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Home My WebLink AboutBLD2012-00057 • S 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 Al Scalf, Building Official PERMIT #: BLD12-00057 SITE ADDRESS: 611 CEDAR AVE#20 Issue Date: 04/2/2012 Port Townsend, 98368 Final Date: APPLICANT: ROBERT E BATES PHONE: 360-385-3933 ROSELLA M BATES 611 CEDAR AVE SPC 77 PORT HADLOCK WA 98339-9556 SUBDIVISION: B&R MOBILE HOME CT SP#1 Block: Lot: PARCEL NUMBER: 901023016 Section: 2 Township: 29 N Range: 01 W PROJECT DESCRIPTION: NEW M/H - SER# H028031AB THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2009 EDITION. OCCUPANCY GROUP: TYPE OF CONSTRUCTION: SPRINKLER SYSTEM yes no THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON I:\F_BLD_Occupa ncy.rpt 10/29/19 MANUFAC'R URED/MOBILE HOME INS TPi_ATION PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT#: BLD12-00057 Received Date: 2/22/2012 SITE ADDRESS: 611 CEDAR AVE#20 Issue Date: 4/2/2012 Port Townsend, 98368 APPLICANT: ROBERT E BATES ROSELLA M BATES 611 CEDAR AVE SPC 77 PORT HADLOCK WA 98339-9556 SUBDIVISION: B&R MOBILE HOME CT SP#1 Block: Lot: PARCEL#: 901023016 Section: 2 Township: 29 N Range: 01 W CONTRACTOR/ WESTGATE MOBILE HOMES INC PHONE: 360-675-1366 DEALER PO BOX 778 OAK HARBOR WA 98277 Contractor's License WESTGMH956LS Expires 1/27/2013 PROJECT DESCRIPTION: NEW M/H MAKE: MARLETTE YEAR: 2012 SIZE: 44X27 Directions To Site: 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 ��I►•7 I 1 Z Minimum setback from Cedar Avenue right-of-way shall be 20 feet. Minimum side and rear yard setbacks shall bo 5 feet. Eresiefi-Ctinirel - SEE CONDITION 2 MH Foundation 71I`Z Blocking&Tie Down S— lZ Skirting&Ventilation 6., 4� P.rrssure-Test- DrywelI/AltDrainage SEE CONDITION I Address Posted -/ SE1ciP rAOuaL Sc ab Pot 21A.Q. FINAL INSPECTION H FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR SPECIAL CONDITIONS APPLY-SEE REVERSE 1PU ILDING PERMIT APPLICATIN M Review eviewT0035 Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD12-00057 Received Date: 2/22/2012 SITE ADDRESS: 1 CEDAR AVE#20 N-ifadtc ck (-34 g g .)9 OWNER: ROBERT E BATES PHONE: 360-385-3933 ROSELLA M BATES 611 CEDAR AVE SPC 77 PORT HADLOCK WA 98339-9556 B&R MOBILE HOME CT SP#1 SUBDIVISION: Block: Lot: PARCEL NUMBER: 901023016 Section: 2 Township: 29 N Range: 01 W CONTRACTOR: WESTGATE MOBILE HOMES INC PHONE: 360-675-1366 PO BOX 778 OAK HARBOR WA 98277 Contractor's License WESTGMH956LS Expires 1/27/2013 REPRESENTATIVE: LYNDA LAVIGNE PHONE: 360-301-0784 PO BOX 193 PORT TOWNSEND WA 98368 PROJECT DESCRIPTION NEW M/H TYPE OF WORK MOB SQUARE FOOTAGE: TYPE OF IMP NEW VALUATION MAIN: 1,173 CODE EDITION: 2009 ADD'L: HEAT TYPE: EEE OCCUPANCY: HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: 05783 BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 3 Prop: 2 Total: 3 Total: 2 . Routing Date: Type Amount Paid Bv: Date: Receipt: Approved/Date Manufactured Homes $222.00 LYK 02/22/12 131482 Total: $222.00 APPROVE AP:o a 2012 Jefferson County Planning & Building Department • SPECIAL CONDITIONS CASE #•D12-00057 1.) DESIGN CRITERIA FOR SPLASHBLOCKS: A VEGETATED FLOWPATH OF AT LEAST 50 FEET SHOULD BE MAINTAINED BETWEEN THE DISCHARGE POINT AND ANY PROPERTY LINE, STRUCTURE, STEEP SLOPE, STREAM, WETLAND, LAKE, OR OTHER IMPERVIOUS SURFACE. SENSITIVE AREA BUFFERS MAY COUNT TOWARD FLOWPATH LENGTHS. A MAXIMUM OF 700 SQUARE FEET OF ROOF AREA MAY DRAIN TO EACH SPLASHBLOCK. A SPLASHBLOCK OR A PAD OF CRUSHED ROCK (2 FEET WIDE BY 3 FEET LONG BY 6 INCHES DEEP) SHOULD BE PLACED AT EACH DOWNSPOUT DISCHARGE POINT. NO EROSION OR FLOODING OF DOWNSTREAM PROPERTIES MAY RESULT. FOR SITES WITH SEPTIC SYSTEMS, THE DISCHARGE POINT MUST BE DOWNSLOPE OF THE PRIMARY AND RESERVE DRAINFILED AREAS. 