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HomeMy WebLinkAboutBLD2000-00567 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 #: BLD00-00567 Received Date 08/30/2000 SITE ADDRESS: 1482 SHINE RD Issue Date 03/22/2001 PORT LUDLOW, 98365 Expiration Date 03/22/2002 APPLICANT: BRIAN BEAULAURLER PHONE: (360)337-1278 1482 SHINE RD PORT LUDLOW WA 98365 SUBDIVISION: SQUAMISH HARBOR SHORT PLAT Block: Lot: 4 PARCEL NUMBER: 721031020 Section: 3 Township: 27 N Range: 01 E CONTRACTOR: OWNER PHONE: LOAN LENDER/ BOND HOLDER: PROJECT DESCRIPTION COMPLETION OF EXISTING 700 SQ FT OVER GARAGE REQUIRED INSPECTIONS: [ ] Setbacks (Shoreline Setbacks): —1 [ ] Footings: [ ] Foundation: [ ] Underground Plumbing/Underground Insulation: (e Jar-c d- 6 c�.c� v ro us �GyG� Jt [ ] Shear Wall: [ ] Framing/Plumbing: [ ] Propane Tank/Lines: [ ] Insulation: OA-- c5--/- D/ / tie-QQ [ ] Sheetrock: c, [ ] Final/Occupancy Approval: HEALTH DEPARTMEN f APPROVAL REQUiktD rktuK TO riNAL INSrtCTION. 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. HOT LINE AVAILABLE 24 HOURS A DAY is\F_BLD_Perm it_Build ng.rpt 10/29/19 f . , ., , BUILDING PERMIT APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD00-00567 Received Date: 8/30/2000 SITE ADDRESS: 1482 SHINE RD PORT LUDLOW, 98365 APPLICANT: BRIAN BEAULAURLER PHONE: (360)337-1278 1482 SHINE RD PORT LUDLOW WA 98365 SUBDIVISION: SQUAMISH HARBOR SHORT PLAT Block: Lot: 4 PARCEL NUMBER: 721031020 Section: 03 Township: 27 N Range: 01 E CONTRACTOR: OWNER PHONE: ARCHITECT/ ENGINEER : PROJECT DESCRIPTION: COMPLETION OF EXISTING 700 SQ FT OVER GARAGE TYPE OF WORK GAR SQUARE FOOTAGE: TYPE OF IMP ALT MAIN: VALUATION 38,745.00 ADD'L: 700 HEAT TYPE: EEE CODE EDITION: 1997 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: CMY WATER SYSTEM: PUD PARCEL TAGS: YES NO BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA Exist: Exist: Wetland Erosion Prop: 1 Prop: 1 Seismic Streams Total: 1 Total: 1 Flood Way Flood Plane F&W Landslide Routing Date: , , I —CD b Shoreline Aquifer Forest: Commercial Rural —F'r ximlty - Nlat eo ditions Type Amount Paid By: Date: Receipt: . ,eroved/Uate -- Permit $393.40 MAM 08/30/00 34174 APPROVED 1 State Building Code $4.50 MAM 08/30/00 34174 Plan Check $118.05 MAM 08/30/00 34174 MAR 2 2 2001 , Total: $515.95 -JEFFERSON COUNTY DEPT. OF COMMUNITY DEVELLOOPPMENT SIGNATURE: �,_ _ is\F_BLD_App_Bld.rpt 10/29/99 Jefferson Comity DoPartmed of roinnultYDave mt ��¢ 'ON C72. 621 Sheridan Street,Port Townsind WA 88308 C3601378-4450 4 „ 1-4 �S �� Ap © fi©- O Quu kI NG Project Description: Building Type: Project Type: Frame Type: ❑ Single Family ❑ New Wood ❑ Garage Attached/Detached ❑ Addition ❑ Steel ❑ Modular Alteration/Remodel ❑ Concrete ❑ Commercial ❑ Repair ❑ Masonry ❑ Multi-fam;ly/#of Units ❑ Demolition ❑ Other. ❑ Industrial /� ❑ Other c_�M�'c.it�t nti! r� �oO I3 LOFT O U F�- C ikiC -� ( AfLLirj J L K00 ti Bedrooms: Bathrooms: Type of Sewage Disposal: Type of Heat: Choose one: Existing 0 Existing: d ❑ Sewer fXCommuniry System )X Electricity ❑ Oil Proposed: I Proposed: ❑ Individual System ❑ Woodstove ❑ Propane Total: 1 Total: If not sewer,fill out the following: ❑ Heat Pump ❑ Conventional ❑ Alternative ❑ Other Pemut# SEP y�. ::T;t (r Water Supply: p ❑ Private well ❑ Two Party Well Public:Name of water system: ��.FF-1,`�jyIV cos 1 t./9 Square Footage: , For