HomeMy WebLinkAboutBLD2008-00205 MLA08-00236
ItUILDING PERMIT APPLICA N Review Type: I
Jefferson County Department cf Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD08-00205 Received Date: 5/14/2008
SITE ADDRESS: 1076 PARKRIDGE DR
OWNER: FREDRICK W SPANN TRUSTEE PHONE: 360-379-0281
DELORES L SPANN TRUSTEE
90 BELVEDERE DR
PORT TOWNSEND WA 98368 WOODLAND HILLS#2 PHASE 2
SUBDIVISION: Block: Lot: 46
PARCEL NUMBER: 999900146 Section: 27 Township: 30 N Range: 01 W
CONTRACTOR: WALTENBAUGH CONSTRUCTION CC) PHONE: (360)385-6105
32 KALA SQUARE PLACE
PORT TOWNSEND WA 98368
Contractor's License WALTECCC12BA Expires 1/2/2010
REPRESENTATIVE: WALTENBAUGH CONSTRUCTION CC) INC PHONE: (360) 385-6105
32 KALA SQUARE PLACE (360) 379-2737
PORT TOWNSEND WA 98368
PROJECT DESCRIPTIOI' NSFR W/ATT GARAGE & A/G 120 GAL PROP TANK
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN: 3,067
VALUATION 546,000.00 ADD'L: HEAT TYPE: EEE
CODE EDITION: 2006 HEAT BASE: HEAT TYPE: RAD
OCCUPANCY: R-3 UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: 5N GARAGE: 864 SHORELINE:
CONST TYPE: DECK: 700 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: ALT
WATER SYSTEM: OTHER
BEDROOMS: BATHROOMS:
Exist: 0 Exist: 0
Prop: 3 Prop: 3
Total: 3 Total: 3
Routing Date:
Type Amount Paid Bv: Date: Receipt: Approved/Date
Permit $3,452.25 LYK 05/14/08 97379
APPROJED
Plan Check $2,243.96 LYK 05/14/08 97379
State Building Code $4.50 LYK 05/14/08 97 379
Potable Water Application $59.00 LYK 05/14/08 97 379 AUG 2008
Total: $5,759.71 Jefferson County Planning
& Building Department
Je.fGrson County Building Di`'rsion Permit NumU!•': BLD08-00205
Applicant: SPANN TRUSTEE
BUILDING PERMIT INSPECTION APPROVALS applicable Code: 2006 International Building Codes
To schedule inspections, call (360)379-4455 no later than 7:00 AM the day of the inspection.
Requests received after 7:00 AM will not be scheduled for that day's inspections.
ELECTRICAL PERMITS are issued by the Washington State Department of Labor& Industries.
The electrical permit must be signed off by the State Inspector prior to the County's Framing Inspection
Inspection Item Date Approval Signature Notes
Setbacks
Foundation Footing e` ,
Footing Drains 9/l4/0a
Foundation Stem Wall Vey is
ail
Underground Plumbing
Under Floor Framing k uUG,
Straps(hold downs)
Ext. Shear Wall Nailing - (7- A
Rough-in Plumbing -cc( C\ j y 6"-)0 T i tEvirT'Tv deS
Framing t ..l c( (mot
Airseal t
Insulation:Walls i _ C -
1
Insulation: Floors - `
Insulation: Ceiling '- '�t `` ',�_. - FL
Int. Shear Wall Nailing
Wallboard Nailing /_ ,9_QY .. ,
Gas Line: Interior , _ \3 ._ci Q'
Gas Line: Exterior J— ( l�
1 —C
Propane Tank
Heat/Chimney Clearance �__I�_LFl S C ,
Drywell/Alt Drainage r ;�
��9�� ' �t, `G, �
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Address Posted
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FINAL INSPECTION .
FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED
THIS PERMIT IS VALID FOR ONE YEAR
• .