2.) CONSTRUCTION ENTRANCES SHALL BE STABILIZED WHEREVER TRAFFIC WILL BE LEAVING A CONSTRUCTION SITE AND TRAVELING ON PAVED ROADS OR OTHER PAVED AREAS WITHIN 1,000 FEET OF THE SITE. THE ENTRANCE SHALL BE CONSTRUCTED ON A FIRM COMPACTED SUBGRADE. QUARRY SPALLS (OR HOG FUEL) SHALL BE ADDED IF THE PAD IS NO LONGER IN ACCORDANCE WITH THE SPECIFICATIONS. (BMP C105, 2005 DOE STORMWATER MANUAL). ANY SEDIMENT THAT IS TRACKED ONTO PAVEMENT SHALL BE REMOVED BY SHOVELING OR STREET SWEEPING. THE SEDIMENT COLLECTED BY SWEEPING SHALL BE REMOVED OR STABILIZED ON STIE. ANY QUARRY SPALLS THAT ARE LOOSENED FROM THE PAD, WHICH END UP ON THE ROADWAY SHALL BE REMOVED IMMEDIATELY. UPON PROJECT COMPLETION AND SITE STABILIZATION, ALL CONSTRUCTION ACCESSES INTENDED AS PERMANENT ACCESS FOR MAINTENANCE SHALL BE PERMANENTLY STABILIZED. 3.) The application was reviewed by the Jefferson County Department of Community Development staff on March 15, 2012 for the potential presence of Environmentally Sensitive Areas (ESAs) under the provisions of the Unified Development Code (UDC). After an initial Geographic Information Systems mapping review and an investigative site inspection, the following ESAs were confirmed to be present on the subject property: SARPA aquifer recharge area. 4.) Aquifer Recharge Areas in Jefferson County are characterized by porous geological formations that allow percolation of the surface water into the soils and the underlying zone of saturation. Aquifers are geologic formations that contain sufficient saturated permeable material to yield significant quantities of water to wells and springs. Aquifers serve as the source of drinking water within most of the rural portions of Jefferson County. 5.) Susceptible Aquifer Recharge Areas are those with geologic and hydrologic conditions that promote rapid infiltration of recharge waters to groundwater aquifers. 6.) Critical Aquifer Recharge Areas are defined as Seawater Intrusion Areas, and Special Aquifer Recharge Protection Areas and the following land uses located within Susceptible Aquifer Recharge Areas (1)All Industrial Land Uses (2)All Commercial Uses (3)All Rural Residential Land Uses requiring a Discretionary Use or Conditional Use Permit(4)All Rural Residential Land Uses with nonconforming uses that would otherwise require a Discretionary Use or Conditional Use Permit(5) Unsewered Planned Rural Residential Developments (6) Unsewered residential development with gross densities greater than one unit per acre. All of the above listed uses shall be subject to the applicable requirements and standards of the Jefferson County Unified Development Code. 7.) Critical Aquifer Recharge Are*ay require special protection measures tOtigate water quality degradation. The submitted proposal does not require additional aquifer protection measures. However, during construction the project shall follow the Best Management Practices (BMPs) and facility design standards as identified and defined in the Stormwater Management Manual for the Puget Sound Basin. 