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HomeMy WebLinkAboutBLD2001-00251 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 #: BLD01-00251 Received Date 05/2/2001 SITE ADDRESS: 282332 HWY 101 Issue Date 05/8/2001 PORT TOWNSEND, 98368 Expiration Date 05/8/2002 APPLICANT: LUCILLE BROWN PHONE: (360)379-1663 C/O MRS MILDRED NORTHUP 282332 B HWY 101 PORT TOWNSEND WA 98368 SUBDIVISION: Block: Lot: T 8 PARCEL NUMBER: 902234013 Section: 23 Township: 29 N Range: 02 W CONTRACTOR: OWNER PHONE: LOAN LENDER/ BOND HOLDER: PROJECT DESCRIPTION NO MLA REQUIRED - FOUNDATION REPAIR REQUIRED INSPECTIONS: [ ] etbacks (Shoreline Setbacks):: ., [� ootin j �� g/lb�b1 fro h epw -- Foundation: [ ] Underground Plumbing/Underground Insulation: [ ] Shear Wall: [ ] Framing/Plumbing: [ ] Propane Tank/Lines: [ ] Insulation: [ ] Sheetrock: [ ] Final/Occupancy Approval: HEALTH DEPARTMENT APPROVAL R QUIRED 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 BUILDING PERMIT APPLICATION Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD01-00251 Received Date: 5/2/2001 SITE ADDRESS: 282332 HWY 101 PORT TOWNSEND, 98368 APPLICANT: LUCILLE BROWN PHONE: (360)379-1663 C/O MRS MILDRED NORTHUP 282332 B HWY 101 PORT TOWNSEND WA 98368 SUBDIVISION: Block: Lot: T 8 PARCEL NUMBER: 902234013 Section: 23 Township: 29 N Range: 02 W CONTRACTOR: OWNER PHONE: ARCHITECT/ ENGINEER : PROJECT DESCRIPTION: NO MLA REQUIRED - FOUNDATION REPAIR TYPE OF WORK COM SQUARE FOOTAGE: COMMERCIAL: TYPE OF IMP REP MAIN: INDUSTRIAL: VALUATION 1,150.00 ADD'L: HEAT TYPE: 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: NUMBER OF EMPLOYEES: WATER SYSTEM: PARCEL TAGS: YES NO BATHROOMS: STORMWATER: YES NO AREA Exist: Wetland Erosion Prop: Seismic Streams Total: Flood Way Floodplain F&W Landslide Routing Date: Shoreline Aquifer Forest: Commercial Rural N r4xlm lty - Type Amount Paid By: Date: Receipt: L� Permit $44.85 MAM 05/02/01 39033 Plan Check $13.46 MAM 05/02/01 39033 MAY 0 4 ?O01 State Building Code $4.50 MAM 05/02/01 39033 Total: $62.81 -JEFFERSON COUNTY DEPT. OF COMMUNI'DE E..O1 ENT SIGNATURE I PP4,011, ,i, v. 1 Jefferson County Department of Community Development ' - " ;l 621 Sheridan Street,Port Townsend WA 08368[3601370-4450 �1 d o 0 '� 'Go"'U M - t� ti � . ERS��N COUNTY _ . ..+ „MMU' ITY DEVELO'MEN P o t cccT - on Project Description: Building Type: Project Type: Frame Type: ❑ Single Family ❑ New ❑ Wood ❑ Garage Attached/Detached ❑ Addition ❑ Steel ❑ Modular ❑ Alteration/Remodel ❑ Concrete ❑ Commercial ❑ Repair ❑ Masonry ❑ Muhi-family/#of Units ❑ Demolition ❑ Other: ❑ Industrial ❑ Other: 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 2ND Floor Base fee /`i g 3M Floor Plan Check fee I S( Htd Basement State Surcharge fee''S I —[ - S Unhtd Basement Subtotal - ' Garage/Carport Pot Water Review fee Decks 911/Rd Approach fee Commercial TOTAL 6 2 - �l Industrial Receipt # Other ,.i:`� /l/ Cash/Check # Total Valuation: Initials : Or Date 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 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 provi " t of 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 ' pr or structure shall be requested and shall occur during regular business hours.Signature:, Date: D�,/%/l Jefferson County Department of Community Development LS ( { fl ' oAT co 621 Sheridan Street,Port Townsend WA 98368 (360) 379-44', 11 V 'o Universal Plot Plan �S$INCs� JEFFERSON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Fill in the following blanks as completely as possible : Project Description: 1-17(n 1 772'lt / 0 &ir°'s 9 Digit Parcel Identification Number (from your tax statement): Site Address 911#: 2 g Z3 3 a / Road Name: lho C1 / )/ Zip Code: 9 c3.73 rya E Legal Description Subdivision Name: Block: Lot(s): Section: 4 Township: a 9 Range: z 4J Parcel Size (acres or square footage): -- Property Owner:4ClC /llc? / ^t� e>h /rus PhAng) 9 ' /6 6 Mailing Address: a Z33 Z /a f P.:j. 11,4 9&-3 6 gplican Occupant: J,, Phone: (if different from owner) 4 � '- ��� -�� 3 B3 -q 979 N iiing ddress „ / A Authorized Rep: f� PJe �. D,_ —19 Mailing Address: 2 8.-7 2 q /� P 7. ij>i) 9 4 6 General Contractor: �Y / Or Manufactured Home Installer: Phone: Mailing Address: Contractor's State License Number. Expiration Date: Septic Designer: Phone: M.Iling Address: Architect:/Engineer: Phone: Mailing Address: Loan Lender/General d IE Phone: Contractor's Bond Holder: Mailing Address: FOR OFFICE USE ONLY Fire District: Planning Area: School District: Zone: 1/00 H:\home\pincntr\fo \universal plot plan bi_O so cu-ic i I� �© �'17 6V1• S a- --cr-, t.,,,,(\cl• ---N cv _ ' • -..., n 3 4/ / 0 -0 0,- /........ . c. . " -.......,, ..., S —r- - i,....5"....4 . . ..... (.5-t • ,....1 , '-..- 0 7 i I / . _....\..at...01' i I . (5-- 7.) S.. ...11 , . IV ! \ 1 C3 rn 1 -13 0 Iffil -n c...., 1&== 1 ---‹ • N, t 1 " y K x ei C Cr' MI 11\ ....., rril cp liT1 .&-.. rn i, ) I if ,d 4 / .. ...., 9. --.....„__ -„,...._ .0... .. . .. . -.. ) \ -1"-- \ . 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