENE B RICH 26429 104TH AVE SE#E301 KENT WA 98030 SUBDIVISION: DISCOVERY BAY VILLAGE Block: Lot: 70 PARCEL NUMBER: 947400070 Section: 13 Township: 29 N Range: 02 W PROJECT DESCRIPTION: NSFR W/ATTACHED GARAGE & RETAINING WALL A/G 50 GAL PROPANE TANK THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2003 EDITION. OCCUPANCY GROUP: R-3 TYPE OF CONSTRUCTION: 5N SPRINKLER SYSTEM yes /o~ THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 2/20/2007 < -ThA 1 C ti. , l,4'14 /5r1)0.4a< 6/11/144)2 bdati- ''-) 12/ /PI Building Officia Signature Date I:\F_BLD_Occupancy.rpt 10/29/19 IR UILDING PERMIT APPLICAI'�f7 ' MLA05-00593 `� Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD05-00638 Received Date: 10/4/2005 SITE ADDRESS: 74 WOODHAVEN LN PORT TOWNSEND, 98368 OWNER: WILLIAM RICH PHONE: 253-630-0063 MARLENE B RICH 26429 104TH AVE SE#E301 KENT WA 98030 DISCOVERY BAY VILLAGE SUBDIVISION: Block: Lot: PARCEL NUMBER: 947400070 Section: 13 Township: 29 N Range: 02 W CONTRACTOR: WINDHORSE CONSTRUCTION PHONE: 360-681-0796 1017 CHICKEN COOP RD SEQUIM WA 98382 Contractor's License WINDHI*961BG Expires 1/2/2006 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOP NSFR W/ATTACHED GARAGE A/G 50 GAL PROPANE TANK A`' '\avc3ctr\ SO1 Qe TYPE OF WORK RES SQUARE FOOTAGE: `' (ZQN�4��l0(1'41O: -R �x'-10—• TYPE OF IMP NEW VALUATION 250,000.00 MAIN: 1,128 CODE EDITION: 2003 ADD'L: 452 HEAT TYPE: EEE OCCUPANCY: R-3 HEAT BASE: HEAT TYPE: HTP OCCUPANCY: UNHEATED: 1,128 #OF STORIES: 2 CONST TYPE: 5N OTHER: GARAGE: 408 SHORELINE: CONST TYPE: SETBACK: DECK: 435 BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: OTHER BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 2 Prop: .23 Total: 2 Total: z '3 Routing Date: .af62/o5 Type Amount Paid By: Date: Receipt: A G•• State Building Code $4.50 SLE 10/04/05 77018 " �/� V `L: Potable Water Application $53.00 SLE 10/04/05 77018 JAN GI 20 Plan Check $1,191.94 SLE 10/04/05 77018 Permit $1,833.75 SLE 10/04/05 77018 Jefferson County Planning Total: $3,083.19 & Building Department • 0 4 1444 . 1 ',1::..,Yr—..• e -2 - _ li , .._ .,. ... I 4-1......i .)1 0 7.- . , I •r[ 1 I 1 , i . i ii 1 • 1 I •.„..--- I Ei- ' I I 1 . . . , , I . , -- I • . 1 J 1 f j ; I I — ' ! 1 - i I Tr r ( li 1 4 I . i --11 I c%. V i i , •-. i C 44 ! rb . .'i ! P 1 / i i I . 1 Cr3 -r) - ; e-- • 1, i I 1 ; 1 1 I. 1 . .pl 1 i 1 1 1 i i , . I \J j =C)V Xol, i 41 ..•••... --- I rt:1 1,-:, . i inn . , 1- 1 i i CI— CI --0- 7.'' 1 CD . 1 • • _ . . . i ifil c i 1 D, C I 0 J • BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD05-00638 Received Date 10/4/2005 SITE ADDRESS: 74 WOODHAVEN LN Issue Date 01/9/2006 PORT TOWNSEND, 98368 APPLICANT: WILLIAM RICH PHONE: 253-630-0063 MARLENE B RICH 26429 104TH AVE SE#E301 KENT WA 98030 SUBDIVISION: DISCOVERY BAY VILLAGE Block: Lot: PARCEL NUMBER: 947400070 Section: 13 Township: 29 N Range: 02 W CONTRACTOR: WINDHORSE CONSTRUCTION PHONE: 0-681-0796 1017 CHICKEN COOP RD �.p SEQUIM WA 98382 d-4i66lenlyt , 100•Ftlat alql 360-681-0796 Contractor's License: WINDHI*961BG Expires: 1/2/2008 PROJECT DESCRIPTION: NSFR W/ATTACHED GARAGE A/G 50 GAL PROPANE TANK CALL IN FOR THE REQUIRED INSPECTIONS THAT APPLY TO YOUR PROJECT. SETBACKS: 9)-)q-06 ('t UFFER: Footing: , s6 4,11, a-Pc04to-E / 4 4_ Cp -/49h)<._ in ��; F.ur c ation: 0 eor k an- o 6 QL L Y II pL �'- 1 Stormwater FINAL Appr val: c1/4p, Underground Plumbing , y /2 062 .11(2 / ti`'� Underground In ulation: .St � PSZ&L CL1 ot• • 1�Ihear Wall : tX r SNEAP AM.45 ? atr Aps Ok 7/�/aG �1 Sheathing: i0 D a Framing: ,gam ' 10-t��lP • /per I°i,NRAMccS�'cM Ft'1 y�a Plumbing: 7 t t Ors Propane ank/ fines: N ' ,o66 6k 414 Insulation: C 1 -at Sheetrock: Septic Sytem Final Approval (If not on sewer): Road Approach Final Approval: Zoning Final Approval: Final/Occupancy Approv 'W-420 U7 HEALTH DEPARTMENT-AND PU LIC 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. 