8.) The applicant is proposing to create or add 1288 square feet of impervious surface and 1191 square feet of land disturbing activities. JCC 18.30.060 and 18.30.070 require your proposal comply with Minimum Requirement#2 (Construction Stormwater Pollution Prevention) of the Department of Ecology Stormwater Management Manual for Western Washington 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. 9.) The project shall comply with Construction Stormwater Pollution Prevention (SWPP) Elements#1 through #12 of the Department of Ecology's Stormwater Management Manual for Western Washington 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. 10.) Jefferson County determined that this proposal is categorically exempt from review under the State Environmental Policy Act (SEPA) pursuant to WAC 197-11-800(1)(b)(i). 11.) The site plan as submitted with the building pemrit application on February 22, 2012 has been reviewed for consistency under the UDC, and has been approved by Jefferson County Department of Community Development. Any modifications, changes, and/or additions to the stamped, approved site plan dated April 2, 2012 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 12.) This approval is for a manufactured home with free standing deck only. Any future permits on this site are subject to review for consistency with applicable codes and ordinances and does not preclude review and conditions which may be placed on future permits. 13.) The parcel has been designated as UGA-HDR under the Jefferson County Comprehensive Land Use Map effective August 28, 1998. 14.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 15.) 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 automobile 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 requirements 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. 16.) This parcel is within the Chimcum - Hadlock no shooting area per JCC 8.50. 17.) A minimum of two (2) on-site parking spaces shall be provided for the single family residence. 18.) Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. Pre-existing legal lots of record less than one acre in size in rural residential districts are subject to the stormwater requirements in Chapter 18.30 JCC 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. 19.) The building height is not to exceed 35 feet. 20.) 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. 21.) 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. 22.) Minimum setback from Cedar Avenue right-of-way shall be 20 feet. Minimum side and rear yard setbacks shall be 5 feet. 23.) The parcel was created through the B & R Mobile Home Park#1 on October 22, 1975 under AFN 231066. 24.) The parcel is served by the Quimper public water system. 25.) An address of 611 Cedar Aver space#1 has been assigned to the lot. or Avenue is a county local access (C637109). 26.) NOTICE: This permit does not excuse the proponent from complying with other local, state, and federal ordinances, regulations, or statutes applicable to the proposed development, but consistent with RCW 90.58. Development pursuant to this permit shall be undertaken subject to the applicable policies and performance standards of the Jefferson County Shoreline Management Master Program and the Jefferson County Unified Development Code. If during excavation or development of the site an area of potential archaeological significance is uncovered, all activity in the immediate area shall be halted, and the Administrator shall be notified at once. The Federal Endangered Species Act rules to protect