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HomeMy WebLinkAboutBLD2013-00079 BLD13-00079 BUILDING PERMIT APPLIC1ION Review Type: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD13-00079 Received Date: 3/11/2013 SITE ADDRESS: 6490 A COYLE RD QUILCENE, 98376 OWNER: DIANAA RUDOLPH PHONE: 360-765-0961 6490 COYLE RD QUILCENE WA 98376-8648 SUBDIVISION: Block: Lot: 2 PARCEL NUMBER: 701271001 Section: 27 Township: 27 N Range: 01 W CONTRACTOR: TOLLEFSON BUILDERS INC PHONE: (360) 732-4080 TODD HULBERT PO BOX 100 CHIMACUM WA 98325 Contractor's License TOLLEBI977N9 Expires 3/16/2013 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI' Remodel, add 8x8 room, kitchen, stairs TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ALT MAIN: 64 VALUATION 75,000.00 ADD'L: HEAT TYPE: CODE EDITION: 2009 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: # OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: 1SURFACE BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date: Type Amount Paid By: Date: Receipt: Approved/Date Permit $818.75 JLA 03/11/13 140084 APPROVED Plan Check $532.19 JLA 03/11/13 140084 APPROVED M State Building Code $4.50 JLA 03/11/13 140084 APR 17 2013 Total: $1,355.44 Jefferson County DOD 11+rl.nn,3r1A.In+n\f,r.,,c\G RI n or,n RIe4 rr,+ 1/11M(111 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 #: BLD13-00079 SITE ADDRESS: 6490 A COYLE RD Issue Date: 04/17/2013 QUILCENE, 98376 Final Date: 10/29/2013 APPLICANT: DIANAA RUDOLPH PHONE: 360-765-0961 6490 COYLE RD QUILCENE WA 98376-8648 SUBDIVISION: Block: Lot: 2 PARCEL NUMBER: 701271001 Section: 27 Township: 27 N Range: 01 W PROJECT DESCRIPTION: Remodel, add 8x8 room, kitchen, stairs THE PROJECT LISTED ABOVE COMPLIES WITH THE REQUIREMENT OF THE BUILDING CODE 2009 EDITION. OCCUPANCY GROUP: R-3 TYPE OF CONSTRUCTION: 5N SPRINKLER SYSTEM yes no THE PROJECT PASSED ITS FINAL INSPECTION AND RECEIVED FINAL SIGN OFF ON 10/29/2013 \\tidemark\data\forms\F_BLD_Occupan cy.rpt 11/13/2013 • Up Front Parcel Reviev Parcel 701271001 Printed: March 12, 2013 DIANAA RUDOLPH Site Address: 6490 CO YLE RD 6490 A COYLE RD QUILCENE WA 983768648 QUILCENE, WA 983768648 QUILCENE WA, 98376 Parcel Number: 701271001 S-T-R: 27-27N-01W Total Acreage 21 Legal Description S27 T27 R1 W LOT 2 SUBJ TO EASE SUBJ/REST COVT Land Use: 1100 #564461 Flood District: Fire District: 2 Planning Area: 9 Flood Map(FIRM)Panel No: School District 48 Zoning: COMP PLAN DESIGNATION: COMMUNITY PLAN: UGA: UGA Trans [ ] Plot plan states "property line" [ ] Assessor's Map (Property lines on submitted plot plan must match the property lines as identified on the Assessor's 1/4 map) [ ] Legal Access to Property YES NO [ ] Parcel Tags or Scanned Documents YES NO [ ] ESA's: Special Reports Nearby YES NO [ ] Designated Ag YES NO [ ] Shoreline Designation: YES NO [ ] Shoreline Slope Stability: YES NO � ic jeA...) Stream Type:YES NO Fish & Wildlife:YES NO - �'. .� Wetlands: YES NO F Rare Plants:YES NO ( CPU#J> Seismic: YES NO Landslide: YES NO Flood: YES NO Erosion: YES NO Aquifer Recharge Area:YES NO SIPZ: none At Risk High Risk Coastal CMZ: none High Risk Moderate Risk Disconnected CMZ Stormwater site plan submitted: YesNo [ ] Forest Lands: YES NO Adjoining Forest Lands: Commercial/ Rural/ Inholding [ ] Mineral Lands: YES NO [ ] Agricultural Lands: YES NO [ ] Archaeology: YES NO [ ] Stormwater: New Impervious Surface Land Disturbing Activity ESA's Stormwater Req's:Min Req#2 Min Req#1 thru#5 Min Req#1 thru#10 Engineering [ ] Notice Provisions/Disclosure:Airport YES NO MRL YES NO Forest Lands YES NO [ ] Landscaping Required: Yes No [ ] Parking Spaces Required NO 2 Other [ 1 Building Height: 35' UBC Standard . .?