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 SPECIAL CONDITIONS APPLY - SEE REVERSE • • SPECIAL CONDITIONS FOR CASE t BLD05-00638 1.) HD. APPROVAL CONTINGENT UPON THE VERIFICATION THAT THE SEPTIC TANK EFFLUENT REACHES THE DISTRIBUTION BOX AT THE DRAINFIELD OF THIS UNUSED SEPTIC SYSTEM INSTALLED 21 YEARS AGO. VERIFICATION BY HD OR LICENSED DESIGNER REQUIRED PRIOR TO BUILDING FINAL.. 2.) ALL RECOMMENDATIONS IN THE GEOTECHNICAL REPORT PREPARED BY STRATUM GROUP DATED NOVEMBER 23, 2005 SHALL BE FOLLOWED. A CERTIFICATE OF OCCUPANCY SHALL NOT BE ISSUED UNTIL AN ORIGINAL LETTER FROM THE STRATUM GROUP HAS BEEN SUBMITTED TO THE JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT CONFIRMING THE PROJECT COMPLIED WITH THE RECOMMENDATIONS OF THE GEOTECHNICAL REPORT. 3.) THE FOLLOWING IS A PORTION OF THE CONCLUSIONS AND RECOMMENDATIONS AS STATED IN THE GEOTECHNICAL REPORT PREPARED BY STRATUM GROUP DATED NOVEMBER 23, 2005. THE FULL REPORT IS FILED IN MLA05-00593 AT THE JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT. "There are four steep potentially unstable slopes on the subject property. The following describes my conclusions and recommendations for each potentially unstable area. Steep cut slope on the west side of the building area Any structure should be set back from the base of the very steep cut slope on the west side of the property at least 25 feet. The proposed home is set back more than 25 feet. 45-degree potentially unstable cut slope above Honeymoon Lane on the east side of the property: Any structure should be set back at least 30 feet from the top of the 45 degree slope above Honeymoon Lane. The proposed home is set back well over 30 feet from the top of the slope. 40-degree slope on the south side of the property: The 35-to 40-degree slope south of the level area is not unstable. However, due to the ris,< of differential settlement, any structure should be setback from the top of the slope on the south side of the level area 10 feet. The proposed home is located 30 feet from the 35-to 40-degree slope. 15-foot high 45-degree slope: The manmade 45 degree slope on the east side of the level building area is potentially unstable due to the steep slope. The slope was created by the placement of fill soils on the slope and the old logging road cut at the base of the slope up to the original slope configuration. A schematic cross-section of the excavation and new slope configuration is provided in the attached Figure 3. The foundation support should be setback at least 5 feet horizontally from the final slope for purposes of avoiding differential settlement. Roof drains and any other drainage should be discharged to a location that will not pose a risk of surface flow on any steep slopes. Soils on the site are very well drained and drainage should be directed into a dispersion trench at locations shown on Figure 4." 