CONDITIONS for Building Permit# :BLD08-00205
1.) 2005 DOE STORMWATER MANUAL DRYWELL DESIGN CRITERIA
ALL INFILTRATION SYSTEMS SHOULD BE AT LEAST 10 FEET FROM ANY
STRUCTURE, PROPERTY LINE, OR SENSITIVE AREA.
FOR SITE WITH SEPTIC SYSTEMS, INFILTRATION SYSTEMS MUST BE
DOWNGRADIENT OF THE DRAINFIELD UNLESS THE SITE TOPOGRAPHY CLEARLY
PROHIBITS SUBSURFACE FLOWS FROM INTERSECTING THE DRAINFIELD.
DRYWELL BOTTOMS MUST BE A MINIMUM OF 1 FOOT ABOVE SEASONAL HIGH
GROUNDWATER LEVEL OR IMPERMEABLE SOIL LAYERS.
f) ii2 EACH DRYWELL MAY SERVE UP TO 1000 SQUARE FEET OF IMPERVIOUS
1 SURFACE FOR EITHER MEDIUM SANDS OR COURSE SANDS.
TYPICALLY DRYWELLS ARE 48 INCHES IN DIAMETER (MINIMUM)AND HAVE A
DEPTH OF 5 FEET (4 FEET OF GRAVEL AND 1 FOOT OF SUITABLE COVER
MATERIAL).
FILTER FABRIC (GEOTEXTILE) MUST BE PLACED ON TOP OF THE DRAIN ROCK
AND ON TRENCH OR DRYWELL SIDES PRIOR TO BACKFILLING.
SPACING BETWEEN DRYWELLS MUST BE A MINIMUM OF 4 FEET.
2.) The applicant shall implement the approved replanting plan that was submitted on August
11, 2008. PRIOR TO SCHEDULING A FINAL BUILDING INSPECTION, THE
APPLICANT SHALL CONTACT THE DEPARTMENT OF COMMUNITY DEVELOPMENT,
DEVELOPMENT REVIEW DIVISION (phone: 360-379-4450) TO SCHEDULE AN
INSPECTION TO VERIFY COMPLIANCE WITH THE REPLANTING PLAN.
3.) A Stormwater Site 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 Jefferson County
Department of Community Development to arrange a schedule to inspect the property for
plan compliance. A Certificate of Occupancy will not be issued until the Department
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.
4.) Outdoor residential storage shall be maintained in an orderly manner and shall create no
fire, safety, health or sanitary hazard.
5.) Not more than 2 unlicensed vehicles shall be stored on any lot 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 Chapter 18.30 JCC. Outdoor storage of 3 or more junk motor
vehicles is prohibited except in those districts where specified as an autormobile wrecking
yard or junk (or salvage) yard and allowed as a permitted use in Table 3-1 or Chapter
18.18 JCC, and such storage shall meet the requriements of JCC 18.20.100, Automobile
wrecking yards and junk (or salvage) yards. In no case, shall any such junk motor
vehicles be stored in a critical area.
6.) A minimum of two (2) on-site parking spaces shall be provided for the single family
residence.
7.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of
impervious surface which includes roof tops, driveways, concrete, etc.
8.) Minimum setback from Parkridge ere right-of-way shall be 20 feet. Minimum
setback shall be 50 feet as per recorded plat. The 50-foot buffer shall remain naturally
vegetated. Minimum side yard setbacks shall be 5 feet.
9.) 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.
10.) 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.
11.) The building height is not to exceed 35 feet.
12.) THE 50-FOOT WIDE BUFFER ADJOINING KALA POINT DIVISION, JANIS BULIS
PRESERVE AND OLD FORT TOWNSEND STATE PARK SHALL REMAIN NATURALLY
VEGETATED.
13.) The subject property is located in the proximity of the Jefferson County International
Airport(JCIA). The JCIA is a public, general aviation airport with a hard surfaces
3,000-foot, 12,500 pound weight bearing capacity runway. JCIA experiences frequent
landings and take-offs. Structure located in the proximity to the airport will, to varying
degrees, be subject to noise and vibration from aircraft during take-off, landing and
approach activities.
