HomeMy WebLinkAboutBLD2001-00190 •
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 #: BLD01-00190 Received Date 04/3/2001
SITE ADDRESS: 2110 E QUILCENE RD Issue Date 04/20/2001
QUILCENE, 98376 Expiration Date 04/20/2002
APPLICANT: HERBERT A NYLUND PHONE: 360-765-3562
PO BOX 538
QUILCENE WA 98376
SUBDIVISION: Block: Lot: T 7
PARCEL NUMBER: 701194005 Section: 19 Township: 27 N Range: 01 W
CONTRACTOR: UNIQUE DECKS & PATIOS PHONE: (360)779-9297
6263 SUNSET AVE NE
BREMERTON WA 98312
Contractor's License: UNIQUDP003RK Expires: 11/20/01
LOAN LENDER/
BOND HOLDER:
PROJECT DESCRIPTION No MLA Req'd ---SUNROOM ADDITION
REQUIRED INSPECTIONS:
[ ] Setbacks (Shoreline Setbacks):
[ ] Footings:
[ ] Foundation:
[ ] Underground Plumbing/Underground Insulation:
[ J Shear Wall:
[ ] Framing/Plumbing:
[ ] Propane Tank/Lines:
[ ] Insulation:
Sheetrock:
[ ] Final/Occupancy Approval: C, --.31—(95—
HEALTH DEP RTMENT 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.
HOT LINE AVAILABLE 24 HOURS A DAY
is\F_BLD_Permit_Buildng.rpt 10/29/99
, ,
` BU!DING PERMIT APPLICATION
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD01-00190 Received Date: 4/3/2001
SITE ADDRESS: 2110 E QUILCENE RD
QUILCENE, 98376
APPLICANT: HERBERT A NYLUND PHONE: 360-765-3562 -
PO BOX 538
QUILCENE WA 98376
SUBDIVISION: Block: Lot: T 7
PARCEL NUMBER: 701194005 Section: 19 Township: 27 N Range: 01 W
CONTRACTOR: UNIQUE DECKS & PATIOS PHONE: (360)779-9297 t -)
6263 SUNSET AVE NE
BREMERTON WA 98312
Contractor's License UNIQUDP003RK Expires 11/20/2001
ARCHITECT/
ENGINEER :
PROJECT DESCRIPTION: SUNROOM ADDITION
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP ADD MAIN:
VALUATION 2,240.00 ADD'L: HEAT TYPE: UH
CODE EDITION: 1997 HEAT BASE: HEAT TYPE:
OCCUPANCY: R-3 UNHEATED: #OF STORIES:
OCCUPANCY:
CONST TYPE: 5N OTHER: 224 SHORELINE:
CONST TYPE: GARAGE: SETBACK:
DECK: BANK HEIGHT:
SEWAGE DISPOSAL: CON
WATER SYSTEM: PWELL PARCEL TAGS: YES NO
BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA
Exist: 2 Exist: 1 Wetland Erosion
Prop: Prop: Seismic Streams
Total: 2 Total: 1 Flood Way Floodplain
F&W Landslide
Routing Date: Shoreline Aquifer
Forest: Commem,ial, Et ral_
Type Amount Paid By: Date: �eceip�------AppRePVED---11
Permit $83.25 MAM 04/03/01 38239
Plan Check $24.98 MAM 04/03/01 38239 { APR 2 0 2001
State Building Code $4.50 MAM 04/03/01 38239
Total: $112.73 JEFFE N COUNTY
DEPT. OF CO 1M NITY L NT
e5' ;_
oN • Jefferson County Depa•ent of Community Development
Ai? ( 621 Sheridan Street,Port Townsend WA 08368[3601378-4450
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Project Description: �0�� 4.
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Building Type: ,/ /' ��0 'roject Type: Frame Type:
-13 Single Family Q� GOOc<J� New Wood
Garage Attached & •. �0\-'� X Addition Steel
Modular cF��J Alteration/Remodel ❑ Concrete
Commercial �<c,GOH Repair ❑ Masonry
Multi-family/#of Units O`. Demolition is Other: 61oss > oit
i Industrial O`�Q�
E Other: Slt,h rocs ,K, ay is lIt' bet fl
Bedrooms: Bathrooms: Type of Sewage Disposal: Type of Heat:
Choose one:
Existing: 7- Existing: ( Sewer Community System ❑ Electricity Oil
Proposed: Proposed: .Individual System ❑ Wood I Propane
,r7)0/9
Total: Total: If not sewer,fill out the following: Heat Pustovemp
'Conventional Alternative ❑ Other
Permit# SEP
Water Supply:
Private well 1 Two Party Well 7. Public:Name of water system:
Square Footage: For Office Use Only
Main Floor
UBC OCCUPANCY GROUP
2ND Floor Base fee q"3-- 2
3rd Floor Plan Check fee a 9 s, q
Htd Basement State Surcharge fee li . ^�0
Unhtd Basement Subtotal 1 1 - ! 3
Garage/Carport Pot Water Review fee '-
Decks 911/Rd Approach fee d t
Commercial ) TOTAL 1 t 2- 3
Industrial Receipt# Oe q
Other P,y AP Cash/Check# yo2 96
Total Valuation: Initials // --C_
•
Or Date ,3—63/
Estimated Cost:
If within 200' of the Shoreli e,
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 applicant's property or structure shall be requested and shall occur during regular business hours.
Signature: 41•1l e. ' G Date: / -3 -o
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