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HomeMy WebLinkAboutBLD1995-00458 • • I JEFFERSON COUNTY BUILDING APPLICATION Jefferson County Permit Center Castle Hill Mall 621 Sheridan St. Port Townsend, WA 98368 360-379-4450 PERMIT # •BLD95-0458 DATE RECEIVED. : 08/16/95 SITE ADDRESS: 1571 ANDERSON LAKE RD :CHIMACUM, WA 98325 APPLICANT. . . :ROGER RISLEY PHONE: 360-385-5092 MAILING ADDR:PO BOX 622 :PORT TOWNSEND WA 98368 CONTRACTOR. . :OWNER PHONE: MAILING ADDR: • CONTR. LIC #: EXPIRATION DATE: / / ARCHITECT/ . . : PHONE: DESIGNER • MAILING ADDR: PARCEL NO. . . :901152004 ALT: CON : LEGAL DESC. . :STR 15-29-01 WWM, TAX # BY: DATE: p lif? LOT , BLOCK , WATER: OK" DATE: 8f�j CAR : Q'c- DATE: ;f/U Y DESCRIPTION OF IMPROVEMENT: Single family residence BUILDING TYPE •RES BEDROOMS--- BATHROOMS-- MAIN FL. . . : 910 sf TYPE OF IMPROVEMENT:NEW EXIST. : 0 EXIST. : 0 ADD'L FL. . : 910 sf GARAGE/CARPORT • PROP. . : 1 PROP. . : 2 HTED BSMT. : 0 sf WOODSTOVE • TOTAL. : 1 TOTAL. : 2 UNHT BSMT. : 0 sf UI3C OCCUPANCY GROUP: SEWAGE DISP. . :SEPTIC OTHER • 0 sf TYPE OF CONST • WATER SUPPLY. :PWELL CRPT/GAR. . : 0 sf UNITS. : 0 STORIES:2 HEAT TYPES. :EEE/ / DECKS • 68 sf DIMENSIONS: MOBILE HOME COMMERCIAL: 0 sf FRAME TYPE:WOOD MAKE: YR: INDUSTRIAL: 0 sf EST COST. $: 91498 SIZE: BANK HT. . . : 0 ft PROJ GRP. . : 6992 SH SETBACK: 0 ft Owner/agent FEES Signature: "`" p type amount by date recpt . \ h ` <� , PRMT $ 837 .25 EMH 08/16/95 111069 Date: PLCK $ 251. 17 EMH 08/16/95 111069 B.C. $ 4 .50 EMH 08/16/95 111069 Issued By: JU Ga D Date: JPA'T $ 1092 .92 TOTAL 37(7(619' :1;-- • • CERTIFICATE OF OCCUPANCY Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 Carl Smith, Director/Building Official PERMIT#: BLD95-00458 APPLICANT: ROGER RISLEY PHONE: MARY JANE KNECHT PO BOX 622 PORT TOWNSEND WA 98368-0622 SITE ADDRESS: 1571 ANDERSON LAKE RD Issue Date: 08/29/1995 CHIMACUM, 98325 Final Date: 8/15/2014 SUBDIVISION: Block: Lot: PARCEL NUMBER: 901152004 Section: 15 Township: 29 N Range: 1W PROJECT DESCRIPTION: Single family residence THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE EDITION. OCCUPANCY GROUP: TYPE OF CONSTRUCTION: SPRINKLER SYSTEM yes no THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 8/15/2014 \\tidemark\data\forms\F_BLD_Occupancy.rpt 8/19/2014 - Lb `t- - e.5- 37 JEFFERSbN COUNWPERMIT CENTER, 621 SHERIDAN ST,'RT TOWNSEND WA 98368 BUILDING PERMIT APPLICATION PROJECT DESCRIPTION: O J R)(;"-P 4" SitsbL, P"`/I'`'' t)'''''''''d).-- '('"'+L'z ik6'V !WILDING TYPE: PROJECT TYPE: FRAME TYPE: SINGLE FAMILY ❑ NEW ❑ WOOD ❑ GARAGE ATTACHED/DETACHED ❑ ADDITION ❑ STEEL ❑ MODULAR ❑ ALTERATION/REMODEL ❑ CONCRETE ❑ COMMERCIAL ❑ REPAIR ❑ MASONRY ❑ MULTI FAMILY/# OF UNITS ❑ DEMOLITION ❑ OTHER ❑ INDUSTRIAL ❑ OTHER BEDROOMS: BATHROOMS: TYPE OF SEWAGE DISPOSAL: EXISTING EXISTING ❑ SEWER ❑ COMMUNITY SYSTEM PROPOSED I PROPOSED 7 g INDIVIDUAL SYSTEM ❑ Conventional TOTAL L TOTAL `1- PERMIT # SEP ❑ Alternative QAiriiiil K► FILL WATER SUPPLY: TYPE OF HEAT: Itc PRIVATE WELL ELECTRICITY ❑ OIL ❑ PUBLIC Name of water system: ❑ WOODSTOVE ❑ PROPANE ❑ HEAT PUMP ❑ OTHER: SQUARE FOOTAGE: MAIN FLOOR q/o SG! /(7 f5,Rt 2ND FLOOR qv() Sa f-r Q✓ FOR OFFICE USE ONLY 3RD FLOOR A/O!1/C UBC OCCUPANCY GROUP .. 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O t u DRiVEwAY COLO Nw0Eit�toq LAcE RR) F"' � ja si-' C. t %..066 010 £Lf!lc Ortett i ousi1Nc) /1-" X Q z % J1� 0.0 ZIt Kt AN o5E0) • O(LL Pos01 �.(LANSF patfc LQ (30t,, Ny L f , 9 \ st- P^no b F� avg.2.6eAMP( `TFliS PLOT PLAN SuPE2ceDE5 AND WASeS PAGE A2 (SITe KAN) of t3i..0C, PuMN$ 22 C--A,LC — . 