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I SITE PLAN
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APPROV
STORMWATER L N
AUG 2 1 2008
�r
(e.s-ON c •
°� JEFFERSON C UN ---
EFFERSON COUNTY
►, DEPARTMENT OF COM UN1'rMi.I t. EM1VELoPME MAY 4 2008 ,
621 Sheridan Street• Port T
O� 360/379-4450 • 360/379-4451 Fax
�`4$ING http://www.co.jefferson.wa.us/commdevelopment/'
STORMWATER SITE PLAN SUBMITTAL TEMPLATE
MLA# Vg ^- , PROJECT/APPLICANT NAME: 1 r Z4Y t C '"bae-a-res
Please answer all of the following questions to the best of your ability. Where the question calls for depiction on a site map, the
applicant may choose to either incorporate the elements into the general plot plan for the Master Land Use Application or to submit a
separate stormwater site plan map.
Project Overview
1. Describe the proposed developed conditions of the site. Indicate position and relative size of proposed improvements on the
site m�appe. �
i W CQn5tru vet w o v Ci d 1 ,S f v c'ctnr ►r�S 1461,4!cv
Existing Conditions Summary
2. Describe the existing topography. Indicate contours on the site map.
Loft is Plat
3. Describe the existing vegetation. Indicate native vegetation areas on the site map.
14-f-1 vet ittl -1.t n
4. Describe the existing soils. Indicate soil type on the site map.
5- Describe the existing site hydrology(i.e., drainage; behavior of water on the site—above, below, and on the ground). Indicate
existing stormwater drainage to and from the site on the site map. Depict separate drainage basins on the site map, if
applicable, and indicate acreage of each.
s o cmidfl .1 oaw,
6. Describe
any excess levels of noise generated by the proposed use or activity:
stormwater site plan templete.doc—rev.10/12/2003 5
•
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7. Describe significant geographic features and critical areas (i.e., environmentally sensitive areas such as wetlands, streams,
steep slopes,etc.)on the site. Indicate location on the site map.
8. Describe the general vicinity of the site, including adjacent land uses and structures,_utilitiesLroads, and sensitive/critical areas
(streams,
wetlands, lakes,steep slopes,eta).
•
MAY 1 4 Lut.)
Permanent Stormwater Control Plan C
`i.%NT
This portion of the Stormwater Site Plan consists of the selection and installation of the appropriate stormwater control BMPs
and facilities to remain in place after construction of the project is completed.
"Medium" size projects are required to have the totals calculated of all impervious surfaces, pollution-generating impervious
surfaces, and pollution-generating pervious surfaces to verify that the thresholds for treatment facilities and flow control
facilities are not exceeded.
g. Describe the developed site hydrology, as proposed. Indicate whether stormwater will be fully dispersed(i.e., per BMP T5.30
in the Manual)or, if not,what types of stormwater flow control will be utilized for the site or specific threshold discharge areas
within the site. Locate these facilities on the site plan and differentiate proposed facilities from existing facilities.
• 41-1-1Mw .rr WI!' 1111,4u44 dAd
10. If the project requires the use of stormwater treatment facilities, describe the types of stormwater treatment facilities proposed
for use on the site. Locate these facilities on the site plan and differentiate proposed facilities from existing facilities. [This is
normally for"large"projects or projects that involve the potential for dispersion of contaminants.]
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11. Describe the performance goals and standards applicable to the project.
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12. Describe the flow control system.
stormwater site plan temptate.doc—rev.10/12/2003
6
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13. Describe the water quality system.
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14. Describe the conveyance system analysis and design.
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15. Describe the source of fill material,physical characteristics of fill material,and deposition of excess material.
