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HomeMy WebLinkAboutBLD2000-00353! . _ . • BUILDING PERMIT APPLICATION Jefferson County Department of Community Development • 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00353 Received Date: 6/1/2000 SITE ADDRESS: 30 RIVERDALE DR QUILCENE, 98376 APPLICANT: RAY E CULVER PHONE: (360)779-2201 PO BOX 413 SUQUAMISH WA 98392 SUBDIVISION: HIDDENDALE TRACTS ADDITION Block: 1 Lot: 15 PARCEL NUMBER: 959400115 Section: 27 Township: 27 N Range: 02 W CONTRACTOR: OWNER PHONE: ARCH ITECT/ ENGINEER : PROJECT DESCRIPTION: DETACHED GARAGE TYPE OF WORK GAR SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 5,760.00 ADD'L: HEAT TYPE: UH CODE EDITION: 1997 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: SHORELINE: GARAGE: 576 CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: PUBLIC PARCEL TAGS: YES NO BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA Exist: Exist: Wetland Erosion Prop: Prop: Seismic Streams Total: Total: Flood Way Flood Plane F&W Landslide Routing Date: Shoreline Aquifer Forest: Commercial Rural Hr xlmrtv Filet Conditions Type Amount Paid By: Date: Receipt: Approvetlluate Permit $125.25 MAM 06/01/00 31608 A • [:" D Plan Check $37.58 MAM 06/01/00 31608 AO / State Building Code $4.50 MAM 06/01/00 31608 J A ,�, Total: $167.33 ), al.asun CcLrrty PianninU 1:1F_BLD_App_Bld.rpt 10/29/99 Jefferson Gaiety 1 l l artment of Cammity Development w4rsi`�SOr7 co GA 621 Sheridan Street Pert Townsend WA 88368 [3601373-4450 :a7 prm o 0 A O PcH© Frr. Project Description: 1 Building Typr. Protect Type: Frame Type: gle Family ✓Newood G ._e Attach,. Detached = Addition = Steel ▪ Modular : Alteration/Remodel = Concrete • Commercial 0 Repair 0 Masonry 0. Multi-family/#of Units = Demolition 0 Other. ▪ Industrial ▪ Other: Bedrooms: Bathrooms: Type of Sewage Disposal: Type of Heat Choose one: Existing ___Q__ Existing: 6 2 Sewer =Community System ❑ Electricity 0 Oil Proposed: ___O___, Proposed: G _ Individual System 0 Woodstove = Propane Total: Total: If not sewer,fill out the following: ❑ Heat Pump ` p Conventional 0 Alternative Other Uv1irve_c`� ` Permit# SEP Water Supply: ▪ Private well = Two Party Well: Public:Name of water system: Square Footage: For Office Use Only Main Floor UBC OCCUPANCY GROUP 2rso Floor Base fee l 2.S - Zc-- 3rd Ficor Plan Check fee _..__ 2`1 ' S t. Htd Basement State Surcharge fee Li . S- Unhtd Basement Subtotal 1(D-7 33 Garage/Carport 57 C, S—KOD Pot Water Review fee . Decks 911/Rd Approach fee Commercial TOTAL (D—j - 3 3 Industrial — Receipt # 3 I(0C-', Other / Cash/Check# t� __.— ---7,T•)tal Valuation: S 7)(0 Initials Or Date 6' I '0- Estimated Cost: • If within 200' of the Shoreline, Distance to Bank or Ordinary High Water Mark ft. Bank Height ft. By signing the application form,the applicant/owner arrests char the information provided herein is true and correct to the best of their knowledge. Any=renal falsehood or any omission of a material fact made by the applicant/owner with respect to this application packet may result in this permit being null and void li • 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 • ss • d right of entry to J •erson Co_ and it's employees,representatives or agents for the purpose of application review and any required later inspections. Access and right of en to -. applicant's p - . /.alI be requested and shall occur during regular business hours. /00 Date: 7I Jefferson County Permit Center ' Department of Community Development 621 Sheridan Street, Pert Townsend WA 68368 (360]379-4450 U0.192PS1� 1101 6r.Z 4. a. tit* a.ate: Project Description: 50..