threatened Chinook and Summer-run Chum salmon became effective on January 8, 2001. Bull trout have been listed as threatened since early 2000. Under the ESA, any person may bring lawsuit against any individual or agency that"takes" listed species (defined as causing harm, harassing, or damaging habitat for the listed species). In addition, the National Marine Fisheries Service can levy penalties. All areas in Jefferson County are included as "critical habitat"for a listed species. Development of property along any marine shoreline, freshwater shoreline, or floodplains could harm habitat if protective measures are not taken. To minimize the potential to damage habitat, all property owners developing adjacent to marine shoreline, freshwater shoreline, or floodplains are advised to do the following: -All development activities should avoid unstable slopes, wetlands, and forested areas near surface waters - Remove minimal vegetation for site development, especially large trees -Allow trees that have fallen into surface waters to remain there - Infiltrate stormwater from buildings and driveways onsite through drywells rather than discharging directly into surface waters or roadside ditches The Federal Bald and Golden Eagle Protection Act requires landowners within 660 feet (1/8th of a mile) of an eagle nest to consult with the US Fish and Wildlife Service. This Eagle Act prohibits anyone from "taking" bald eagles. This federal law defines the term "take" and describes the possible legal consequences when a "take"occurs. Among other actions, "take" includes a disturbance of bald eagles or their habitat. Under federal law a permit may still be required for activities that impact bald eagles or their habitat. Contact the US Fish and Wildlife Service (http://www.fws.gov/pacific/eagle/) to learn more about how this law affects your project. Any individual, group, or agency can bring suit for a listed species "taking", even if you are in compliance with Jefferson County development codes. The risk of a lawsuit against you can be reduced by consulting with a professional fisheries habitat biologist, and following the recommendations for site development provided by the biologist. For more information, contact the National Marine Fisheries Service in Seattle, or the U.S. Fish and Wildlife Service. JALK WESTERMAN III Jefierwen C. tv CrarthesHc ASSESSOR . PO Her 12111,Port Taw-wread. WA 50368 (360)385•9los MOBILE HOME INFORMATION FORM OWNER'S NAME/MAILING ADDRESS: NAME: L y Ai.O#1 ,L , V /6 AI ADDRESS: P o 3 J n / 3 , v?.r "Ta w ni;;c--)4v(Q , /.,•4 03 36 6 PHONE NO. 34.b -3o /— 0764 The purpose of this questionnaire is to obtain information regarding either the current location of a mobile home or the previous ownership and location of a mobile home. This will help our office determine whether the mobile home is already on the tax rolls in Jefferson County or if it has been moved to this county from another area. 1►MOBILE HOME DATA: (A) MAKE /Y).9-t?L c 7-7 (II) MODEL VA VC O/f7hM 2814-A (C) YEAR 20 1 2- (D) LENGTH 41-`0 (E)WIDTH -26 'b " (F)SERIAL# PEN5.JC.t, 4G)YOUR PURCHASE PRICE (Do not include sales tax) SS;4 1 0 PURCHASE DATE ilD4bilkt. 