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16. Proposed methods of placement and compaction consistent with the applicable stppdards-on Appendix-Chapter 33 of-the
Uniform Building Code. ,
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17. Describe the proposed surfacing material. J
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18. Describe methods for restoration of the site.
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19. An Operation and Maintenance Manual is required for each flow control and treatment facility. [This is normally required for
"large"projects only and only those for which facilities are required to control flow or treat runoff.] If included,list the Manuals
here. , /I
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20. List here and include any special reports or studies conducted to prepare the Stormwater Site Plan.
21. List other necessary permits and approvals as required by other regulatory agencies. If those permits or approvals include
conditions that affect the drainage plan or contain more restrictive drainage-related requirements,describe those conditions or
restrictions here.
stormwater site plan template.coc—rev.10/12/2003 7
•
CONSTRUCTION STORMWATER POLLUTION PREVENTION PLAN(SWPPP)
The Construction SWPPP addresses sediment and erosion control during construction. The BMPs indicated by the applicant in the
template that follows must be installed on the ground during all construction phases of the project. The proponent is responsible for
preventing sediment and erosion impacts to environmentally sensitive areas and off-site areas. Consult the Construction Stormwater
Pollution Prevention (SWPP) Best Management Practices (BMPs) Packet for guidance, particularly with rural residential
development.
SECTION I—CONSTRUCTION SWPPP NARRATIVE
1. Construction Stormwater Pollution Plan Elements. Describe'low each of the Construction SWPPP elements has been or
will be addressed. Identify the type and location of BMPs used to satisfy the required element. If an element is not applicable
to the proposal,justify in writing. Descriptions of the 12 Elements are found at section 2.5.2 of the Manual(beginning on page
2-15).
12 Required Elements—Construction SWPPP
1. Mark Clearing Limits.
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2. Establish Construction Access.
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3. Control Flow Rates.
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4. Install Sediment Controls.
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5. Stabilize Sods. • •
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6. Protect Slopes. ..
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7. Protect Drain Inlets.
stormwater site plan tomplate.doc—rev.10/1212003 8
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12 Required Elements—Construction SWPPP(continued)
8. Stabilize Channels and Outlets.
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9. Control Pollutants.
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10. Control De-Watering(the act of pumping groundwater or stormwater away from an active construction site).
In)tu- r .l l l na.*t,cAr---ul v sty r to vw S o i ( + ot cs+u-tea'
11. Maintain Best Management Practices(BMPs).
12. Manage the Project.
a6 41,
2. Adjacent Areas.
a. Description of the adjacent areas that may be affected by site disturbance (e.g., streams, lakes, wetlands, residential
areas, roads).
b. Description of the downstream drainage path leading from the site to the receiving body of water(minimum distance of 400
yards). r r_ WI
Se-t c i ace s L h�. Qr
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3. Environmentally Sensitive Areas. ! (r' Y
a. Description of environmentally sensitive areas that are on or adjacent to the Site:,' iY
J1J9
stormwater site plan template.doc—rev.10/12/2003 9
II 0
b. Description of special requirements for working in or near environmentally sensitive areas.
01 A _.
4. Erosion Problem Areas. Description of potential erosion problems on site in the context of the characteristics of the on-site
soils(e.g.,erodibility,settleability,permeability,depth,texture,soil structure).
5. Construction Phasing.
a. Construe'ion sequence
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tIb. Constru on phasing(if proposed)
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6. Construction Schedule. Wet season is October 1 through April 30(page 2-21 of the Manual).
I. Provide a pr�osgd const ch"
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II. Wet Season Construction Activities.
a. Propos d wet season conr.s trrop activities.
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b. Proposed
�wet season construction activities for environmentally sensitive areas.
14 (
7. Financial/Ownership Responsibilities.
a. Identify the prop y owner responsible for the initiation of bonds and/or other financial securities.
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b. Describe bonds and/or other evidence of financial responsibility for liability associated with erosion and sedimentation
impacts.