Office Use Only Main Floor USC OCCUPANCY GROUP 2ND Floor 1 L�C�tti i N NL?..i/)) Base fee r �� 3�Floor ,� r�' r ���� P o ,, , Htd Basement tate'Surcharge fee Unhtd Basement �\^�� btotal =. Garage/Carport + % Pot WaterReview fee Decks4 911/Rd Approach fee PP � Commercial / TOTAL I 7L. ,.a► / s Industrial Receipt#, L' [ } Other Cash/Check# , Total Valuation: Initials _ t- -- ._. Or Date l"/ OU Estimated Cost: (� e If within 200' of horeline, 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 is true and correct to the best of their knowledge. Any material falsehood or any omon of a material fact made by the applicant/owner with respect to this application padre[may result in this penny being null and void. I(Dither agree Lo save,in emnify and hold harmless Jefferson County against all liabilities,judgments,court costs,reasonable attomey'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 right of entry to Jefferson County and it's employees,representatives or agents for the purpose of application review and any required later inspections Access and right of entry to the applicant's property or structureshall be requested and shall occur during regular business hours. ((�� Signature: P /..' =Q'°L - Date: U 0 (� . . ILL f\L_ Di._ , 0 Ix , 5 ) '--. ri 7 Fd. _.7 "S ' . ii jhlf. / / -- •\kiE7L-7-- • , , c 1 ''.;U _,'' ' `',A, tk _ :\ ':''.7 i) C ,(13•J '.. .,, 17 '----- - ' • • ! V•1 4N Ack.J , , 1 <3.- ,-. ., ,/ . I 3 , ...- 1 AppR.Ill , a . i , : DA.t ti I / b.•r.--‘4- . MAR 2 2 2001 i`--- u•-, .,. 1 , •-.--_ 1 i - •1 ., i-- - DEPT.OF COMM NITY DEVELA PM NT i i 1 I .1. SIGNATURE: A.,_... - - I' 1 , 1 '-5 a i, I 1, I (...‘...0 •'-r:'-1.- ' 4 5\- 3°$-- 'I 1 .1 Fo'Q foa i .1. I +°I • I I I I 2,1J-4 • I I 1‘‘. L tyr of •.., c--' I 1 •x" v< ; 0_ I •,e .N '.'y I c A FPI c..f‘CCI 1 -- i, 1 , . , - r• 1 )(3 .G°3R -,- ; i -SA F_tePioe,v• 1 .) PN1° C' °1"\ ' • SciV cleos( i-- 1 Z.. 1 . i • 51 0 1, 1 ; • , , g iiit':,‘ \ I le -- --. \ DI 7 9 0 1j 131 ' N.7 ---,- !N 1 Vy (ri,s1 -2 Jefferson County Department of Community Development 621 Sheridan Street,Port Townsend WA 98368 (360) 379-4450 Universal Plot Plan Fill in the following blanks as completely as possible : Project Description: C4t1 Pl. ' n DF 11X / 1 / --- 7OL L.0 Fr 0 V rf- ( / k-E 9 Digit Parcel Identification Number (from your tax statement): 7 _ (J3 D �O Site Address 911#: °=- Road Name: J I+( �l _._ 4Zi Code: ` . 1-, t P � ) Legal Description Subdivision Name: L') 1- SQ11+�1"(Il <4 (- /4-Kr )r, Block: Lot(s): Section: Township: Range: Parcel Size (acres or square footage): 6b3 Acckb s Property Owner: i J Kt Pit 1\1 U Z-i4 U Phone: 36 G- 3 2-1 g Mailing Address: Applicant/Occupant: Phone: (if different from owner) to( \rzl Mailing Address: Authorized Rep: Phone: we) IV Mailing Address: General Contractor: Or Manufactured Home Installer: 0 W Ni ' Phone: Mailing Address: Contractor's State License Number: Expiration Date: Septic Designer: X t �� ( � Phone: Ste,htN F _9 Mailing Address: ( Architect:/Engineer: y,� � � Phone: Mailing Address: �A/V Loan Lender/General Phone: Contractor's Bond Holder: N U t\) Mailing Address: FOR OFFICE USE ONLY Fire District: Planning Area: School District: Zone: 1/00 H:\home\pincntr\forms\universal plot plan . .i SQUAki/SH /WiOR SHORT PL, SECTION 3 " T. 27 N . 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