HomeMy WebLinkAboutBLD2000-00759 w,` ° •
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 #: BLD00-00759 Received Date 11/27/2000
SITE ADDRESS: 992 DOSEWALLIPS RIVER RD Issue Date 12/6/2000
BRINNON, 98320 Expiration Date 12/6/2001
APPLICANT: CAROLYN MC ANDREW PHONE: (360)796-3187
PO BOX 98
BRINNON WA 98320
SUBDIVISION: Block: Lot: T 33
PARCEL NUMBER: 602341028 Section: 34 Township: 26 N Range: 02 W
CONTRACTOR: WILSON CONSTRUCTION PHONE: (360)385-6517
240 MOA HILL RD
PORT TOWNSEND WA 98368
Contractor's License: WILSOC*032NQ Expires: 08/18/2001
LOAN LENDER/ INTERWEST BANK
BOND HOLDER: 2101 WASHINGTON ST
PORT TOWNSEND WA 98368
PROJECT DESCRIPTION FOUNDATION ONLY
REQUIRED INSPECTIONS:
[ ] Footings/Setbacks (Shoreline Setbacks) r. ci' c CtC / hgvi Ci)_
-DJ t-e
[ ] Underground Plumbing/Underground Insulation:
[ ] Shear Wall:
[ ] Framing/Plumbing:
[ ] Propane Tank/Lines:
[ ] Insulation:
[ ] Sheetrock:
[ ] Final/Occupancy 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
SILDING PERMIT APPLICATI N
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD00-00759 Received Date: 11/27/2000
SITE ADDRESS: 992 DOSEWALLIPS RIVER RD
BRINNON, 98320
APPLICANT: CAROLYN MC ANDREW PHONE: (360)796-3187
PO BOX 98
BRINNON WA 98320
SUBDIVISION: Block: Lot: T 33
PARCEL NUMBER: 602341028 Section: 34 Township: 26 N Range: 02 W
CONTRACTOR: WILSON CONSTRUCTION PHONE: (360)385-6517
240 MOA HILL RD
PORT TOWNSEND WA 98368
Contractor's License WILSOC*032NQ Expires 08/18/2001
ARCH ITECT/
ENGINEER :
PROJECT DESCRIPTION: FOUNDATION ONLY
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION 8,301.00 ADD'L: HEAT TYPE: UH
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: CON
WATER SYSTEM: PWELL PARCEL TAGS: YES NO
BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA
Exist: Exist: Wetland Erosion
Prop: Prop: Seismic Streams
Total: Total: Flood Way Flood Plane
F&W Landslide
Routing Date: ` 0 I /400 Shoreline Aquifer
Forest: Commercial Rural
1-'r xlmlty - Flat U• A d ions
Type Amount Paid By: Date: Receipt: APiu •►_• ..
ED
Permit $167.25 MAM 11/27/00 35513
Plan Check $50.18 MAM 11/27/00 35513 bRA0 No t--D
State Building Code $4.50 MAM 11/27/00 35513 D E C 0 6 2000
Total: $221.93 Jefferson County Planning
& Building Department
is\F_BLD_App_Bld.rpt 10/29/99
Jefforson Coun i : 1 artinent of Community Development
4���'orr °moo. 621 Slmrnlan Street,Port Town,:nd WA 08368[360]378-4450
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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-family/#of Units ❑ Demolition ❑ Other:
❑ Industrial
g Other: }—tsJv%cloc fT.. C?NLY
Bedrooms: Bathrooms: Type of Sewage Disposal: Type of Heat:
Choose one:
Existing: Z. Existing: i ❑ Sewer ❑Community System ❑ Electricity ❑ Oil
Proposed: ... 0' Proposed: ,13v- ❑ Individual System ❑ Woodstove ❑ Propane
Total: 2, Total: 1 If not sewer,fill out the following: ❑ Heat Pump
❑ Conventional ❑ Alternative ❑ Other
Perrnit# SEP Gj'D— 6(f9
Water Supply:
❑ Private well ❑ Two Party Well❑ Public:Name of water system:
Square Footage: For Office Use Only
Main Floor UBC OCCUPANCY GROUP
21`'n Floor Base fee 16 7, 2 5
3rd Floor Plan Check fee S0• /g
Htd Basement State Surcharge fee 'r SO
Unhtd Basement 2 Z
Subtotal 6)3
Garage/Carport Pot Water Review fee
Decks 911/Rd Approach fee
Commercial TOTAL 2 2.— (r 13
Industrial Receipt # 3 5 S 1
Other Cash/Check#
Total Valuation: Initials
Or Date I
Estimated Cost: 83 01 J ----)
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 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.
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 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 en to the applicant's property or structure shall be requested and shall occur during regular business hours.
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Signature: Cl.#` C% idtI tP Date: // o2//Od
1.
Jeffersoneunty Department of Community Devilment
-,0N coG 621 Sheridan Street,Port Townsend.WA 98368 (360) 379-4450
', 0) Universal Plot Plan
Fill in the following blanks as completely as possible :
Project Description:
1 Aew - vjel da vn - Qc e c i5-b l oil'i q
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9 Digit Parcel Identification Number (from your tax statement): I
Site Address I
911#: q q Road Name o S f 4-1—" $ Zip Code: 9 8 3 2 0
Legal Description 1
Subdivision Name: j Block: Lot(s):
Section: 535 I Township: 7 R` Range: if Z L✓
Parcel Size (acres or square footage):
Property Owner: � N Phone:,
� (oo
4YA) S 796-3/87
Maio gg Address: )4 o• --A( s,
/NiVO.✓, A,M 983 20
j Applicant/Occupant: Phone:
1 (if different from owner)
' M1:'lung Address:
Authorized Rep: Phone:
Nfaiiin,Address:
General Contractor: W ;1 S N C O n S k c c—Ir
30) •- 3SoZ $ Ge.1\
ri Or Manufactured Home Installer: 5>‘, .� a y4;1 s or1 Phone: 3gs _6S•\, o e
Vai ing Address: n
Contractor's State license Number. Expiration Date: ,,
Septic Designer: Phone:
laiiinz Address:
Architect:/Engineer: i Phone:
`faLL. Address:
Loan Lender/General Z rl-/r E,-W E Sit g ar1C Phone: 3 _yyyy
Contractor's Bond Holder:
Miiiirg Address: (�
a1A--o k V\k Pt s\. + \N\c�fio N\ i Y r • •
FOR OFFICE USE O NL Y
Fire District: Planning Area: i School District: I Zone:
:CH:\home\pircr.tr\fors\universal plot plan