HomeMy WebLinkAboutBLD2000-00731 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 #: BLD00-00731 Received Date 11/13/2000
SITE ADDRESS: 221 FULTON CREEK Issue Date 11/13/2000
BRINNON, 98320 Expiration Date 11/13/2001
APPLICANT: RANDY SCHLEICH PHONE: (360)796-3128
RONALD HESSELTINE
PO BOX 333
BRINNON WA 98320
SUBDIVISION: Block: Lot: T 11
PARCEL NUMBER: 502304008 Section: 30 Township: 25 N Range: 02 W
CONTRACTOR:
LOAN LENDER/
BOND HOLDER:
PROJECT DESCRIPTION Residence made smaller to become ADU
REQUIRED INSPECTIONS:
[ ] Footings/Setbacks (Shoreline Setbacks):
[ ] Foundation:
[ ] Underground Plumbing/Underground Insulation:
[ ] Shear Wall:
[ ] Framing/Plumbing:
[ ] Propane Tank/Lines:
[ ] Insulation:
[ ] Sheetrock:
[ ] Final/bccupancy Approval:
HEALTH DEPARTMENT APPROVAL 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.
Inspector's Phone Hours 8:00 a.m. - 9:00 a.m.
SPECIAL CONDITIONS MAY APPLY - SEE REVERSE
HOT LINE AVAILABLE 24 HOURS A DAY
BUILDING PERMIT APPLICATION
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD00-00731 Received Date: 11/13/2000
SITE ADDRESS: 221 FULTON CREEK
BRINNON, 98320
APPLICANT: RANDY SCHLEICH PHONE: (360)796-3128
RONALD HESSELTINE
PO BOX 333
BRINNON WA 98320
SUBDIVISION: Block: Lot: T 11
PARCEL NUMBER: 502304008 Section: 30 Township: 25 N Range: 02 W
CONTRACTOR: PHONE:
PHONE:
ARCH ITECT/
ENGINEER :
PROJECT DESCRIPTION: Residence made smaller to become ADU
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP ADU MAIN: 800
VALUATION 1,200.00 ADD'L: HEAT TYPE: WOD
CODE EDITION: HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: GARAGE: SHORELINE:
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: CON
WATER SYSTEM: PWELL 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: Shoreline Aquifer
Forest: Commercial Rural
1-'r ximitv - flat Conditions
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $44.85 RAC 11/09/00 34575
Plan Check $13.46 RAC 11/09/00 34575
State Building Code $4.50 RAC 11/09/00 34575
Total: $62.81
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Project Description: R ' '\ $FR ,\�
Building Type: Project Type: Frame Type: 1
Single Family KNew Wood
Garage Attached/Detached FE Addition i Steel
Modular J Alteratic `, Concrete
I Commercial i Repair E. Masonry
I Multi-family/#of Units I Demolition E Other:
I Industrial
E Other:
Bedrooms: Bathrooms: Type of Sewage Disposal: Type of Heat:
Choose one:
Existing: 3 Existing: _2,__ E Sewer FE Community System ,Electricity I Oil
Proposed: Proposed: X Individual System I Woodstove I Propane
Total: 3 Total: Z If not sewer,fill out the following: il Heat Pump
Conventional ❑ Alternative I Other
Permit # SEP
Water Supply:
Private well `' Two Party Well I Public:Name of water system:
Square Footage: For Office Use Only
Main Floor ZC4fl UBC OCCUPANCY GROUPS.-�
2�Floor Base fee
ii
3ed Floor Plan Check fee / 3 • ytp
i
Htd Basement State Surcharge fee I., S C)
Unhtd Basement Subtotal (o 4 -,-
Garage/Carport Pot Water Review fee
Decks 911/Rd Approach fee ' ____
Commercial TOTAL
Industrial Receipt #34/3 7 5�'
Other _ Cash/Check# c`,7 .3 S' .
Total Valuation: ' / 10 Initials -1-- e--/ .
Or Date // ?—°d
Estimated Cost:
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 is true and cotueu 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 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 pro cess and right of entry to efferson County and it's employees,representatives or agents for the purpose of application review and any required later inspections.
Access and right of the ap cant's pr or all be req ed and shall occur during regular business hours.
Signature;" /' / Date /