�rc. �e L 9 Digit Parcel Identification Number(from your tax statement): G Sri 400 11S'i- Sq 400 l6 Site Address -. m (q_ `,k �j 911#: C) Road Nae: Zip Code: 9 031 Legal Description ® \ Subdivision Name: k � Crd�� ����CTS � `o, Block: 1 Lot(s): IS.1- frO Section: Township: Range: Parcel Size (acres or square footage): Property Owner: f Phon U r, ccv Mailing Address: p 0 fc2, / Applicant/Occupant: Phone: (if different from owner) Mailing Address: Authorized Rep: Phone: Mailing Address: General Contractor: Or Manufactured Home Installer: C)V,% /\ Phone: Mailing Address: Contractor's State License Number: Expiration Date: Septic Designer: Phone: Mailing Address: Architect:/Engineer: Phone: Mailing Address: Loan Lender/General Phone: Contractor's Bond Holder: • Mailing Address: FOR 01-Ti 'E USE ONLY' Fire District: [ .Planning Area:: School Distriet. 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Jl I BUILDING PERMIT APPLICATION r'; Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00353 Received Date: 6/1/2000 SITE ADDRESS: 30 RIVERDALE DR QUILCENE, 98376 APPLICANT: RAY E CULVER PHONE: (360)779-2201 PO BOX 413 SUQUAMISH WA 98392 SUBDIVISION: HIDDENDALE TRACTS ADDITION Block: 1 Lot: 15 PARCEL NUMBER: 959400115 Section: 27 Township: 27 N Range: 02 W CONTRACTOR: OWNER PHONE: ARCH ITECT/ ENGINEER : PROJECT DESCRIPTION: DETACHED GARAGE TYPE OF WORK GAR SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: VALUATION 5,760.00 ADD'L: HEAT TYPE: UH CODE EDITION: 1997 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: SHORELINE: CONST TYPE: GARAGE. 576 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: PUBLIC PARCEL TAGS: YES NO BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA Exist: Exist: Wetland Erosion Prop: Prop: Seismic Streams Total: Total: Flood Way Flood Plane F&W Landslide Routing Date: Shoreline Aquifer Forest: Commercial Rural Pr xtmrt Plat G d tons Type Amount Paid By: Date: Receipt: rove a •.d,t Permit $125.25 MAM 06/01/00 31608 r 'cal rea Plan Check $37.58 MAM 06/01/00 31608 iew lam- ;i 7 '� State Building Code $4.50 MAM 06/01/00 31608 rev " Total: $167.33 -,,Qm V (L �tl� d1 1:1F_BLD_App Bld.rpt 10/29/99 -,,."''7" was. BUILDING PERMIT Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 (360)379-4450 FAX(360)379-4451 (800) 831-2678 PERMIT #: BLD00-00353 Received Date 06/1/2000 SITE ADDRESS: 30 RIVERDALE DR Issue Date 07/31/2000 QUILCENE, 98376 Expiration Date 07/31/2001 APPLICANT: RAY E CULVER PHONE: (360)779-2201 PO BOX 413 SUQUAMISH WA 98392 SUBDIVISION: HIDDENDALE TRACTS ADDITION Block: 1 Lot: 15 PARCEL NUMBER: 959400115 Section: 27 Township: 27 N Range: 02 W CONTRACTOR: OWNER PHONE: LOAN LENDER/ BOND HOLDER: PROJECT DESCRIPTION DETACHED GARAGE REQUIRED INSPECTIONS: [ Footings/Setbacks (Shoreline Setbacks): [v]--- Foundation: /0 • r ' r • . / 4 sC•9PS /c' [ ] Underground Plumbing/Underground Insulation: • ' [/ Shear Wall:4714.c ' — [ ] 'lumbing: ®C 2-�� dZ [ ] Propane Tank/Lines: [ ] Insulation: [ ] Sheetrock: [ -]� Final/Occupancy Approval: r✓/eo.wo 9-5--o HEALTH DEPARTMENT 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. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS. Office Hours 9:00 a.m. -4:30 p.m. Inspector's Phone Hours 8:00 a.m. - 9:00 a.m. SPECIAL CONDITIONS MAY APPLY - SEE REVERSE HOT LINE AVAILABLE 24 HOURS A DAY