HomeMy WebLinkAboutBLD1995-00146 r
JEFFERSON COUNTY BUILDING APPLICATION
Jefferson County Permit Center
Castle Hill Mall
621 Sheridan St.
Port Townsend, WA 98368
360-379-4450
PERMIT # •BLD95-0146 DATE RECEIVED. : 03/28/95
SITE ADDRESS: 3184 LELAND VALLEY RD W
:QUILCENE, WA 98376
APPLICANT. . . : STEVE HOWE PHONE: 360-765-4308
MAILING ADDR: 3184 LELAND VALLEY RD
:QUILCENE WA 98376
CONTRACTOR. . :OWNER PHONE:
MAILING ADDR:
CONTR. LIC #:OWNER EXPIRATION DATE: / /
ARCHITECT/ . . : PHONE:
DESIGNER
MAILING ADDR:
PARCEL NO. . . : 702021014 ALT: CON :
LEGAL DESC. . : STR 02-27-02 WWM, TAX # BY: DATE:
LOT , BLOCK ,
WATER: ?;�j DATE:
CAR : ...._ DATE: s y.Lar`�i ,
DESCRIPTION OF IMPROVEMENT: Detached garage w/full loft unheated
BUILDING TYPE *GAR BEDROOMS--- BATHROOMS-- MAIN FL. . . : 0 sf
TYPE OF IMPROVEMENT:NEW EXIST. : 0 EXIST. : 0 ADD'L FL. . : 672 sf
GARAGE/CARPORT •D PROP. . : 0 PROP. . : 0 HTED BSMT. : 0 sf
WOODSTOVE TOTAL. : 0 TOTAL. : 0 UNHT BSMT. : 0 sf
UBC OCCUPANCY GROUP: SEWAGE DISP. . : SEPTIC OTHER • 0 sf
TYPE OF CONST WATER SUPPLY. :CAPE GEO CRPT/GAR. . : 672 sf
UNITS. : 0 STORIES: 2 HEAT TYPES. : DECKS • 0 sf
DIMENSIONS: MOBILE HOME COMMERCIAL: 0 sf
FRAME TYPE:WOOD MAKE: YR: INDUSTRIAL: 0 sf
EST COST. $: 13440 SIZE: BANK HT. . . : 0 ft
PROJ GRP. . : 5923 SH SETBACK: 0 ft
Owner/agent FEES
Signature: type amount by date recpt
PRMT $ 153 . 00 AW 03/28/95 106312
Date: PLCK $ 45. 90 AW 03/28/95 106312
p B.C. $ 4 . 50 AW 03/28/95 106312
Issued By: M 2 /(
Date: J $ s En my Piannin9
& uildirig Department
$ 203 . 40 TOTAL
3 24 (cc'
r . ,
EiagT- 6l`l o
*JEFFERSON COUNTY BUILDING PERMIT APPLICATION
BUILDING TYPE IMPROVEMENT TYPE
❑ SINGLE FAMILY PS., NEW BUILDING
❑ MOBILE ❑ ADDITION 500+/500-
0 MODULAR 0 ALTERATION
N. GARAGE ATTACHED/DETACHED 0 REPAIR
❑ W00DSTOVE 0 DEMOLITION
❑ MULTI—FAMILY/UNITS ❑ RELOCATION
❑ COMMERCIAL
❑ INDUSTRIAL
❑ HOTEL/MOTEL/DORM/UNITS
❑ OTHER UBC OCCUPANCY GROUP
DESCRIPTION OF IMPROVEMENT:
SQUARE FOOTAGE PRINCIPLE TYPE OF HEATING FUEL
MAIN FLOOR ❑ ELE► RI TY OIL
2ND FLOOR % -2) Li
❑ lis'STO E ❑ GAS
3RD FLOOR ❑ ETP P 0 OTHER
HTD BASEMENT
UNHTD BASEMENT
CARPORT PRINCIPLE TYPE OF FRAME
GARAGE (z, 7 Z`f 1.Zd' 1 li-
DECKS 0 WOOD ❑ MASONRY
COMMERCIAL ❑ MANUFACTURED ❑ OTHER
INDUSTRIAL __._' 4... .0STRUCTURAL STEEL
OTHER /'" � �y"��/
TOTAL VALUATI I 3 `1-C`"A_O OR ESTIMATED COST
❑ INSTALLED 19_
TYPE OF SEWAGE DISPOSAL: ❑ SEWER SEPTIC SYSTEM
C� NOT INSTALLED
S$..('Olaf—o- 0
TYPE OF WATER SUPPLY: PRIVAJ,E ❑ DRILLED WELL
�`
PUBLIC ❑ CITY • NAME
❑ PUD ,. STATE I.D.
NUMBER OF EXISTING BEDROOMS..., NUMBER OF EXISTING BATHROOMS
NUMBER OF PROPOSED BEDROOMS OPOSED BATHROOMS
TOTAL NUMBER OF BEDROOMS TOTAL NUMBER OF
I
IF WATERFRONT PROPERTY NAME OF ADJA NT BODY OF WAT
BANK HEIGHT SETBACK
SIGNATURE Iti,.‘,k \ilk DATEN:\its\ �••-C �'7 ) �) Y
APPLICANT
NAME (PLEASE PRINT) (:1434‘.>j. \4;�"")..Q
1
6. Does the site have steep slopes with little to no vegetation? YES X\ NO
If YES, please describe:
7. Does the site contain high percentages of silt and/or very fine YES X NO
sand?
If YES, please describe:
8. Does the site contain ground water seepage or springs near the YES )c5 NO
surface of the ground?
If YES, please describe:
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 c Date u
dA' ,
FOR OFFICE USE ONLY
❑ Wetlands ❑ Seismic
CRITICAL AREAS ON OR El Aquifer Recharge Area (zone_) ❑ Fish & Wildlife Area 1
IMMEDIATELY ADJACENT TO SITE: 0 Frequently Flooded Area 0 Fish & Wildlife Area 2
0 Erosion
0 Landslide
Zone:
Parcel Size: Status:
Comprehensive Plan Land Use Designation: Reviewed by:
Community Plan: Date:
•
Jefferson County Permit Center Date
621 Sheridan Street Fee 1
Port Townsend WA 98368 Rec #
CRITICAL AREAS QUESTIONNAIRE Ck #
Case #
Applicant Name
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 X NO
property or on any nearby property at any time during the year?
If YES, please describe:
2. Has any portion of the property or any nearby property ever been x YES NO
identified as a wetland or swamp?
If YES, please describe: 5 umk l cJ ��vL� V`4Lk
3. Are any willows, skunk cabbage, alders, or cottonwoods present VYES NO
on your property or adjacent properties?
If YES, please describe: S l,f tq 1 C. CD\W p'\/\_ VC7P vtly
4. Are there any indications on any portion of the property or on any YES X 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)
a El 4 o o ❑
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1 / IJ : :
rill i i i i' �.❑
II /
='-...- ............
(Questionnaire Continues on Back)