� _ �'4, " w ,V Date I off/ time received- am / pm Mon_ Tues_ e Thur. --Fri. Bt D: IR ; ' _ Date: ID^� �_ OWNER: .� • "\ - - Contact Warner_ ADDRESS: b l- k`C..V.,- Contact Number 360 - 206 Notes: . - Foundation Plumbing - Framing • . Propane Tank. Mechanical '. • Setbacks Under-ground Framing Underground . Furnace Footing Rough in Alrseal Above ground - Gas Stemwall _ Hydronic Exterior shear Exterior lines Oil _ Straps Interior shear Interior lines Ducts Post Hole Ventilation . . . Appliance - Underfloor Gas/wood stove Man-Homes . Setbacks - Insulation. Firrallnspection Foundation- Block&Tie floor _wall ceiling. . Address Posted r ...-.1.,,.. 0.-....ez ,..,f,.. . . .047%.4.::...... ... - - iairfirt—7:.1 eistelzi:i - .:. - • . . t ,2-0 ichw,_4, • a D : ,..fr.I - N Mon. TueS. Wed: m Dateill--- time received___L______a_ /0 V — • BLD: 1 . . ipel a , • - Contact Namw. __________ OWNER: . _ _A ■■■• - - . 12: contact Number:360____3_-as_----66.31 ADDRESS: - • ---- a . , . ' . a• Notes: - - - . . • - - . , •Foundation PIurr____t__?ing - Framing' - Pr° ar..—P--i-t:---r"1-c • tilect-- 1—liGal. • —__-- Underground Furnace — Under-ground Framing ____ Setbacks — Gas ____ Above ground - Rough in Air seal __ Footing _ Oil Hydronic Exterior shear Exterior lines Stemwall _ Ducts Interior shear Interior lines . Straps — Appliance ____ Ventilation •Post Hole ___ Gas/wood stove Underfloor s Man4_-191-11es -..b Final Inspection • insulation. Setbacks ____ - • Foundation ____ • . floor _wall ceiling . Address Posted Block&Tie _ i . . _ ____--■■■MMMMMMMMMMMMMIIMIIIIIIIIIIIIIMs 1. H3,..finnfiP., .....z.l.c...m..m................. . . _ \, 2 - • ...-- • ; Date jajA_____ time received tp, U ,+.4 (.1-6,)I pm Mon. Tue . .0 Thur. -Fri. - BLD: , ---- .. –11 Date: OWNER: akAck•ert lele\---,• . Contact Name. - • ADDRESS: bkccp-tk-- -axtLe a I Contact Number.360 0 (--61C-S7 • i.,. Notes: . ? - . . . . • - . . . .Foundation Plumbing - Framing . Propane Tank Mechanical . . Setbacks _ Under-ground Framing tinder ground Furnace Footing _ Rough in Air seal Above ground - Gas — Stemwall ___. Hydronic Exterior shear Exterior lines Oil Straps ______ Interior shear Interior lines . Ducts • Post Hole Ventilation Appliance - Underfloor .. Gas/wood stove Man-Homes . • . . Setbacks • ns ula-----) - Final Inspection =. - Foundation- -›.- Block&Tie _ li floor: wall ceiling. Address Posted . 1 ...- • 11.•/- g. CF Date 1p' time received /4/(2.. am /6) Tues. •Wed: Thur. -Fri. - BLD: /3 - ?C j Date: ‘10 j2 / . OWNER: r Contact Name: �-✓� ADDRESS: &LI 9•b A �Y 4 . Contact Number:360 3 0 x 9 7 • :�.�. t 206 ?s. Notes: • . - Foundation Plumbing Framing Propane Tank Mechanical Setbacks x Under-ground Framing Underground Furnace - Footing k Rough In Air seal Above ground Gas Sfemwall _ Hydronic Exterior shear Exterior lines Oil _ Straps Interior Interior •_ Ducts Post Hole Ventilation _ Appliance _ Underfloor Gaslwood stove Man•Honies —'- Setbacks Insulation. Final Inspection :;} Foundation sV =a Block&Tie floor _wall__ ceiling . Address Posted i ) , . ..,...4-s, .v.totizia:,<, • ci.e.114=re:4sit '44-vcra"..9:3 •-.^•—b—^ATSM.r4a•M‘ Atz^,- • ... • . . i3..:7417 f,3 1 g g 4111 ' f:itVkk,;-tAt4.014.1 - - - ' - • • Si IR- - I r-p,, "----, Date 6 'time received i ( ..c."? am i(p_rn 4 Mon. TueS. Thur. --Fri. BID: Git Date: °-- - OWNER: r v..A... A .$ t . - Contact Name: 4 oil . o IA(0. ti)CY ' - 4.,..... ADDRESS: . 411A1111 Contact Number.360 3 o( f,S,7.3 7 . .