4.) A STORMWATER PLAN HAS BEEN SUBMITTED AND APPROVED BY THE DEPARTMENT OF COMMUNITY DEVELOPMENT. ONCE THE SUBJECT PERMIT HAS BEEN ISSUED THE APPLICANT SHALL FULLY IMPLEMENT THE PROVISIONS OF THE SUBMITTED PLAN AND CONTACT THE STRATUM GROUP TO ARRANGE A SCHEDULE TO INSPECT THE PROPERTY FOR PLAN COMPLIANCE. A CERTIFICATE OF OCCUPANCY WILL NOT BE ISSUED UNTIL THE STRATUM GROUP VERIFIES PLAN COMPLIANCE. NO CLEARING FOR ROADWAYS OR UTILITIES SHALL OCCUR ON THE PROJECT SITE UNTIL CLEARING NECESSARY FOR THE INSTALLATION OF TEMPORARY SEDIMENTATION AND EROSION CONTROL MEASURES HAVE BEEN COMPLETED. 5.) A vegetative buffer of 15-feet shall be permanently maintained from the top or edge of the Landslide Hazard Area. All buffers shall be measured perpendicularly from the top of the Landslide Hazard Area. •6.) A Geotechnical Report prepared by Stratum Group dated November 23, z005 was submitted in conjunction with this application. The report addressed the stability of the geologic hazard area. The report states, "Based on the proposed building locations and the elevations provided by Linwood, it is my opinion that the home as proposed will not be at risk from landslides and will not cause any off-site slope stability problems as long as the recommendations . . . are followed." 7.) Landslide Hazard Areas and their associated buffers shall remain naturally vegetated. Should buffer disturbance occur during construction, the Unified Development Code (UDC) Administrator shall require replanting with native vegetation. No alterations shall be made to the Landslide Hazard Area or its associated buffer without prior authorization by the UDC Administrator. 8.) Prior to and during approved construction activities, the perimeter of the landslide hazard area buffer shall be marked with a temporary sign. The sign shall be placed in such a manner that it can be directly observed from the construction area. The sign shall contain the following statement: "Landslide Hazard Area and Buffer- Do not Remove or Alter Existing Vegetation." 9.) All construction activities shall not encroach upon the buffer. This includes the storage or preparation of materials. 10.) The applicant shall permanently separate the boundary of the Landslide Hazard Area Buffer from the remainder of the subject property through installing logs, trees, a hedge row, or any other prominent physical marking approved by the UDC Administrator. 11.) To help prevent seawater from intruding landward into underground aquifers, all new development activity on Marrowstone Island, Indian Island and within 1/4 mile of any marine shoreline shall be required to infiltrate all stormwater runoff onsite. 12.) VOLUNTARY MEASURES OF COASTAL &AT RISK SIPZ: Water conservation measures: 1. Roof and other intercepted precipitation shall be routed to on-site detention ponds and/or other approved means and allowed to be released to the soil slowly. 2. Water collected from Storm water and roof catchments may be used for watering lawns and gardens. Unless catchment water has been treated to meet drinking water standards, there shall be no cross connections allowed between the potable supply and impounded water. 3. Water withdrawn from wells on each property shall not be used for watering of lawns and/or gardens. 4. Ground water withdrawn from each property shall be restricted to a rate of three (3) gallons per minute. 5. Installation of water conserving fixtures such as low flow toilets, faucets and shower restrictors and other water saving plumbing fixtures. 6. Landscaping plan (xeriscaping, native vegetation with minimal amounts of irrigation). Please NOTE that the above listed measures are not intended to be exhaustive, but rather is intended to be illustrative of the types of water conservation measures. 