21 PREVIOUS OWNER/LOCATION OF MOBILE HOME: (IF NEW MOVE TO QUESTION 31 (Al FROM WHOM DID YOU PURCHASE MOBILE N/A ADDRESS (B)WAS MOBILE HOME ASSESSED IN JEFFERSON COUNTY LASF VICAR?Yes No It Yes, Previous address of...bile. 1 U) It No, What County was Mobile assess4d,in last year. J 3)WHERE MOBILE HOME IS TO BE LOCATED: IEEi ERSOIr COUNTY rr�- OF(fl"rt,q�lfdlTY UEVEI OPNIENT (A)WILL THE MOBILE HOME BE IN MOBILE HOME PARK? Yc& No (B)IF LOCATED IN MOBILE HOME PARK: NAME dir,ADDRESS OF PARK II R. Mo\o e. hoMe wort- Lot/Space # 263 6 t 1 c,EaRR Sr. Nr,:r►-MDLekK, wA (C) IF NOT LOCATED IN MOBILE HOME PARK: NAME OF LAND OWNER: N/A LOCATION ADDRESS REAL PROPERTY PARCEL #/DESCRIPTION LCuj ti . Signature f applicant `J THANK YOU FOR YOUR HELP! 4JO COSSELL, Property Technician , O -n O H hic � N < CD N U] O m C n: bri 0 24 x 40 z �1Idi•� 11111 :ail■■ algal III■■ "' ' ■■■11 WIy m y -��m��a�� SHELF `� o ,■■■1 ® 'WASHERu DRYER , _ ,1■■■1 N 17 y ail ids, NO 7■■■1 ■l x 13 IEEE Me...-4111111r." u■■■■■■■r■■r■I X. i■■■■■■■■■■■■I A 211 alli Iii,,, 1::::: .... -, ■■■■I N .. a RIP= MI 1■■■■ ■■i I !�C N rn �, 11■■■■ - MI • 0% v 1■■■■■ ■■! o0 u■■■■■ ■■ o , V W r mei z �■■■■■■■■■■ w x H N Fin immimmigui z 1 a3338 fa a 01 co co nil LINEN 11 ilir. __--2_..Eri It o III i. A o� o � a x o . , x I 0 -z o .. 0. 46 x 40 3 to ma lim 0 46 x 40 0 3 �vav Ci .i 06, JEFFERSON 'OUNTY /w!liPir/ \g A DEPARTMENT".COMMUNITY DEVELOPMENT '' ` `- 621 Sheridan Street • Port Townsend • Washington 98368 360/379-4450 • 360/379-4451 Fax 0 www.co.jefferson.wa.us/commdevelopment 1`s$ING' Master Permit Application MLA: 9' Project Description(include separate sheets as necessary): Install Manufacured Home (new) in Park Tax Parcel Property Number: 901023016 Size: .8425'sq ft (65' X 120') (acres/square feet) Site Address and/or Directions to Property: 611 Cedar Ave #20, Port Hadlock WA 98339 Property Owner(s)of Record:Robert Bates Telephone:360-385-3933 Fax: n/a email: n/a Mailing Address: 611 Cedar Ave, #77, Port Hadlock, WA 98339 Applicant/Agent(if different from owner): Lynda LaVigne Telephone:360-301-0784 Fax:n/a email:granmayaya@gmail.coon Mailing Address: PO Box 193, Port Townsend, WA 98368 What kind of Permit?(Check each box that applies IaBuilding ❑Variance(Minor, Major or Reasonable Economic Use) El Demolition Permit ❑ Conditional Use[C(a), C(d),or C]** ❑ Single Family ❑ Garage Attached/Detached 0 Discretionary"D"or Unnamed Use Classification L l Manufactured Home 0 Modular 0 Special Use(Essential Public-Faciliti ** " � El Commercial* 0 Boundary Line Adjustment III i u V ❑ Change of Use 0 Short Plat** , — ❑ Address ❑ Road Approach ❑ Binding Site Plan** I I n� 1 ❑ Home Business ❑ Cottagelndustry ❑ Long Plat** ❑ Propane ❑ Planned Rural Residential Development(PRRD)/Amendm is �* ❑ Sign 0 Plat Vacation/Alteration** L5 I 1 ❑Allowed"Yes"Use Consistency Analysis ❑Shoreline Master Program Exeriiptt ** ❑Stormwater Management ❑ Shoreline Management Substantial e4 PuY ❑Site Plan Approval Advance Determination (SPAAD)* ❑ Shoreline Management Variance "" ,n;IT�.O[1'Fi.QPMFNT ❑Temporary Use ❑ Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* 0 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: L nda LaVigne DESIGNATION OF AGENT I hereby designate y g/(ne to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE Lt' �✓ 6 ! , ; Date: .2 — `I / '• 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 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 employees,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 he or she wants prior notice. Signature: Ar.Cl-c.„ (. ,L\,l,1 1^-R.