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HomeMy WebLinkAboutBLD2010-00370 THIS BUILDING IS NOT FINALED . THIS IS AN INCOMPLETE BUILDING APPLICATION . THE PERMIT WAS NEVER ISSUED . 1111 UILDING PERMIT APPLICA N MRReevewT 8 Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD10-00370 Received Date: 10/25/2010 SITE ADDRESS: 841 FAIRMOUNT RD PORT TOWNSEND, 98368 OWNER: VICTORIA WINTERINGHAM PHONE: 800-906-0653 311 FOREST AVE VERMILLION SD 570693111 SUBDIVISION: Block: Lot: T 74+ PARCEL NUMBER: 902241007 Section: 24 Township: 29 N Range: 02 W CONTRACTOR: ALL SAVE CONSTRUCTION &MGMT LL PHONE: 360-732-0477 DAVE CLEVENGER 340 CHERRY AVE CHIMACUM WA 98325 Contractor's License ALLSASC915LE Expires 6/5/2011 REPRESENTATIVE: HENRY M SOUZA PHONE: (360) 379-8338 DESIGNS BY SOUZA INC (360) 379-9136 164 SWANSON YUnil �.;� PROJECT DESCRIPTION RE ' CE ° REPAIF IS I iNa STAIRS TO BEACH, PIER, RAMP & FLOAT TYPE OF WORK NON SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION .7-2-889 76073/6)% ADD'L: HEAT TYPE: CODE EDITION: 2009 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: WATER SYSTEM: BEDROOMS: BATHROOMS: Exist: 0 Exist: 0 Prop: 0 Prop: 0 Total: 0 Total: 0 Routing Date: r) a5-IL Type ai v: Date: Receipt: Approved/Date Permit $797.75 LYK 10/25/10 120224 Plan Check $518.54 LYK 10/25/10 120224 State Building Code $4.50 LYK 10/25/10 120224 Total: $1,320.79 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 assum'ng the res••risibility of the General Contractor for the proposed project. Signature: .0—o- / Date: /0/2_,C//6 GENERAL C CTOR NUFACTURED HOME INSTALLER PHONE: FAX: ,4L4- 'i 0"-•S > �� ,��,�- go .s'Z O- ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICEN WAINS `° NUMBER: NUMBER ARCHITECT/ENGINEER: ke f(i 1 i 0`i x/..,1 if PHONE 10 FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: ❑ New ❑ Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: Bank 0 Community System ❑ Alteration/Remodel ❑ Concrete Total: Hei�ht:f, 0 Individual System Repair ❑ Masonry ( SEP Permit# Demolition Other: Bedrooms: Water Supply: lv,. rl��, Existing: Setback: ❑ Private well 0 Two Party Type of Heat Proposed: ❑ Public Total: C ldltel Name of System: SrL All e If this is a Commercial Protect 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: 1 Underground Tank I Above ground Tank Size of Propane Tank: OCT iQ 1 Heat Stove I Cook Stove I Woodstove 1 Fireplace Insert 1 Hot Water Tank 1 Pellet Stove I Other Is this appliance being installed in a Manufactured/Mobile Home? Yes / No When applying fora 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. S•uare Foota,a Current Pro•osed w: .r - �.---.wt.. e EH Bld App Review Main Floor Heated 2"O Floor Heated Consistency Review: 21+ _ Other Heated r,'' .",, - ' ,. -- i%Wit oll. Mezzanine ccKRr' K 4 8 9� Heated Basement ., Plan Check fee: Unheated Basement 7-7: r, State Surcharge fee: Other Unheated "' —`^• , Garage/Caort � ° SUBTOTAL • rp Decks t 911/Rd Approach fee: r �} Other T* .. TOTAL: $ aq.i 19 90 „ Receipt Number: I 20 22q TM W CashlCheck Number. 7,401(030:v ESTIM, ED COST(REQUIRED) Date: .Fair ,� - value of all labor and materials,• dation to finrsn �� l A !r Ir 'o , - Initials: .. s G:\PermitCenter\###FORMS###\DRD FORMS\Master Permit Application 5-29-08.doc 1I- . BUILDING PERMIT APPLICATION 2 fefferson Count y ing Department• County Courthouse•Port Tot id,Wa 98368 • 385- 70 N E I. LOCATION: �oEgraphicname S w SIDE OF ROAD FEET S W FROM INTER EC ION OF n "' ROAD AND ROAD other specific location or landmark: I kLtkiYYt-ts-�t.,�i — i.