„ 2.06 . . Notes:, - - " - - • - . - - . . . Foundation Plumbing - Framing Propane Tank - Mechanical Setbacks _ Under-ground Framing — Under ground Furnace Footing Rough in Air seal Above ground Gas _ Stemwall ____ Hydronic Exterior shear Exterior lines Oil Straps Interior shear Interior lines . Ducts Post Hole Ventilation Appliance • Underfloor .. Gas/wood stove Man-Homes Setbacks - Insulation. . Final Inspection ':.-.:• ;,(...i - Foundation- . . Block&Tie floor _wall ceiling. 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' / '' ' — ...... - )Z r., ' ,..-:,,'. :1,1........... . / / i 4-'O• / / 1 545 4 0• E F r,A Z ✓ gt /p 9 ll / / vJvJ�d52� y` �..--- 2g/ A5 5 1g ,'' N o 5'• Oo0ov �r0 s wpb\ '. JI Z J r VJ III ,1 q 2 `., v W C/O 0 e U Q W W C7 �� S� S \X a •, N O ''`'- `', .� ■W 'Q ■ .i ry a Q '�%iw0 \ R N q j "r-z-'�i/ll� (" c°v C z m N 0 C. .z ° UO IZ N MiNNs • 4061A) i -79 (4,-;41:0N coJEFFERSON COUNTY ' .•, �� A DEPARTMENT OF COMMUNITY NITY DEVELOPMENT "' ' `4 621 Sheridan Street • Port Townsend • Washington 98368 360/379-4450 • 360/379-4451 Fax gS Norp. www.co.jefferson.wa.us/commdevelopment Master Permit Application MLA: Project Description(include separate sheets as necessary): 2�vvto -32Q.1 — _4 Tax Parcel Number: —10( Z71 w [ Property Size: -Z.0 Soy' (acres/square feet) Site Address and/or Directions to Property: Property Owner(s)of Record: DI'',vo, R vc-f)c)f pi-, Telephone: 3L c' 74, 5 3 err Fax: email: Mailing Address: Applicant/Agent(if different from owner): `t``fie.( I,-h,!la4,-:--\--- Telephone: 4 c.2 t:::- / -).....3?- ,-( Fax: email:1'.;or46't°vlt (0,,,`Idefs; Mailing Address: Po tou,i i' c rck., ✓a^w<=ui.., t.J✓4" `z""", What kind of Permit?(Check each box that applies ❑ Lot or Road Segregation p:uilding ❑ Critical Areas Stewardship Plan El Demolition Permit ❑Variance(Minor, Major or Reaso [ •V � U ' 7 ❑ Single Family ❑ Garage Attached/Detached ❑ Conditional Use[C(a),C(d),or Cl*` 7 ❑ Manufactured Home .❑ Modular , . ❑ Discretionary"D"or Unnamed Us • ification j ❑ Commercial* ❑ Special Use(Essential Public Fadlllf • ')1 * L Change of Use ❑ Boundary Line Adjustment MAN 11 2013 ❑ Address ❑ Road Approach_ ❑ Short Plat** ❑ Home Business ❑ Cottage Industry ❑ Binding Site Plan** ■ El Propane ❑ Long Plat** JEFFERSON COUNTY El Siyii . ❑ Planned Rurai Residential Developm 'DAJNi frEfe tiMENT' ❑Allowed"Yes" Use Consistency Analysis ❑ Plat Vacation/Alteration** ❑ Stormwater Management ❑ Shoreline Master Program Exemption/Permit Revisions** ❑ Site Plan Approval Advance Determination(SPAAD)* ❑ Shoreline Management Substantial Development** ❑ Temporary Use ❑ Shoreline Management Variance ❑Wireless Telecommunication* ❑ Comprehensive Plan/UDC/Land Use District Map Amendment ❑ Forest Practices Act/Release of Six-Year Moratorium ❑Jefferson County Shoreline Master Program Amendment *May require a Pre-Application Conference ❑Tree Vegetation Request **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 7 ht) i4 i)i—K -i-- to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE , Date: AlA4C/il I I Zo 13 , By signing this application form,t e owner/agent attests that the information provided herein,and in any attachments,is true and correct to the best of 1 his, her or its 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 t he or a wants prior notice. - .. Signature: � �._..._.__._-. —.._.. Date: A/ ' II 2ei The action or actions Applic 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 i compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non-transferable onsib i for adhering to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. f; Signature: _ Date: A4 4 A.c,ii I e 2 c;3 r.\n.___'J`__.__\4111J4Cr\DT.KC444144\11DT1 CrlD TRC\/`.......-.no TI C....---\T1 n_—:. A_-1-__.