HomeMy WebLinkAbout02- Supplemental Application RevisedDEPARTMENT OF COMMUNITY DEVEI, �I3N'1'� 4;;1
621 Shcridtui Street, Port Townsend, WA 98368
Tel:360.379.4450 1 Pax:360.379.4451
Web: www.co.jefrenon.we.us/commttnitydevelopment
E-mail: dcd@co.jefllenon.ws.us JEFFERSON COUNTY DCD
SUPPLEMENTAL APPLICATION
HOSPITALITY ESTABLISHMENTS
MLA PROJECT/APPLICANT NAME: �PR.� cr � 4LSA j.3 o, 1_ j I t,'CjfA 3
Tax Parcel Number S a a I p 1N i
What type of hospitality establishment are you applying for?
® Bed and Breakfast inns (4-6 units) 13 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 abllk,
How many sleeping rooms shall be accommodated? d DGu� tJOt�y.,
2. Will you be serving food to guests?
no
3. Are there cooking facilities or kitchen facilities in this rental? If so how many?
4. How many off street parking spots do you currently have? How ma off Ire
�A-qll n bi
5. Will you have any signs advertising your business? If yes a sign permit may It
y , OfA2.
sing spots proposed?
W. n t?
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. n n
7. Which will you be renting (Check one): ® residence 13 accessory dwelling unit
Does the property contain both a residence AND an accessory dwelling unit? TIC) If yes, will the owner or lessee
a• reside on the premises?
VPPILL USE ONLY
itality Permit Fees
Use Review
$291.00
nmental Health - Se tic
$94.00
mental Health - Potable Water if servjn food
b
A l for Food Establishment Permit
In ection for Fire/Life/Safe
$194.00
ee
$24.00
lo Fee - 5%
$30.15
Total Fees• $633.15
.— ......, ... oy o,jF.Y.
By signing the application form, the applicant/owner 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, e)derior safety lighting, and smoke & carbon monoxide detectlon & warning sufficiency. It is impossible for the transient
rental rmil to be n exhaustive review of all potential life/safety issues.
Ax ;� aL� ��
(APPLICAN AUTHORIZED RE ENTATN) E SIGNATURE) (DAT
Representative authorization is required if application Is not signed by the Owner.]
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