-{• 1} K. -- LEGAL DESCRIPTION: l Lot Block bdivision Tax Number V.Section Section Township Range ,/� r H.TYPE AND COST OF BUILDING- �,` TYPE OF IMPROVEMENT BUILDING TYPE. MOBILITY V 'v`1•y`� r New building 0Single Family ❑New County Resident ❑ dition ❑Multi-Family Is this structure to serve the residential ❑Alteration number of units or commercial needs of those employed 0 Repair,replacement ❑Hotel,Motel,Dormitory at either the US.Navy's Trident or number of units Indian Island Facilities? O ❑Wrecking ❑Mobile Home 0 Moving(relocation) ❑Other-Specify ❑ ❑Foundation only WN RSHIP USE ©YES Private(individual,corporation, ❑Full-time Residency NO CI Second Home:Recreation Cabin,etc. nonprofit institution,etc.)Public(Federal,State or local gov't.) UBC OCCUPANCY GROUP: ❑Second Homer Future conversion to COST - permanent residence (omit cents) Nonresidential-Describe in detail proposed use of buildings,e.g.,food • Cost of improvement $ processing plant,machine shop,laundry building at hospital,elementary To be installed but not included school,secondary school,college,parochial school,parking garage for in the above cost department store,rental office building,office buildingat,industrial plant. a. Electrical If use of existing building is being changed enter proposed use;- b. Plumbing (� � l� _ I n , -y. c. Heating,air conditioning \11 (� I` �y r �LC,r i')�KZ �: v lYtiti�� i d. Other(elevator,etc.) ' • TOTAL COST OF IMPROVEMENT$,ti o.4 l EYA.W 0.1/4-- �nn([-X1A 1 1�T,. �n _ III.SELECTED CHARACTERISTICS OF BUILDING- ' PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL DIMENSIONS ElMasonry(wall bearing) ❑Public or Private •Number of Stories ❑Wood Frame •Total square feet of floor area, ❑Individual(septic tank,etc.) all floors,based on exterior 0Structural steel dimensions ❑ TYPE OF WATER SUPPLY Reinforcedconcrete Total land area,sq.ft. ❑Other-Specify ❑Public or private company 0 Individual(well,cistern) NUMBER OF OFF-STREET PARKING SPACES PRINCIPAL TYPE OF HEATING FUEL Enclosed TYPE OF FIREPLACE CI Gas Outdoors 0 Oii RESIDENTIAL BUILDINGS ONLY ❑Electricity Number of bedrooms ❑Coal TYPE OF MECHANICAL ❑Other-S Number of Full pecify bathrooms Partial IV.IDENTIFICATION- � Name Mailing Address-Number,street,city and State ZIP code Tel.No. Owner(�,/) ,. 7t 2. ",ram. . 1Y�.3`�` Contractor '."'' i f State License No. Architect The owner of this building and the undersigned agree to conform to all applicable laws. ure of a cant Address Application date ,s,..)ti, f&_,,j.,./-/"Ve.---1,C,,, 6/2 /77 rl PLANNING AREA (STRICT CHOOL DISTRICT 0 WATER DISTRICT APPROVED BY OLYMPIC HEALTH DISTRICT: \\ (- APPROVED BY: PERMIT FEE ISSUE DATE ' PERMIT NUMBER U I LDI NG.O PP Id AL la\t-f L/ Th.Pr:nrary-Pnrr Townsend 11, Iv/Iv I t/ i 41 Alk lir / J _ • ,I. z CA) V Q sJIr✓�g ur?ld ails Q — i _ /....,_ / o g \ _____/- 4 / -- -______ -________ 113/1l1 — _d /____ S.N08HJ13N 9,1SIX3 ld ,OL'05 ___i_________ - - 9 OQC N0110f1a321/M Sa1313 N21a Ib I , eO� I _ W021d�IOb9J3S OS os. - , ..0- , ___ , - ,.. ___ ___ , e / , _ , \ NDVG_IgG �� ` \ ``\`sue, .„.--_ 1N0213 OZ / - ------ rn�� �_- lir / 12J3�10021 ------ -�-- i _ " / 30 W01109 .\-„. 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