HomeMy WebLinkAboutBLD2002-00334 •
•
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 #: BLD02-00334 Received Date 06/10/2002
SITE ADDRESS: 41 HEMLOCK DR Issue Date 07/16/2002
PORT TOWNSEND, 98368
APPLICANT: GUNNAR R JOSLYN PHONE:
PO BOX 3581
LEWISTOWN MT 59457-3581
SUBDIVISION: CAPE GEORGE VILLAGE DIV 3 Block: Lot: 36
PARCEL NUMBER: 940500035 Section: 13 Township: 30 N Range: 02 W
CONTRACTOR: JAIME KOZELISKY PHONE: (360)385-3215
1112 S JACOB MILLER RD
PORT TOWNSEND WA 98368
LOAN LENDER/
BOND HOLDER:
PROJECT DESCRIPTION REPLACE FOUNDATION UNDER EXISTING STRUCTURE
REQUIRED INSPECTIONS:
[ ] SETBACK / Footings:
[ ] Foundation:
[ ] Underground Plumbing/Underground Insulation:
[ ] Shear Wall:
[ ] Framing/Plumbing:
[ ] Propane Tank/Lines:
[ ] Insulation:
[ ] Sheetrock:
[ ] Septic System Final Approval: _
[ ] Zoning Final Approval:
[ ] Final/Occupancy Approval: Q)( ?''2--crc
HEALTH DEPARTMENT 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
S BUILDING PERMIT APPLIctTION B RD0 0view 03Z4
pe:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD02-00334 Received Date: 6/10/2002
SITE ADDRESS: 41 HEMLOCK DR
PORT TOWNSEND, 98368
OWNER: GUNNAR R JOSLYN PHONE:
PO BOX 3581
LEWISTOWN MT 59457-3581
SUBDIVISION: CAPE GEORGE VILLAGE DIV 3 Block: Lot: 36
PARCEL NUMBER: 940500035 Section: 13 Township: 30 N Range: 02 W
CONTRACTOR: JAIME KOZELISKY PHONE: (360)385-3215
1112 S JACOB MILLER RD
PORT TOWNSEND WA 98368
REPRESENTATIVE(S): JAIME KOZELISKY
1112 S JACOB MILLER RD
PORT TOWNSEND WA 98368
PROJECT DESCRIPTIOP REPLACE FOUNDATION UNDER EXISTING STRUCTURE
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP REP MAIN: 1,000
VALUATION 6,400.00 ADD'L: 200 HEAT TYPE: WOD
CODE EDITION: 1997 HEAT BASE: HEAT TYPE:
OCCUPANCY:
OCCUPANCY: UNHEATED: #OF STORIES:
CONST TYPE: OTHER: SHORELINE:
CONST TYPE: GARAGE: SETBACK:
DECK: BANK HEIGHT:
SEWAGE DISPOSAL: OSS
WATER SYSTEM: CAPE GEO 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
Routing Date: F&W Landslide
61 (.2__( -2—0 l Shoreline Aquifer
Forest: Commercial Rural
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $139.25 MAM 06/10/02 47746
Plan Check $90.51 MAM 06/10/02 47746
State Building Code $4.50 MAM 06/10/02 47746
Total: $234.26
SON co ` Jeffs=Col ►Department of Calomelity Development
�� �� 621 merman street,Port Townsend WA 88 ram)371-4 50
.\ •i'' '. I ..i,...„
prm :? A
FtIN
• 1---\ \
Project Description: JUN 1 0 2002 ,,
Building Type: Project Type: Frame Type: �!
' Single Family 0; New 4 X Wood
Y
Garage Attached/Detached Addition p. Steel =, LOPMENT
J ;Modular pcP1. U
Alteration/Remodel -- Concrete
Commercial < Repair 1 Masonry
• Multi-family/#of Units I Demolition I Other:
• Industrial
Other:
Bathrooms: Bedrooms: Type of Sewage Disposal: Type of Heat:
Choose one:
Existing: I Existing: 2. 7 Sewer 0 Community System 1 Electricity 1 Oil
Proposed: Proposed: k Individual System g Woodstove E Propane
Total: I Total: Z If not sewer,fill out the following: i Heat Pump
Conventional C Alternative 1 Other
Permit# SEP
Water Supply:
❑ Private well 1 Two Party Well L:Tri.CUblic:Name of water system: 0/4-P.= C,t U,..
Square Footage: For Office Use Only
Main Floor 16700
Consistency Review 4;00-
2ND Floor ?b D Base fee '139 •'z
3'Floor Plan Check fee—655% Cl 0`S
Htd Basement State Surcharge fee 14-S
Unhtd Basement Subtotal 239- . 2C
Garage/Carport Pot Water Review fee Cb
Decks 911/Rd Approach fee
Commercial TOTAL 1234 •42-_
_
Industrial Receipt# �1 7 7 tiL,
Other Fvltr, 1s— p.PEA `e' Cash/Check# 6.(7 '.7®-
Total Valuation: Initials /P►'•'/`J
Or Date 6/ii®dZ-
Estimated Cos .
(oyoo
If within 200' o the S�ne,
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 nght of entry to the applicant's property or structure shall be requested and shall occur during regular business hours. /
Signature: > '` �L Date: r/ '"!.6 45 ?
.OVER 1
H:HOME\PLNCNTR\INFOBLDG\FORMS\BLDpermitApplication 11-8-01
t
\,p/
I r
->7Lv7
J J
cJ�
— - •
s Y
441
4.
✓1 J
JUN 1 0 2002 ; 4 Q
LI 1st
\\\\)\\
1 —a
`\ y, eQ
a
..§1
cio
N �\ \\x z G21 y3i/1 p Jo
0
A If
1`f
` r
KQZELISKY'S HOME SERVICE
1112 II Jacob Miller Road r-
port 7bwnaano, WA 98868
Mono 3604854215 1 2002 ,i
JUN0
I
f,).,i,!:(i,,,,_
___ ,..)pm,..,,,,r
... q i i i 6...,1 4k...." 17-1(W`..lor
, .
I1 "Plvvvrevow-
px , ,
It \ 1 "1
t 1 1 . ti
.*, !. 1 I t,r,s 6,,
j ._._. . .. • � , I
J/ r
\,..,, �
te` // R ,> •Q pt
gi
\ -P,1
•
,c>. "li---r,_,--------------
:----------.
irN /
/
-
tc
l ran'ii [,11-26 4f
�'80 >i007IN3H
h
All_ -
TO 'd SIGH, 8£Q 9Ob NA1SOt S3IN