1t b. 1 Jeffellon County Permit Center • . Date 621 Sheridan Street Fee Port Townsend WA 98368 Rec # CRITICAL AREAS QUESTIONNAIRE Ck # Case # Applicant Name It51..Z1 I r` LEA I IC Building Application Land Use Application _ Shoreline Application On-site Sewage Application _ Subdivision Application _ Other: 1. Is there any standing or running water on the surface of the )( YES NO property or on any nearby property at any time during the year? If YES, please describe: pv-T N NNIS u u 0...05EST 150 F7 Rto lh Slay' CO G 1v PPQ5 S1 f 00.10 2. Has any portion of the property or any nearby property ever been )4 YES NO identified as a wetland or swamp? If YES, please describe: WE TL,\I'J' Fv616'c;12S$N LAKE' tU e- r-wSci 2.5v F €T voE-S1 , 2,00 SQL 1'`l CATTAIL. P'Nt Ott Pc\)-J• rue 115 pi- 'To e f\S j ' Nor t 3. Are any willows, skunk cabbage, alders, or cottonwoods present )< YES NO on your property or adjacent properties? b " If YES, please describe: SA-AX U00Le �t U.0 (j iidoko� tv; i 't) ONE CoTt i id∎to Rae SEeY' 0, N{U4,1 Kau-t& W's-rC12. At-t)EfIS ttv r)Lr R-o DS. it'PeuX tZ SiCU J( CA(a P C 5 Sap 1AU3 EL QED pEPaoSt6,tJ APJf^o-'c 300 ' Fist 0E C7)-1-X.> Si-ti 4. Are there any indications on any portion of the property or on any YES NO nearby property of rockslides, earthflows, mudflows, or landslides? If YES, please describe: 5. Please indicate which line best represents the steepest slope found on your property. (Check appropriate box) 0 0 4 Q a a p / / r / / / / / / / ,.0 / / i / / i /1/1/I///// �'� .'-� ('J eta l'�f' '�-at�7 ' • .' _.D ( tvl c0uJ'G'1 Rj J I\ D cur 04� �?_ ____________{3 (Questionnaire Continues on Back) • . r 6. Does the site have steep slopes with little to no vegetation? YES X NO If YES, please describe: t X'C P7 /20C1.k ou/C/LO/25 M75', cov>v71 kit/t/ 7. Does the site contain high percentages of silt and/or very fine ,AYES NO sand? If YES, please describe: i• OC1' .DN(5 6LI?CLILLY CbOPALi ) SILT 7IPkciv., OF r' P iV' PLAN b I\(L A 8. Does the site contain ground water seepage or springs near the )'YES NO surface of the ground? If YES, please describe: SEiNsot,11.-1 vkeA- tAI're -TA ei-C S C 6v'rIClc cu5PC-s 1MrC°I2imett61.6, The applicant hereby certifies that all of the above statements and the information contained in any other transmittals made herewith are true, and the applicant acknowledges that any action taken by Jefferson County based in whole or in part on this application may be reversed if it develops that any such statement or other information contained herein is false. Signature Date 1c L-'1 , c1 FOR OFFICE USE ONLY ❑ Wetlands ❑ Seismic CRITICAL AREAS ON OR ❑ Aquifer Recharge Area (zone 1 ❑ Fish & Wildlife Area 1 IMMEDIATELY ADJACENT TO SITE: ❑ Frequently Flooded Area T ❑ Fish & Wildlife Area 2 ❑ Erosion ❑ Landslide Zone: Parcel Size: Status: Comprehensive Plan Land Use Designation: Reviewed by: Community Plan: Date: • 0 JEFFERSON COUNTY BUILDING PERMIT • Jefferson County Permit Center Castle Hill Mall 621 Sheridan St. Port Townsend, WA 98368 360-379-4450 PERMIT # •BLD95-0458 DATE ISSUED. :08/29/95 SITE ADDRESS: 1571 ANDERSON LAKE RD :CHIMACUM, WA 98325 APPLICANT. . . :ROGER RISLEY PHONE: 360-385-5092 MAILING ADDR:PO BOX 622 :PORT TOWNSEND WA 98368 CONTRACTOR. . :OWNER PHONE: MAILING ADDR: CONTR. LIC #: EXPIRATION DATE: / / LOAN LENDER. : MAILING ADDR: • PARCEL NO. . . :901152004 LEGAL DESC. . :STR 15-29-01 WWM, TAX # LOT , BLOCK , DESCRIPTION OF IMPROVEMENT: Single family residence ( looting/Setbacks (Shoreline Setback) : o FF p, p� g (Foundation: Qlt` I l- ,-g 5- ,1 „, ( ) Underground Plumbing/Underground Insulation: ( ) Framing p lumbin• 'Chimne : •/ Cs' frsrwctr 0 - at• TP% - c ��_ .�_, ��_ - �p ( ) Insulation: ,4op►.J. "4 , Z7/ 3/0.0# ( ) Sheetrock: OK U j. q4 416 9 8/4 ( ) Final/Occupancy Approval: • -4'1r1l 9/151if THIS PERMIT IS VALID FOR ONE YEAR. 24 Hour Recorder for Inspections CALL 379-4455 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS Office Hours 9 a.m. to 4:30 p.m. Inspector's Phone Hours 8 - 9 a.m. �ro i i i i 1 i �n X` r i c b 0 h c b 0 h