HomeMy WebLinkAboutBLD2001-00681 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#: BLD01-00681 Received Date 12/11/2001
SITE ADDRESS: 5605 OLD GARDINER RD Issue Date 12/13/2001
PORT TOWNSEND, 98368 Expiration Date 12/13/2002
APPLICANT: RAMON F BRODERS PHONE: (360)385-3840
4503 OLD GARDINER RD
PORT TOWNSEND WA 98368-9778
SUBDIVISION: JUNCTION CITY Block: 49 Lot: 3-5+
PARCEL NUMBER: 964504903 Section: 13 Township: 29 N Range: 02 W
CONTRACTOR: OWNER PHONE:
LOAN LENDER/
BOND HOLDER:
PROJECT DESCRIPTION NO MLA REQ'D - RETAINING WALL
REQUIRED INSPECTIONS:
[ ] Setbacks (Shoreline Setbacks):
[ ] Footings:
[ ] Foundation: i'�.� < ) -- v . 4--�_
[ ] Underground Plumbing/Under r and Insulation:
[ ] Shear Wall:
[ ] Framing/Plumbing:
[ ] Propane Tank/Lines:
[ ] Insulation:
[ ] Sheetrock:
[ ] Final/Occupancy Approval: _ iC �6
HEALTH DEPARTME 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.
HOT LINE AVAILABLE 24 HOURS A DAY
is\F_BLD_Permit_Buildng.rpt 10/29/19
' BLD01-00681
BUILDING PERMIT APPLICATION Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368 -
PERMIT #: BLD01-00681 Received Date: 12/11/2001
SITE ADDRESS: 5605 OLD GARDINER RD
PORT TOWNSEND, 98368
OWNER: RAMON F BRODERS PHONE: (360)385-3840
4503 OLD GARDINER RD
PORT TOWNSEND WA 98368-9778
SUBDIVISION: JUNCTION CITY Block: 49 Lot: 3-5+
PARCEL NUMBER: 964504903 Section: 13 Township: 29 N Range: 02 W
CONTRACTOR: OWNER PHONE:
REPRESENTATIVE(S):
PROJECT DESCRIPTIO NO MLA REQ'D - RETAINING WALL
TYPE OF WORK NON SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION 5,250.00 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: OSS
WATER SYSTEM: PARCEL TAGS: YES NO
BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA
Exist: Exist: Wetland Erosion
Prop: Prop: Seismic Streams
Total: Total: Flood Way Floodplain
F&W Landslide
Routing Date: `,I _ ' _U l Shoreline Aquifer
Forest: Commercial Rural
Proximity Plat Conditione
Type Amount Paid By: Date: Receipt: (... ___Approved/Date
Permit $125.25 MAM 12/11/01 42467
Plan Check $37.58 MAM 12/11/01 42467 APP7R
0
VED
State Building Code $4.50 MAM 12/11/01 42467
Total: $167.33 Utl; 1 3 2001
`TEFFERSON COUNTY--
DEPT.OF C NITY E1.ELO ENT
7
'Jefferson County Department of Community Development
...„4" ozv °&� 621 Sheridan Street,Port Townsend WA 88368[380I 378-4450
y f= ' perm :
13 App
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Project Description:
Building Type: ®E�+(' 1 1 Luul Project Type: Frame Type:
Single Family , New ❑ Wood
11 Garage Attached/Detached ❑ Addition ❑ eel
C' Modular :Alteation/Remodel Concrete Sal a'.,�'
Commercial JEFFERSON COUNTYReprair ❑ Masonry
11 Multi-family/#of Units C Demolition
DC ❑ Other:
_' ndustrial
Other: ��`� � 643L)
athrooms: Bedrooms: Type of Sewage Disposal: Type of Heat:
Choose one:
Existing: ,..—i ,.--Existing: C Sewer ❑ Community System ❑ Electricity U Oil
Proposed: �J Proposed: ❑ Individual System ❑ Woodstove ❑ Propane
Total: Total: If not sewer,fill out the following: ❑ Heat Pump
C Conventional Alternative , --- C Other
Permit# SEP 9 „�—5 S
Water Supply:
Private well C Two Party Well' Public:Name of water system:
Square Footage: For Office Use Only
Main Floor Consistency Review 39.00
t4�� ,
2ND Floor Base fee
3rd Floor Plan Check fee 3 -2 r5p
Htd Basement State Surcharge fee /I-\—0
Unhtd Basement Subtotal .C) l0- 33
Garage/Carport Pot Water Review fee
Decks 911/Rd Approach fee /�
Commercial 0 TOTAL ---�� (D - t�_3
Industrial ^� �v J Receipt# , 9�p/7
Othero�`�j.7 5 \1 Cash/Check# ....... 3 7,b
Total Valuation: V) Initials l C-
Or Date lc —//—0/
Estimated Cost:
If within 200' of the'Shoreline,
Distance to Bank or Ordinary High Water M k ft.Bank Height ft.
By signing the application form,the applicant/owner attests t t 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 spect to this application packet may result in this permit being null and void.
I further agree to save,indemnify and hold harmless Jefferson ounty 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 nting of this permit.
I further agree to provide access and right of entry to Jefferson unty 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: 67-7-2-70e Date: % 2 / 0
OVER ►
H:HOME\PLNCNTR\INFOBLDG\FORMS\BLDpermitApplication 11-8-01
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Stormwater Calculations
IMPERVIOUS SURFACE
NEW EXISTING Structures(all roof area) sq/ft Structures(all roof area) f/ ln
& sq/ft
Driveway sq/ft Driveway / 2-0 U sq/ft
Sidewalks sq/ft Sidewalks sq/ft
>['
Patios sq/ft Patios / ' sq/ft
Covered/Solid Decks sq/ft Covered/Solid Decks sq/ft
Other 5' ) sq/ft Other sq/ft
Total New C 7--Ssq/ft Total Existing S / 2— sq/ft
TOTAL NEW+TOTAL EXISTING* —`a 0 3 7 sq/ft
*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 sq/ft Well, Structures, Utilities, etc. sq/ft
Driveway sq/ft Other 7.2- S- sq/ft
Total Land Disturbance 5 . 5--- sq/ft
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