-__C nn no_1__ • • 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 assumi? onsibility of the General Contractor for the proposed project. Signature: g>h� Date: 3// .-/ / GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: t 1-e-i—su.. ,�:t, s :17 (34.0 s-31 2 3 7.1 ( ) MAILING ADDRESS: EMAIL:—r cfc,(®, -rot t,pi5j,,byWLeis, Gc..44, , CONTRACTOR'S LICENSE WAINS NUMBER: T' i t q_iv 1 cl 7 7 I/t NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX:( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: I Shoreline: Type of Sewage Disposal: El New ❑ Wood Existing: ❑ Sewer ❑ Addition ❑ Steel Proposed: Bank ❑ Community System lir Alteration/Remodel ❑ Concrete Total: _ Height: ❑ Individual System ❑ Repair ❑ Masonry SEP Permit# _ ❑ Demolition ❑ Other: Bedrooms: Water Supply: Existing: Setback: ❑ Private well ❑ Two Party Type of Heat: Proposed: ❑ Public Total: Name of System: 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 • :BC 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 I Above ground Tank Size of Propane Tank: I Heat Stove i Cook_. I Woodstove I Fireplace Insert I Hot Water Tank I Pellet Stove I 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 property lines,buildings and septic system components, including the reserve area. Square Footage Current Proposed For Office Use Only Amount Revision Main Floor Heated 6.,`� f ,/t /EH Bld App Review: -2nd Floor Heated Consistency Review: Other Heated Base fee: ( Mezzanine Additional Section: / Heated Basement Plan Check fee: 5 3241 Unheated Basement -- to Surcharge fee: Other Unheated r ct Water Review fee Garage/Carport 111 a MA t 1 I i SUBTOTAL — Decks 1/Rd Approach fee: _ JFFFFRcON notlNTy' /� Other {._ DEPT.OF COMM,INIT(DEVELOPMErt TOTAL: $ /J-'s.'� ,t�C.J Receipt Number: / Cash/Check Number: ESTIMATED COST(REQUIRED) Date: •Fair ma value of all labor and materials foundation to finish - c2 Initials: -75� - __ .\1111111,/ln r SC4 4444\r\Dr,1,r DATC\r'.......,.-..rinrl II,._..,,.\rT,....,,-Do.....:. A...J:,,..:,...C'XI fIR.L„- Contractors or TradespeopleSinter Friendly Page Page 1 of 2 General/Specialty Contractor A business registered as a construction contractor with L&I to perform construction work within the scope of its specialty.A General or Specialty construction Contractor must maintain a surety bond or assignment of account and carry general liability insurance. Business and Licensing Information Name TOLLEFSON BUILDERS INC UBI No. 601222162 Phone 3607324080 Status Active Address Po Box 100 License No. TOLLEBI977N9 Suite/Apt. License Type Construction Contractor City Chimacum Effective Date 8/29/2003 State WA Expiration Date 3/16/2015 Zip 98325 Suspend Date County Jefferson Specialty 1 General Business Type Corporation Specialty 2 Unused Parent Company Other Associated Licenses Specialty Specialty Effective Expiration License Name Type 1 2 Date Date Status TOLLSCI107D6 TOLLSHARK Construction General Unused 3/26/1990 3/15/2005 Archived CONSTRUCTION INC Contractor TOLLSHARK Construction TOLLSCC217NO CNST/CUSTOM Contractor General Unused 8/20/1979 8/20/1990 Archived WOODWORK Business Owner Information Name Role Effective Date Expiration Date HULBERT,TODD J President 02/15/2013 ADAMSON, KAY J Secretary 02/15/2013 TOLLEFSON, RICK F President 08/29/2003 02/15/2013 MAYSHARK, HOLLY H Secretary 08/29/2003 02/15/2013 Bond Information Bond Bond Company Name Bond Account Number Effective Date Expiration Date Cancel Date Impaired Date Bond Amount Received Date 5 TRAVELERS CAS& 206085510 03/15/2002 Until Cancelled $12,000.0001/25/2002 SURETY l Assignment of Savings Information No records found for the