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HomeMy WebLinkAboutBLD2000-00818 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 #: BLD00-00818 Received Date 12/21/2000 SITE ADDRESS: 171 WHITNEY RD Issue Date 12/22/2000 QUILCENE, 98376 Expiration Date 12/22/2001 APPLICANT: ARLE NE I HANSEN PHONE:, '6© -76 6 Z 171 WHITNEY RD QUILCENE WA 98376 SUBDIVISION: BRYANT SHORT PLAT#2 Block: Lot: 2 PARCEL NUMBER: 601273016 Section: 27 Township: 26 N Range: 01 W CONTRACTOR: ----THE ARE CORPORA-Tt PHONE: 253-927-6992 DENNIS SELt 10013 24TH-S ET EAST PUYALLUP WA 983 Contractor's License: 01273016 Expires: 09/16/2001 LOAN LENDER/ BOND HOLDER: PROJECT DESCRIPTION RESIDENTIAL FIRE DAMAGE REPAIR REQUIRED INSPECTIONS: [ ] Footings/Setbacks (Shoreline Setbacks): [ ] Foundation: [ ] Underground Plumbing/Underground Insulation: [ ] Shear Wall: [ ] raming/Plumbing:+ Ilk ..3- — U / /.2ce Z�1 [ ] ropane Tank/Lines: ] ulation [ ] Sheetrock: [ Final/Occupancy Approval: iD.43 '2-- 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 #: BLD00-00818 Received Date: 12/21/2000 SITE ADDRESS: 171 WHITNEY RD QUILCENE, 98376 APPLICANT: ARLE NE I HANSEN PHONE: 171 WHITNEY RD QUILCENE WA 98376 SUBDIVISION: BRYANT SHORT PLAT#2 Block: Lot: 2 PARCEL NUMBER: 601273016 Section: 27 Township: 26 N Range: 01 W CONTRACTOR: FLARE CORPOR IOV PHONE: 253-927-6992 DENNIS CAMPBELt 10013 24TJPs EET EAST P_UY LUP WA 98371 Caonnttractor's License 601273016 Expires 09/16/2001 ARCH ITECT/ ENGINEER : PROJECT DESCRIPTION: RESIDENTIAL FIRE DAMAGE REPAIR TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP REP MAIN: VALUATION 60,000.00 ADD'L: HEAT TYPE: CODE EDITION: 1997 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: OSS WATER SYSTEM: PARCEL TAGS: YES NO BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA Exist: 4 Exist: Wetland Erosion Prop: `( Prop: Seismic Streams Total,4 Total: Flood Way Flood Plane F&W Landslide Routing Date: I Z�al 1 Shoreline Aquifer Forest: Commercial Rural 1-'r ximityy - I-'lat Conditions Type Amount Paid By: Date: Receipt: Approved/Date Permit $720.75 ZAN 12/21/00 35664 APPROVED Plan Check $216.23 ZAN 12/21/00 35664 State Building Code $4.50 ZAN 12/21/00 35664 Total: $941.48 ®E 2 2 2000 Jefferson County Planning &Building Department is\F_BLD_App_Bld.rpt 10/29/19 Jefferson County Department of Community Development �4 �N C0 r621 Sleet an Street,Port Townsend WA 88368[360]378-4450 .-D As'..",7 '4 PE r m OV �? A pD5c5© Project Description: Building Type: Project Type: Frame Type: Single Family D New Wood ❑ Garage Attached/Detached ❑ Addition ❑ Steel ❑ Modular NI] Alteration/Remodel ❑ Concrete ❑ Commercial Repair ❑ Masonry ❑ Multi-family/#of Units ❑ Demolition ❑ Other: ❑ Industrial ❑ Other: I' ' e lt— Bedrooms: Bathrooms: Type of Sewage Disposal: Type of Heat: Choose one: Existing: Existing: ❑ Sewer ❑Community System ❑ Electricity ❑ Oil Proposed: Proposed: ❑ Individual System ❑ Woodstove ❑ Propane Total: Total: If not sewer,fill out the following: ❑ Heat Pump ❑Conventional ❑ Alternative ❑ Other Permit# SEP Water Supply: ❑ Private well ❑ Two Party Well❑ Public:Name of water system: Square Footage: For Office Use Only Main Floor UBC OCCUPANCY GROUP 2NDFloor Base fee '7�•7`5 3rd Floor Plan Check fee 2-1 Co * 2--3 Htd Basement State Surcharge fee y�1� /s�O Unhtd Basement Subtotal `�"l I . —f Garage/Carport Pot Water Review fee 0 Decks 911/Rd Approach fee Commercial TOTAL q i• Yg Industrial Receipt # 3 , Other Cash/Check# Sg 4 0 Total Valuation: 0006 Initials Or Date 2( /a) Estimated Cost: r 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 entry to the plicant's prop or structure shall be requested and shall occur during regular business hours. Signature: Afre Date: Od�r / 1a;7 Jefferson County Department of Community Development 04,5ON ca4 621 Sheridan Street,Port Townsend WA 98368 (360) 379-4450 Universal Plot Plan Fill in the following blanks as completely as possible: Project Description: 9 Digit Parcel Identification Number (from your tax statement): Site Address 911#: t`l l Road Name: to A;.j-jet e eel') Zip Code: 1 a 3 76 Legal Description _ Subdivision Name: 'g I hlOr. Pcoa T. 14" 2 Block: Lot(s): Section: d -7 Township: ep Range: Parcel Size (acres or square footage): Property Owner: Az461 . r N,As-erg Phob) 76r� `1ee0 Mailing Address: /� l? Gti ti'GV-eti It) Quid e ext. L-04z e j 376 Applicant/Occupant: I Phone: (if different from owner) 7 We C7.42t. ( C -3) `� '7..6 9Q 2— Mailing Address: /Qu/3 ,2 V 7 Z-146 T Fele t,ucao ci( 9 37 t Authorized Rep: Phone: Mailing Address: General Contractor: ��,n, Or Manufactured Home Installer: / jA F/,4/2-e-- 692,3pPhone: Mailing Address: Contractor's State License Number: Expiration Date: Septic Designer: Phone: Mailing Address: Architect:/Engineer: Phone: Mailing Address: Loan Lender/General Phone: Contractor's Bond Holder: / e( &o/ (s3 ) ,L"q3--3VV Mailing Address: ec) 60,c piffire r /got, msie.7/7 -7;3ce.ima, Lova q '4dl/ FOR OFFICE USE ONLY Fire District: Planning Area: School District: Zone: 1/00 H:\home\pincntr\forms\universal plot plan \ZP 1-1d K& .-P q irk>'�' 3 ›. 0 - sr 79 Q ill 32" l•' cv W 3Tvltr4GE St�c ' '1j--- k,/ Ctl ' ,,N_ J 1 % r ,, 4 /2:51'; >I\ \c) r \*4....,y .b\ RI t ill R o- 4 t:3 t fizt7i T ‘,. , .0. -. (11 Q. v -. o ~i1:-. 14\:, t. N z„ i ,. t z ____,..0,:, .4 d _ e-°-*-*sue-•+ `J . 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