HomeMy WebLinkAboutBLD2001-00617 UILDING PERMIT APPLICA!ON ReAOw 00549
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368 •
PERMIT #: BLD01-00617 Received Date: 10/30/2001
SITE ADDRESS: 250 MAPLE LN
PORT LUDLOW, 98365
OWNER: F NEIL L LAMKA PHONE: (206)467-1234
KATHRYN LOUISE LAMKA
2349 FAUNTLEROY AVE SW
SEATTLE WA 98126-2161
SUBDIVISION: OLYMPUS BEACH Block: Lot: 55&5
PARCEL NUMBER: 978900038 Section: 4 Township: 28 N Range: 01 E
CONTRACTOR: LANDER CUSTOM DESIGNED HOMES PHONE: (360)437-2501
PO BOX 65437
PORT LUDLOW WA 98365
Contractor's License LANDECDO22JT Expires 03/12/2002
REPRESENTATIVE(S): RICK LANDER
LANDER CUSTOM HOMES
PO BOX 65437
PORT LUDLOW WA 98365
PROJECT DESCRIPTIO RESIDENTIAL ADDITION & REMODEL
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP ADD MAIN: 1,642
VALUATION 144,116.00 ADD'L: 678 HEAT TYPE: EEE
CODE EDITION: 1997 HEAT BASE: HEAT TYPE: HTP
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: GARAGE: 587 SHORELINE:
CONST TYPE: DECK: 350 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: OSS
WATER SYSTEM: PUBLIC PARCEL TAGS: YES NO
BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA
Exist: 2 Exist: 2 Wetland Erosion
Prop: Prop: Seismic Streams
Total: 2 Total: 2 Flood Way Floodplain
Routing Date: F&W Landslide
(� _ 1_0 \ g Shoreline Aquifer
Forest: Commercial Rural
Proximity— Plat Conditions
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $1,245.75 MAM 10/29/01 42172
Plan Check $373.73 MAM 10/29/01 42172
State Building Code $4.50 MAM 10/29/01 42172
Potable Water Application $30.00 MAM 10/29/01 42172
Total: $1,653.98
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Jefferson County Department of Community Development
621 Sheridan Street,Port Townsend WA 98368(360)319-4450 i,-;',1
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Per. mo? Appliticato.
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Project Description: _ , -1
Building`Type: Project Type: Frame T e:
Single Family New Wood
Garage Attached/Detached 'ddition Steel
Modular Alteration/ emodel Concrete
Commercial Repair Masonry
Multi-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: � dividual System Woodstove Propane
Total: Z-- Total: -� — If not sewer,tilt out the following: CHeat Pump
Conventional Alternative Other
I Permit# SEP .T.< f�- 7)YJ fi'
Water Supply:
Private well Two Party Well Public:Name of water system:
Square Footage: (� p/ 6-13 For Office Use Only
Main Floor , Z 1 2 BC OC��'h ROJP '3 9,0 0
62ND Floor ? A 4 L 3 t 1 Base fee °a_ LI S.% —1
3rd Floor - Plan Check fee 3'7 3 .-13
Htd Basement ��/ State Surcharge fee I • Q'
Unhtd Basement / ( , Subtotal I LD C p - R
Garage/Carport —j T) o_ V Pot Water Review fee , 6�0 '�
Decks 3 0 ' ) OC) 911/Rd Approach fee
Commercial / OT
AL \ 9 0` •92 Y
Industrial eipt# �
Other h/Check# // 5
Total Valuation: tials i 4 C--
Or l
te ` ` /
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 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.
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Signature:/e....."‘,"? 02 - i"d 17 if Date: /O `2 9 — d /
II:HOME\PLNCNTR\IN FOBLDG\FORMS\BLDpemutApplicationl/2000
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Stormwater Calculations
IMPERVIOUS SURFACE
NEW EXISTING
Structures (ail roof area) 2 2- 9' sq/ft Structures(all roof area) 2 / OU) sq/ft
Driveway 3 ? sq/ft Driveway 4 4 9 sgtft
Sidewalks sq/ft Sidewalks / N L Lj sgrft
Patios / N C.f—l sq/ft Patios i Lbi. sq/ft
Solid Decks _ S b sq/ft Solid Decks ?,.,.,e' sq/ft
Other sq/ft Other 1 9 sq/ft
Total New Z 9 C� sg/ft Total Existing t C so/ft
TOTAL NEW<TOTAL,EXISTING' <1 a > sg/ft c r 1.-044
*This amount will be used to check total lot coverage
Please also indicate the amount of land disturbing activity, in addition to the creation of impervious surface, that will take
place:
LAND DISTURBING ACTIVITY
Drainfield area cleared
91sq/ft Well, Structures, Utilities,etc. _sgift
Driveway sq/ft Other 16.Sr
sq/ft
Total Land Disturbance sq/ft
LIECEEIWIE -Th
_ DEC 4 2001 j
JEFFERSON COUNTY
DEPT.OF COMMUNITY DEVELOPMENT
I2:21 TO 170 33Q Z0d 086 SSNOHN01Sf13 e13QNFi1 S08Z2.217092
„� Jefferson County Permit Center * Department of Community Development
° y 621 Sheridan Street,Port Townsend WA 98368(360)379-4450
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Fill in the flaring blasts as ably as prssiMe:
Project Description:
2-t e`r-D , ' / 4-,4.O i 77-a iv f C7 A 92►4'5 Pz.- yl- 111Dpki
9 Digit Parcel Identification Number(from your tax statement):
9 ,79 00o38 I
Site Address
911#: 2. C-) Road Name: &I R P LIE LAN/L Zip Code: 9 f 2j ?g- ”
Legal Description
Subdivision Name: d Ly f u,,-4. (3 1�f-c,(- Block: Lot(s):
Section: Township: Range:
Parcel Size(acres o quare- ootag • / I Q 6 `i -7
Property Owner: iki 1 1L.44 Phone: t
Mailing Address:
Avid. 14' 5 ,T77_14;. 9 A/2-6
Applicant/Occupant: Phone:
(if different from owner) /670,its j e,U„s. MfL 6O_ ¢3 2 _24 )I
Mailing Address: _
F'o _ QX -
6Z- 41 7 f'D - i LfU16L0c.. ...) % 3c " -
Authorized Rep: / (, /<_ L�IQt t i2 Phone:
Mailing Address:
General Contractor:
Or Manufactured Home Installer: /, d 0✓E / Phone:
Mailing Address:
Contractor's State License Number:4,4 N L E L b C, 2 Z 7
Expiration Date-/Z Z
Septic Designer: /\)/ /4 X rS h ND Phone:
Mailing Address: z. S Kt/ y _
Architect:/Engineer: ��7 / jam 0\
, Phone:
Mailing Address:
S-7 ;" 6OLttN-7.4144 S-r-, S OL \/IA/POOO� WI r I
Loan Lender/General Phone:
Contractor's Bond Holder: /*c-74f /17 f 777L
Mailing Address:
FOR Ok'HC E USE ONLY
Fire District Planning Area: School District: Zone:
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