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8. Engineering Calculations. Provide Design ulations on a separate sheet for the following, if applicable.
a. Sediment Ponds/Traps. _. M A Y ! 4 -Q0' , `
b. Diversions. —.
c. Waterways. — (,k -
d. Runoff/Stormwater Detention Calculations _h'� {�`
to
stermwater site plan template.doc—rev.1 0/1 22 00 3
• III
Stormwater Site Plan Changes
If the designer wishes to make changes or revisions to the originally approved Stormwater Site Plan, the proposed revisions shall be
submitted to DCD prior to construction. The submittal shall include substitute pages that include all proposed changes, revised
drawings showing any structural changes, and any other supporting in"ormation that explains and supports the reason for the change.
Final Corrected Plan Submittal
If the project included construction of conveyance systems,treatment facilities,flow control facilities, or structural source control BMPs
(not standard on-site stormwater management BMPs), the applicant shall submit a final corrected plan("as-builts")when the project is
completed. These should be engineering drawings (stamped by a licensed civil engineer) that accurately represent the project as
constructed.
APPLICANT SIGNATURE
By signing the Construction SWPPP worksheet, I as the applicantowner attest that the information provided herein is true and
correct:tc) the best of y knowled e. I also certify that this application is being made with the full knowledge and consent of all
owners) ` the affected 'perty.
1 YC- / 5/ /3 /66
{,EAI7DO ER R AOTHORIZED PRESENTATIVE SIGNATURE) (DATE)/
THIS SPACE MAY BE USED FOR ADDITIONAL NOTES, IF NEEDED:
MY ]A400i 20 ,; ,ai
1
stormwater site plan template.doc-rev.10/12/2003 12
0
�w' 50N cam JEFFERSOiCOUNTY
r� • \ ti DEPARTMENT OF COMMUNITY DEVELOPMENT
~' '�' �' 621 Sheridan Street • Port Townsend • Washington 98368 ZOOS
360/379-4450 • 360/379-4451 Fax �Y �U
q p www.co.jefferson.wa.us/commdevelopment
SktING�S
Master Permit Application MLA: n ,� 'c. 0
Project Description(include separate sheets as nece sary):
Wu) MAIS-1-tr-u.c,fA i t wood -Frit,6t,l Is 0 ti fil -, res teleocv
Tax Parcel � Property
Number: c1/1 1 0 0 ) l 1'60 Size: 7. ZZ (acre square feet)
Site Address and/ r Directions to Property:
jb'�(D a&K.rtd er 4, Pori ooke:,-rJ WA- g368
Property Owner(s)of Record: ' Pre al a(- D€J O V`r2S S, o
Telephone: 310 U 3 11- D a D 1 Fax: email:
Mailing Address: el r3e wG>(V €kQ.. Port -1_ M ot� s-e—t1d w a w364
Applicant/Agent(if different from owner): 401 ilDa4 (t^1y1£`IntdL/yv Cp 1
Telephone:3&,O 3 5'-4 toy Fax: 36 0 ,311!r} 3'1 email: ,b-if0(o U1 . e't
Mailing Address: 3a p�� �r-'-L ►tS' 4 r .11
What kind of Permit?(Check each tfox that applies
Building ❑Variance(Minor, Major or Reasonable Economic Use)
Demolition Permit Ell Conditional Use[C(a),C(d),or C]**
Single Family Atriarag AttachedDetached ❑Discretionary"D"or Unnamed Use Classification
❑ Manufactured Home ❑ Modular El Special Use(Essential Public Facilities)**
El Commercial* ❑Boundary Line Adjustment
El Change of Use ❑Short Plat*"
❑ Address El Road Approach ❑Biicling Site Plan**
El Home Business El Cottagelndustry El Long Plat**
❑Propane ❑Planned Rural Residential Development(PRRD)/Amendments**
❑Sign ❑Plat Vacation/Alteration**
El Allowed"Yes'Use Consistency Analysis El Shoreline Master Program Exemption/Permit Revisions**
❑Stormwater Management ❑Shoreline Management Substantial Development**
❑Site Plan Approval Advance Determination(SPAAD)* ❑Shoreline Management Variance
❑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 ❑Tree Vegetaion Request
*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:
D I ATION OF AGENT
I hereby designate tSact as tnv agent in matters relating
to this application for permit(s).
