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Home My WebLink AboutBLD2000-00440 BUILDING PERMIT APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00440 Received Date: 6/30/2000 SITE ADDRESS: HWY 101 BRINNON, 98320 APPLICANT: GERALD WILLIAMS PHONE: (253)630-8187 21210 SE 286TH PL KENT WA 98042-6856 SUBDIVISION: BELLEVIEW Block: 14 Lot: 13-18 PARCEL NUMBER: 932101402 Section: 29 Township: 25 N Range: 02 W CONTRACTOR: VICTOR GRANT DBA A-SQUARE CONST PHONE: (360)796-3014 733 WAWA POINT RD BRINNON WA 98320 Contractor's License SQUAR**02352 Expires 09/04/1998 ARCHITECT/ CLARK RAMS OFFICE ENGINEER : 935 N 5TH AVE SEQUIM WA 98382 PROJECT DESCRIPTION: SINGLE FAMILY RESIDENCE TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 565 VALUATION 66,544.00 ADD'L: 565 HEAT TYPE: EEE CODE EDITION: 1997 HEAT BASE: HEAT TYPE: WOD OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: SHORELINE: CONST TYPE: DECK: 400 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: PWELL PARCEL TAGS: YES NO BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA Exist: Exist: Wetland Erosion Prop: 2 Prop: 2 Seismic Streams Total: 2 Total: 2 Flood Way Flood Plane F&W Landslide Routing Date: Shoreline Aquifer Forest: Commercial Rural — Type Amount Paid By: Date: Pr ecmitt Plat C d dons y: �ecetp : Approyeake__ _ Permit $762.75 MAM 06/30/00 32034 APPROVED Code Violation $762.75 MAM 06/30/00 32034 Plan Check $228.83 MAM 06/30/00 32034 State Building Code $4.50 MAM 06/30/00 32034 JUN 0 7 2001 Potable Water Application $30.00 MAM 06/30/00 32034 JEFFERSON COUNTY Total: $1,788.83 DEPT. OF COM NI •D ' '�' ENT SIGNATURE: -- _.� i A:71111IMAIA.P -- / s / i:1F_BLD_App_Bld.rpt 10/29/99 s�� Jefferson Comity 1 l aliment of Connmmity Deveioornent cy4`i CO 621 Sheridan Street.Port Town::nd WA 88368 1360]378-4450 w �,', 4-.4 .„,,,,e.,...„. Perm , u 6 Ap p ,o cacilern -4`91r13.■16'-- Project Description: Building Type: Project Type: Frame Type: X Single Family X New X Wood Garage Attached/Detached = Addition ❑ Steel 2 Modular = Alteration/Remodel = Concrete Commercial = Repair = Masonry Multi-family/#of Units = Demolition ❑ Other. = Industrial = Other: Bedrooms: Bathrooms: Type of Sewage Disposal: Type of Heat: ' Choose one: Existing: I Existing: Z. Sewer 2 Community System Proposed: Proposed: y 'X Woodstove Oil Total: 2 Total: = Individual System Woodstove Propane If not sewer,fill out the following: 2 Heat Pump XConventional = Alternative Other i Permit # SEP Ot ty--1 Water Supply: Private well = Two Parry Well= Public:Name of water system: Square Footage: 3l L�2 For Office Use Only � 3 Main Floor .S(o s' �{- OCCUPANCY GROUP 762.75 'ND Floor S'�'S e—t'Z' 31L?2 Base tee 4T1o�/► Tyr /42 . 1S- 3rd Ficor /11/R Plon Check fee _ 2Z� , `13 Htd Basement State Surcharge fee 4.5� Unhtd Basement /V /// ,4 Subtotal J 7 S g . 13 Garage/Carport /Vial. Pot Water Review fee 30 • °° Decks 4 C)h E'r k-1001) 911/Rd Approach fee Commercial TOTAL 1 5( J 7 g3 Industrial Receipt # .3 oti)3 y C'ttre* Cash/Check# 4.3. . Uj-- T.ual Valuation: < • Initials Or eliC Date ,3 O- O 0 Estimated Cost: 6-0 Od D 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 attests that the information provided herein a true and correct to the best of their knowledge. Any material 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 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 tight of entry to Jefferson County and it's employees,representatives or agents for the purpose of application review and anyrequired late inspections. Access and right of entry to the applicant's property or structure shall be request and shall occur during regular business hours. I Signature: lit/ G7d Date: / 9 fl' 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 #: BLD00-00440 Received Date 06/30/2000 SITE ADDRESS: 311846 HWY 101 Issue Date 06/7/2001 BRINNON, 98320 Expiration Date 06/7/2002 APPLICANT: GERALD WILLIAMS PHONE: (253)630-8187 21210 SE 286TH PL KENT WA 98042-6856 SUBDIVISION: BELLEVIEW Block: 14 Lot: 13-18 PARCEL NUMBER: 932101402 Section: 29 Township: 25 N Range: 02 W CONTRACTOR: PHONE: Contractor's License: LOAN LENDER/ UNITED PACIFIC INS CO BOND HOLDER: RELIANCE SURETY CO PO BOX 9719 FEDERAL WAY WA 98063 PROJECT DESCRIPTION SINGLE FAMILY RESIDENCE REQUIRED INSPECTIONS: [ ] Setbacks (Shoreline Setbacks): [ ] Footings: [ ] Foundation: [ ] Underground Plumbing/Underground Insulation: [ ] Shear Wall: [ ] Framing/Plumbing: [ ] Propane Tank/Lines: [ ] Insulation: [ ],i Sheetrock: [ Final/Occupancy Approval: 6.2 C.,:5 (0-act-lEt•� HEALTH DEPART ENT A PROVAL 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. SPECIAL CONDITIONS APPLY- SEE REVERSE HOT LINE AVAILABLE 24 HOURS A DAY SPECIAL CONDITIONS FOR CASE BLD00-00440 1.) SEPTIC SYSTEM to be installed ASAP --- Septic Permit SEP00-141 EXPIRES 6/5/02. i:\F BLD Permit_Buildng.rpt 10/29/99