HomeMy WebLinkAboutBLD2001-00561 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 #: BLD01-00561 Received Date 10/4/2001
SITE ADDRESS: 51 SHORE DR Issue Date 11/1/2001
PORT LUDLOW, 98365 Expiration Date 11/1/2002
APPLICANT: L JOY CRIEZ PHONE: (206)452-8829
23713 96TH PL W
EDMONDS WA 980205619
SUBDIVISION: PARADISE BAY ESTATES Block: 13 Lot: 3
PARCEL NUMBER: 983401302 Section: 23 Township: 28 N Range: 01 E
CONTRACTOR:
LOAN LENDER/
BOND HOLDER:
PROJECT DESCRIPTION NO MLA REQ'D -CONVERT GARAGE TO STUDY
REQUIRED INSPECTIONS:
[ ] Setbacks (Shoreline Setbacks):
[ ] Footings:
[ ] Foundation:
[ ] Underground Plumbing/Underground Insulation:
[ ] Shear Wall:
[ ] Framing/Plumbing:
[ ] Propane Tank/Lines:
[ ] Insulation:
[ ] Sheetrock: / t
�1,t
[ ] Final/Occupancy Approval: ' le./ -kilt itst, iefr/717 reel, O %r 2 L,�Oe l Z 2
HEALTH DEPARTMENT APPROVAL REQUIRED
Q D 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.
HOT LINE AVAILABLE 24 HOURS A DAY
is\F_BLD_Permit_Buildng.rpt 10/29/19
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' BUILDING PERMIT APPLICATION Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD01-00561 Received Date: 10/4/2001
SITE ADDRESS: 51 SHORE DR
PORT LUDLOW, 98365
OWNER: L JOY CRIEZ PHONE: (206)452-8829
23713 96TH PL W
EDMONDS WA 980205619
SUBDIVISION: PARADISE BAY ESTATES Block: 13 Lot: 3
PARCEL NUMBER: 983401302 Section: 23 Township: 28 N Range: 01 E
CONTRACTOR: PHONE:
PHONE:
REPRESENTATIVE(S):
PROJECT DESCRIPTIO NO MLA REQ'D - CONVERT GARAGE TO JESIROOM ,5 TO Z7 y
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP ALT MAIN: 289
VALUATION 16,785.00 ADD'L: HEAT TYPE: EEE
CODE EDITION: 1997 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: GARAGE: SHORELINE:
CONST TYPE: SETBACK:
DECK: BANK HEIGHT:
SEWAGE DISPOSAL: OSS
WATER SYSTEM: PARCEL TAGS: YES NO
BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA
Exist: 1 Exist: 2 Wetland Erosion
Prop: Prop: Seismic Streams
Total: 1 Total: 2 Flood Way Floodplain
Routing Date: F&W Landslide
ry f,_ /O/ r ` Shoreline Aquifer
Forest: Commercial Rural
Proximity Plat Conditions
Type Amount Paid By: Date: Receipt: .__.y,:,.-. -Approved/pate
Permit $279.25 MAM 10/04/01 42202 APPROVED
Plan Check $83.78 MAM 10/04/01 42202
State Building Code $4.50 MAM 10/04/01 42202 NOV O 1 2001
Total: $367.53
J__4.,r •1 SIN .
DEPT.OF C N D PMENT
SIGNAT •
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°V JEFFERSON COUNTY _ l!�� rr p IE
al DEPARTMENT OF COMMUNITY DEVELOPMENT �I • ___B
iS �O 621 Sheridan Street • Port Townsend • Washington 98368 _ OCTL:
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TNG 360/379-4450 • 800/831-2678 • 360/379-4451 Fax
JEFFui ty COUNTY
BUILDING PERMIT APPLICATIONEPT. OF COMMUNITY DEVELOPMENT
Project Description:
Building Type: Project Type: Frame Type:
"'Single Family New Wood
Garage Attached/Detached Addition Steel
Modular )(Alteration/Remodel Concrete
Commercial )( Repair Masonry
1 Multi-family/#of Units Demolition Other:
Industrial
I Other:
Bedrooms: Bathrooms: Type of Sewage Disposal: Type of Heat:
�`TC P y �/ Choose one:
Existing: �� Existing: ,� 4'G- Sewer Community System )(Electricity D Oil
Proposed: /// ,,, Proposed: /� , 'individual System Woodstove LI Propane
Total: Total: 7 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: / p or Office Use Only
Main Floor7A 1 1(J7 0 5, /Z C OCCUPANCY GROUP
2ND Floor y Base fee Oa2 9- t: 5
3rd Floor Plan Check fee 0V3 v `--)(?
Htd Basement State Surcharge fee q- S-0
Unhtd Basement Subtotal ,3 Co —7 - S.,3
Garage/Carport Pot Water Review fee
Decks 911/Rd Approach fee .
Commercial TOTAL ,3 7- 5 I
Industrial Receipt# , o a
Other Cash/Check# 3 3 83
Total Valuation: Initials8:14/
Or Date C%/0
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 attorney'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: Date: /0 , - - d/
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