13.) MANDATORY MEASURES FOR COASTAL SIPZ: 1. For proof of potable water on a building permit application, applicant must utilize DOH-approved public water system if available. 2. If public water is unavailable, a qualifying alternative system may be used as proof of potable water or an individual well may be used as proof of potable water subject to the following requirement: a. Chloride concentration of a laboratory-certified well water sample submitted with building permit application. 3. If public water is unavailable, a qualifying alternative system may be used as proof of potable water. 14.) The project shall adhere to the Best Management Practices (BMPs) to control stormwater, erosion and sediment during construction. BMPs shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 15.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 0 16.) Not more than two (2) unlicensed or inoperable vehicles shall be stored•any lot less than one-half acre unless totally screened from view of neighboring dwellings and rights-of-way. Such screening shall meet all applicable performance and development standards specific to the district in which the storage is kept, and shall be in keeping with the character of the area. Screening shall meet the requirements of Unified Development Code (UDC) Section 6. Outdoor storage of thirteen (13) or more unlicensed or inoperable vehicles is prohibited except in those districts where specified as an automobile wrecking yard or junk (or salvage) yard and allowed as a Permitted Use in Table 3-1 of the UDC, and such storage shall meet the requirements of UDC Section 4.10. In no case, shall any such unlicensed or inoperable vehiclesbe stored in an Environmentally Sensitive Area (ESA). 17.) Pre-existing legal lots of record less than one acre in size in Rural Residential districts are subject to the stormwater requirements in UDC Section 6.7 and must meet the "Area of Impervious Surface Coverage"to the maximum extent practicable as determined by the Administrator." Lot coverage is defined as amount of impervious surface, which includes rooftops, driveways, concrete, etc. 18.) The building height is not to exceed 35 feet. 19.) Exterior lighting for residential uses shall not exceed twenty feet (20') in height from the finished grade, excepting when such lighting is an integral part of a building or structure. Ground level lighting is encouraged. 20.) Lighting fixtures shall be designed and hooded to prevent the light source from being directly visible from outside the boundaries of the property. The intensity or brightness of all lighting, during construction and after project completion shall not adversely affect the use of surrounding properties or adjoining rights-of-way. 21.) Setback from Woodhaven Lane right-of-way is no less than 20 ft., setback from Honeymoon Lane right-of-way is no less than 20 ft.side and rear setbacks are no less than 5 ft. If an environmentally sensitive area (ESA) is present, then the more restrictive setback shall apply. 22.) A minimum of two (2) on-site parking spaces is required for the single-family residence. I:\F_BLD_Permit_Buildng.rpt 10/29/1999 , . . • 3_ ... 0 , . . , ..,:. i 1 FIN3iNO0-13Ar --77 - ----' . . , , 1---- -Ii A ti ' LA ---------____ _I i' t, iN____ ' if• 1 V ! I 1 . ,. . ! AI • ____________.---- I • -- 11- i 'I 7, ; i Dc, 1 _ %,...-/ 1! ,....