- Date: 7- - 1 1- 1 Z The action or actions Applicant will unde ke 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 responsibility for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: V—k'`r.al cam-- `.Ct k1 )-)\/•-k Date: L 1 ( - 1 Z- C:\Documents and Settings\carat\Local Settings\Temporary Internet Files\OLK86\Master Permit Application 12-19-2006.doc BUILDER STATEMENT41111 ill 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: '"174 Date: GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: Westgate Homes Po GO X 776, oAk N4A -Czo R ,v-)4(16421 ( )360-675-1366 ( )360-675-4760 MAILING ADDRESS: sales@westgatehomes.com EMAIL: sales@westgatehomes.com CONTRACTOR'S LICENSE WAINS NUMBER: Dealer # 4045 NUMBERM100 CONKLBH037JG ARCHITECT/ENGINEER: Marlette Homes PHONE (800)547-2444 FAX:041) 5€ /1484 MAILING ADDRESS: 400 W. Elm St, Hermiston, OR 97838 EMAIL web- www.marlettehomes.com Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ✓ New X Wood Existing: Sewer 2 Bank ✓ CommunitySystem Addition Steel Proposed: y Alteration/Remodel Concrete Total: 2 AIVht: Individual System Repair Masonry SEP Permit# 75-i4- /OLt-(Cf7 Demolition Other: Bedrooms: 0 f,_- �_ p; _ ____ Existing: Setb ci:� grOu v to rMelR\� J a y hype f.H t: Proposed: 3 n/a ), I te-Pubis--_-_ Crec ric urn. Total: 3 ---I, ; System. --r- Name of Ir L If this is a Commercial Project you must answer the following: / 't. f Number of Parking Spaces: Current: Proposed: Numbe of A A-Pa[king Spaces_ 1 } i Number of occupants(includes owners,tenants, employees,etc) Current I PrifrseifFERSON COUNTY IBC Occupancy: IBC Type of construction: Will you have-Food-Si al nitlQRMEP;T If this is a Propane Tank and/or Appliance Installation permit, mark all items below that apply: N/P. ❑Underground Tank °Above ground Tank Size of Propane Tank: ❑Heat Stove 0 Cook Stove 0 Woodstove 0 Fireplace Insert 0 Hot Water Tank ElPellet Stove 0 Other Is this appliance being installed in a Manufactured/Mobile Homer .,te/ No i''iA 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 Current Proposed For Office Use Only Amount Revision Main Floor Heated 1,173 EH Bld App Review: r-110-- 2na Floor Heated 0 Consistency Review: 22? r Other Heated 0 Base fee: Mezzanine 0 Additional Section: -- -- Heated Basement 0 Plan Check fee: ___ Unheated Basement 0 State Surcharge fee: Other Unheated 0 Pot Water Review fee: -_.._ _ Garage/Carport SUBTOTAL 0 H2O Decks 89 911/Rd Approach fee: Other 0 TOTAL: $5 2_v Receipt Number: l `-C Z 1,173 Cash/Check Number: ESTIMATED COST(REQUIRED) Date: n .Fair market value of all labor and materials foundation to finish -- t-L�(-1�}- Initials: - C:\Documents and Settings\caral\Local Settings\Temporary Internet Files\OLK86\Master Permit Application 12-19-2006.doc I LA\ IGNE BITE PLAn1 t .._ • A 1 kt ij,1-4-CIS/ • p, « 13.E G c1 �S, 7 800 s oar& ra.ept ► \_. 4)0sh ;c _.kS c ncd- ',_, \(Q.;s-1-0 con X ' 46 i De.01r1 15' A ilEt4) I, \ , \r ), FE--,1 ((-.. iiviai-n1 IR 11 20' \ \ , �I _, , ,) ,.. ),- ILL I. \ f f f I RAN COUNTY OEPT_PI 'n UNITY OEM IOPMENT 28s4' ) W Y VI S�`� a. 0 . °I..' ,._<. I _ S I )06 •V/' i 1 s NOTE: z', ` AL1. S ivER , I. ' MAr4ot�AC.I �. �.riC ' el-EcriktC, d,i hob W/lTt x - }}DmE ONES ARE • /i 1117391(. i � w i n 0 a. r Jii -. . ......_.... .._.__ I ,,, ;, I rxa QFytt4) E- 1'1' tail l< 6'5%% fL ... '::1- --.\ zm H ' ov Z l iv k: g „...,›..g 0,e dy, r 7 , Ve - 5;:r-firrrill4r 5 r- - .A0.1 I1/4 NAME : LyNDA LA4IGNE' V SITE'A-DO KES S : (o l l CED k R AVE 4 20 f r E. < yV PA-RcEL 4 : 9 o I o23 0 I(0 IQtkoNE li : 360-301 - 01e4- Y SC4C.. .1 I '► = Io' N