IV OWNER SIGNATURE aeiyyyf Date: ✓ —/3—1 )Er
By signing this application form,the owner/agen 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 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 its emp oyees,representatives or agents for the sole purpose of application
review and any required later inspections. Staffs access and right of entry will be assumed unless the applicant informs the County in writing at the
time of the application that r she ants tire. — 5-_ / 3 .Y3
44' Signature: Date: UX
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 County development code.The Applicant acknowledges that he,she or it holds individual
and non-transferable res ibili ring to and complying with the ESA. The Applicant has read this disclaimer and signs anck9,13.tes it below.
ir Signature: Date: c
C:\Documents and Settings\caral\Local Settings\Temporary Internet Files\OLK86\Master Permit Application 12-19-2006.doc
• .
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:
GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX:
Witi+e,rtib��ri.S�-�1jruc rn^J& I KC 10) ) 3$S-(n/0 5 (3�) 37'f'-)-737
MAILING ADDRESS: 3a Ic.O-It-DID.Pi. pbrf 'turylSPjj EMAIL: '�d,oJyrn t .net
CONTRACTOR'S LICENSE U WAINS �1
NUMBER: W t-vreCGD 12.0A NUMBER 60/ 63/li -43
ARCHITECT/ENGINEER: l PHONE ( ) FAX:( )
MAILING ADDRESS: EMAIL
Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal:
New X Wood Existing: 0 Sewer
❑ Addition ❑ Steel Proposed: .?j Bank^ ❑ Community System
[Ti Alteration/Remodel ❑ Concrete Total: 3 He t t: ,Individual System
❑ Repair ❑ Masonry SEP Permit#S Ck:
❑ Demolition ❑ Other: Bedrooms: Water Supply:
Existing: ❑ Private well ❑ Two Party
Type of Heat: Proposed: 3 X Public
ettddnc, bo;ler-- Total: 3 / Name of System:
MI(Olt-F loot
If this is a Commercial Project you must answer the following: .t- 4 ,_•j'Jv
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 applyi
0 Underground Tank AAbove ground Tank Size of Propane Tank: 1?-0 0.1
❑Heat Stove 0 Cook Stove 0 Woodstove 0 Fireplace Insert 0 Hot Water Tank ❑Pelle tove 0 Other
Is this appliance being installed in a Manufactured/Mobile Home? Yes / No
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 properly lines,buildings and septic system components,
including the reserve area.
Square Footage Current Proposed For Office Use Only Amount Revision
Main Floor Heated 30( �,;�� EH Bld App Review.
(J
2°°Floor Heated '/' Consistency Review: / 3 7
Other Heated Base fee: _
Mezzanine Additional Section:
Heated Basement Plan Check fee:
Unheated Basement State Surcharge fee:
Other Unheated Pot Water Review fee:/ /D 5
-kz v, .3 -60
Garage/Carport / 2,�rn�. SUBTOTA
(� 60 )-Zn7f
Decks 70 O \-1-"`-'\ 911/Rd Approach fee:
Other _ �• TOTAL: $/ 2 2°7/
LAj\ Receipt Number: Q_3161
Cash/Check Number:15-1/ 1 1 ! I
ESTIMATED COST-(REQUIRED) Date:Fair market v of all labor and nish �5-) p
( 000 Initials:
C:\Documents an Settings\Temporary Internet Files\OLK86\Master Permit Application 12-19-2006.doc
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��l 0. Sequim,WA 360-681-0444 32 Kula Sq.',Place Port I°wn,end,WA .360-385-61115 J
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