HomeMy WebLinkAbout02- Supplemental ApplicationDEPARTMENT OF COMMUNITY DEVEL
621 Sheridan Street, Port Townsend, WA 98368
Te1:360.379.4450 1 Fax:360.379.4451
Web: www.co.jefferson.wa.us/commimitydevelopment d
E-mail: dcd@co.jefferson.wa.us JEFFERSON COUNT
Y DCD
SUPPLEMENTAL APPLICATION
HOSPITALITY ESTABLISHMENTS
MLA #
PROJECT/APPLICANT NAME: c]{3.Q"c'-
3' F Lt
� $SQ
Tax Parcel Number: 7 o a a , fl ]
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What type of hospitality establishment are you applying for?
® Bed and Breakfast Inns (4-6 units) ® Bed and Breakfast Residence (1-3 units) ® Transient Residence or Guest House
Less than 30 days
Please answer all of the following questions to the best of your ability:
1.
How many sleeping rooms shall be accommodated? lra D� 17�V'1}J r ` S1
2.
Will you be serving food to guests? no
3.
Are there cooking facilities or kitchen facilities in this rental? If so how many? S p(A,e_
4.
How many off street parking spots do you currently have? How ma toff )treat paping spots proposed?
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5.
Will you have any signs advertising your business? If yes a sign permit may be needed. O
6.
Will you make any remodels or structural changes to any building associated with the hospitality establishment? If yes, a
building permit application may be required.
7.
Which will you be renting (Check one): residence In accessory dwelling unit
Does the property contain both a residence AND an accessory dwelling unit? TA Q If yes, will the owner or lessee
8.
reside on the prernises?
OFFICE USE ONLY
Hospitality Permit Fees
Land Use Review
$291.00
Environmental Health - Septic
$94.00
Environmental Health — Potable Water if serving food
_
Apply for Food Establishment Permit
-Building Inspection for Fire/Life/Safe
_
$194.00
Scan Fee
$24.00
Technology Fee — 5%
$30.15
Total Fees* $633.15
*Additional fees may apply.
ACKNOWLEDGEMENT
By signing the application form, the applicantlowner attests that the information provided herein is 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.
The life -safety review for this transient rental permit is limited to basic life safety relating to 911 locator consistency, handrails,
egress, exterior safety lighting, and smoke & carbon monoxide detection & warning sufficiency. It is impossible for the transient
rental rmit to be n e austive review of all potential life/safety issues.
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(APPLICAN AUTHORIZED REP ENTATIVE SIGNATURE) (DA7 )
Representative authorization is reauired if apolication is not sinned by the Owner 1
DEPARTMENT OF COMMUNITY DEVELOPMENT
621 Sheridan Street, Port Townsend, WA 98368
Tel:360,379.4450 1 Fax: 360.379.4451
Web: WMMMJCJ&,Mn warns/cnmmunty& y�dopMenr
E-mail: datucLmcffcrson.lyB.Liti
HECIKL.IST
TRANSIENT RENTAL FIRE/LIFE/SAFETY
Your proposed project must have a FIRE/LIFE/SAFETY inspection to review for non-structural
life safety provision of the code. A floor plan is required to show where all items are located in
the structure, prior to the inspection. Refer to the Example — Floor Plan handout for an
acceptable format. This plan must contain the following information checked below to be
considered reviewable by the Planning, Building, and Environmental Health Departments.
Land Use:
r-j
Number of parking spaces?
Is there a sign advertising the business? If so you may need a building permit.
Building:
Is there a sufficient # and location of smoke detectors in the building?
a
Is there a sufficient # and location of carbon monoxide detectors in the building?
Are there handrails on all the stairs?
Is there adequate ingress and egress? _
Is the red 911 Address plateposted?
Is there exterior lighting?
5
Is there lighting on all the stairs?
JEFTERSON COUNTY DCD