„------, ; , 1 ., 1 1 - 1 , 77 i I 1 ' 1 ' C.) i (5) ..Itnl 1 t.g 3 .• , 1 i _,A2..1 , ! ! • , . 1 ! • _ , 1 i 1 1 ; . 1 I I ).,1,:,,,,,,.7.7 is ‘• l"--...., I 4..; ........ 1 i \ I • C_ --)) . 2-- _2 - I-. . e.. 4) i ; ! , .1 1 4 .1 , --is -b < DI > l < i,?) G.,.. E--- --------- 7:1 b II I- .7 '''' AK 411''5O1\1 N,1_,, JEFFERSONUNTY __ DEPARTMENT OF COMMUNITY DEVELOPMENT 1 621 Sheridan Street • Port Townsend • Washington 98368 4 360/379-4450 • 360/379-4451 Fax S rS c5 NG www.co.jefferson.wa.us/commdevelopment 0%,' — 4 - ,r- Master Permit Application MLA: 55)13 LProject Description(include separate sheets as necessary): •--, ' L.c-t 9-r , >, 5.c-1>c'1.-, t-., . T.Zcr /v,)2 2 i.,' , L> A,l �� S. ,--P, >, rg 'T - 2 cjo\-,. )2. 1 Jul W. , Tax Parcel Number: c `_t'} LiC0� `4-U Property Z,6',o e G., LJ (acres/square feet) Site Address and/or Directions to Property: 1-4 k) U c)b AA- t-'y1 t, r on'e Property Owner(s)of Record: 9-0 t (1 611-b t`-i A i-e7tE R L e__\` Telephone: ZS3 tp3�' C^�(�3 Fax: email: Mailing Address: 2Co 11 Z 9 10 `� c; 3t0) ) N)1 W 4 98030 Applicant/Agent(if different from owner): M 4'(►4 C.,e_-1-• ACC pj ve v Telephone: 2' '8 12 S Fax:_ Z'4 4 $O Q .33 email: se 1-t•Q-%c pijykevi,Cc.hvL Mailing Address: .5 8 2S Cifl Gg✓,b,Joey- ( PO -) MU"Sc CI What kind of Permit?(Check each box that applies) &Building ❑ Variance(Minor, Major or Reasonable Economic Use) ❑ Demolition Permit ❑ Conditional Use[C(a),C(d),or C]*` IWSingle Famil ❑ Discretionary"D"or Unnamed Use Classification 'Garage Detached ❑ Special Use(Essential Public Facilities)** ❑ Manufactured Home ❑ Boundary Line Adjustment ❑ Modular ❑ Short Plat** 0 Commercial* ❑ Binding Site Plan** ❑Change of Use ❑ Long Plat** ❑Address ❑ Road Approach 0 Planned Rural Residential Development(PRRD)/Amendments** Ct1'Propane ❑ Plat Vacation/Alteration** ❑Allowed"Yes"Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions'"' 0 Stormwater Management ❑ Shoreline Management Substantial Development** ❑ Site Plan Approval Advance Determination(SPAAD)* ❑ Shoreline Management Variance El Temporary Use ❑ Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* ❑Jefferson County Shoreline Master Program Amendment ❑ Forest Practices Act/Release of Six-Year Moratorium *May require a Pre—Application Conference _ **Requires a Pre-Application Conference Please identify any other local, state or federal permits required for this proposal, if known: DESIGNATION OF AGENT I hereby designate #/K CS' cPXl71 Q to act as my,agent in,matters relating to this application for permit(s). OWNER SIGNATURE / / Date: -../S/o 3 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,her or it's 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 this permit being null and void. I further agree to save,indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attorneys 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 its employees,representatives or agents for the sole purpose of application review and any required later inspections.Access and ri try to this property shall be reduested and shall occur only during regular business hours. /K �� • Signature: (/C �`��/' �6 7, 7�1 .�p�rct � Date: ��> s The action or actions Applicant will undertake as a result of the issuance of this permit may negatively impact upon one or more threatened or endangered species and could lead to a potential"take"of an endangered species as those terms are defined in the federal law known as the "Endangered Species Act"or"ESA."Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this permit has been issued will not violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s)even if you are in compliance with the Jefferson'Co development code.The Applicant acknowledges that he,she or it holds individual and non-transferable responsibility or abering to and ying`with the ESA. The App,nt has read this disclaimer a d signs and dates it below. Signature:---- �4 /4` � C '--r7 J7l6d u' �� c__, Date: 3A5- > G:\PeimitCenter\FORMS\DRD FORMS\Master Permit Application 7-8-04.doc III 0 OWNER BUILDER STATEMENT • The signer of this statement does hereby certify 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: Date: CI r- GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: v i „ vi VU w'Y1 a h o-:i›C C L 2-, , tkc i--,, ,�� 11,(. p ( i C ) (P 01 L) (,, (?,(ce) (egg) Lit ct(rs MAILING ADDRESS: t O l C CA,c cs Ccc..{> (La 51x,n YMAIL: CONTRACTOR'S LICENSE t+ WAINS ------•..-. PpttNt NUMBER: I)\.1 w!A tk-r till I t- C•, NUMBER ARCHITECT/ENGINEER: 7 I N N('✓ Ey\G t��( . PHONE ( ;/)c13& ) t'2.g� FAX: ( ,V ) g ) Oq J3 MAILING ADDRESS: ()IZd /1 l'i ) t t e k ti j Tzje J-j i -,,i/l)Y-x-[,\EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: [( New W-'Wood Existing: 11 Sewer ❑ Addition ❑ Steel Proposed: L Bank [1 Community System ❑ Alteration/Remodel ❑ Concrete Total: 'L Height: N'(ndividual Syst m 0 Repair ❑ Masonry r` ASEP Permit# 663 (4 9 ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well Li Two Party Type of Heat,: Proposed: 2- Y.-Public ToTotal:-e/ic-c—fy 1pc Name of System:l7 i•,� t`rei - .4�/- iteitfe 1(7,t)61,n w-Y-Tev cc.- If this is a Commercial Project you must answer the following: Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces: Number of occupants(includes owners,tenants,employees,etc) Current Proposed IBC Occupancy: _ IBC Type of construction: Will you have Food Service? Yes / No If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply: ❑ Underground Tank Lt'Above ground Tank Size of Propane Tank: S-4 VHeat Stove ❑ Cook Stove ❑ Woodstove ❑ Fireplace Insert ['Hot Water Tank ❑ Pellet Stove ❑ Other Is this appliance being installed in a Manufactured/Mobile Home? Yes /a When applying for a permit to install a propane tank you must also submit a site plan showing all of the buildings,all property lines, tank location and size,distances from the propane tank to all property lines,buildings and septic system components, including the reserve area. Square Footage For Office Use Only I I — Current Proposed j=rrQ2vP -L;� Main Floor C 1 '1 3 g�Consistency Review: n ,`l 2""Floor 6, a ,.vo. Base fee: 17�0e}•1 l 2 33, I yi 1.zI use. 3td Floor '-Addiuonai section •: ► {.+�i 119 1 . F1 5,4g Mezzanine: Plan Check fee: Y t r ) Heated Basement I r r i.,. ted State Surcharge fee: 5v Unheated Basemen C:l 'ot Water Review fee: 0,0 Other Unheated ! 911/Rd Approach fee: _. Garage/Carport L) C` . 16A5P TOTAL: $ 3, 62Co _11 Decks L(3 S� tOto`Z " t-Number: rid d I a Other g A r ash/Check Number: 9y-� 3-i ESTIMATED COST(REQUIRED) • I t` '- Date: ,p. 1165 •Fair markety. • . . a..ran. . -naisfound. • • /V ' - U . a,, s•, 1 n,[Isla: _arr� .� _ = t L---fir: ag „oo�• - at ,50a G:\Penni .-'ha...! -s= •' S\Master Permit Application- - "T2eAXS•t cY1 W«.QJ. CO(r(01h I — --_- ,-,---,7/1/4.-im I-- (`/-(1-) - 'i---410/ ---- "1111111.1M111111M1111&1111.!. O 'J dd�M Zee y �b-78 �M 'IbQ,�\- ' - \ �% �(e ..) „s �N 5 '111S NO ,I, 1Ib13a 3 N Z'h. _ u//rh -. 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