previous 6 year period Insurance Information Insurance Company Name Policy Number Effective Date Expiration Date Cancel Date Impaired Date Amount Received Date 18 Houston TEN-11142 05/15/2012 05/15/2013 $1,000,000.0005/15/2012 Specialty Ins Co Contractors 17 Bonding& C11SJ6295 05/15/2012 05/15/2013 05/15/2012 $1,000,000.0005/09/2012 Insuranc American 16 Safety 10TSRGL37620005/15/2011 05/15/2012 $1,000,000.0005/12/2011 Indemnity Co AMERICAN 15 SAFETY 10TSRGL30730005/15/2010 05/15/2011 $1,000,000.00 05/14/2010 INDEMNITY CO AMERICAN 14 SAFETY 1OTSRGL236700 05/15/2009 05/15/2010 $1,000,000.00 05/14/2009 INDEMNITY CO https://fortress.wa.gov/lni/bbip/Print.aspx 3/11/2013 Contractors or Tradespeopleter Friendly Page Page 2 of 2 AMERICAN 10TSR-GL1 161- 13 SAFETY 00 05/15/2008 05/15/2009 $1,000,000.00 05/14/2008 INDEMNITY CO AMERICAN 10TSRGL1161- 12 SAFETY 00 05/15/2007 05/15/2008 $1,000,000.00 05/16/2007 INDEMNITY CO AMERICAN 11 SAFETY 10TSRGL 05/15/2007 05/15/2008 $1,000,000.00 05/14/2007 INDEMNITY CO AMERICAN 10 SAFETY 10TSRGL06730005/15/2006 05/15/2007 $1,000,000.00 06/13/2006 INDEMNITY CO AMERICAN 9 SAFETY TSR021100398 05/15/2006 05/15/2007 $1,000,000.0005/11/2006 INDEMNITY CO 8 U S F INS CO TSR105610 05/15/2006 05/15/2007 $1,000,000.0002/22/2006 Summons/Complaint Information No unsatisfied complaints on file within prior 6 year period Warrant Information No unsatisfied warrants on file within prior 6 year period Infractions/Citations Information No records found for the previous 6 year period https://fortress.wa.gov/lni/bbip/Print.aspx 3/11/2013 Jefferson County Building vision Permit liter: BLD13-00079 Applicant: RUDOLPH BUILDING PERMIT INSPECTION APPROVALS Applicable Code: 2009 International Building Codes To schedule inspections, call (360)379-4455 no later than 3:00PM the day before the inspection is needed. Requests received after 3:00 PM will not be scheduled for the next 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 Foundation Footing Foundation Stem Wall .b!s-Tk 141,- ( -24 Under Floor Framing Of©113 -- Ext. Shear Wall Nailing Framing 9P Insulation: Walls tP' 13—V3 Insulation: Floors Wallboard Nailing _.L..t_l3 )— FINAL INSPECTION /Q,�✓ j`_I3 FINAL INSPECTION MUST BE APPROVED PRIOR TO BUILDING BEING OCCUPIED THIS PERMIT IS VALID FOR ONE YEAR • • CONDITIONS for Building Permit# : \\tirlamark\rlata\forms\F RI fl Permit Rlrin rot 4/17/7n1f1 BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD13-00079 Received Date: 3/11/2013 SITE ADDRESS: 6490 A COYLE RD Issue Date 4/17/2013 QUILCENE, 98376 Expiration Date 4/17/2014 OWNER: DIANAA RUDOLPH PHONE: 360-765-0961 6490 COYLE RD QUILCENE WA 98376-8648 SUBDIVISION: Block: Lot: 2 PARCEL NUMBER: 701271001 Section: 27 Township: 27 N Range: 01 W CONTRACTOR: TOLLEFSON BUILDERS INC PHONE: (360) 732-4080 TODD HULBERT PO BOX 100 CHIMACUM WA 98325 Contractor's License TOLLEBI977N9 Expires 3/16/2015 PROJECT DESCRIPTION: Remodel, add 8x8 room, kitchen, stairs TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ALT MAIN: 64 VALUATION 75,000.00 ADD'L: HEAT TYPE CODE EDITION. 2009 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: 1SURFACE Type Amount Paid By: Date: Receipt: BEDROOMS: BATHROOMS: Permit $818.75 JLA 03/11/13 140084 Exist: Exist: Plan Check $532.19 JLA 03/11/13 140084 Prop: Prop: State Building Code $4.50 JLA 03/11/13 140084 Total. Total. Total: $1,355.44 Directions to Site: HEALTH DEPARTMENT AND PUBLIC 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. Request must be received by 3pm the day before the inspection is needed. Office Hours 9:00 am -4:30 pm MONDAY - THURSDAY HOT LINE AVAILABLE 24 HOURS A DAY