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HomeMy WebLinkAboutBLD2002-00541 BUILDING PERMIT APPLICATION BL v Reviewiew T Ty541 ype: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD02-00541 Received Date: 9/13/2002 SITE ADDRESS: 160 FOXFIELD DR PORT TOWNSEND, 98368 OWNER: PATRICIA A SLACK TRUSTEE PHONE: (360)379-0941 THE FLEMING TRUST 160 FOXFIELD DR PORT TOWNSEND WA 98368 SUBDIVISION: KALA POINT#1 Block: Lot: 9 PARCEL NUMBER: 964700009 Section: 27 Township: 30 N Range: 01 W CONTRACTOR: DOVETAIL PHONE: (360)379-0941 160 FOXFIELD DR PORT TOWNSEND WA 98368 Contractor's License DOVET**983ME Expires 7/5/2004 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOI SKYLIGHTS TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ALT MAIN: VALUATION 1,200.00 ADD'L: HEAT TYPE: EEE CODE EDITION: 1997 HEAT BASE: HEAT TYPE: WOD OCCUPANCY: OCCUPANCY: UNHEATED: #OF STORIES: CONST TYPE: OTHER: SHORELINE: CONST TYPE: GARAGE: SETBACK: DECK: BANK HEIGHT: SEWAGE DISPOSAL: OSS WATER SYSTEM: PUBLIC PARCEL TAGS: YES NO_ BEDROOMS: BATHROOMS: STORMWATER: YES____ NO AREA Exist: 5 Exist: 3 Wetland Erosion Prop: Prop: Seismic _ _ Streams Total: 5 Total: 3 Flood Way_ Floodplain Routing Date: F&W Landslide Shoreline_ Aquifer Forest: Commercial Rural Type Amount Paid By: Date: Receipt: Approved/Date Permit $44.85 MAM 09/13/02 49640 Plan Check $29.15 MAM 09/13/02 49640 State Building Code $4.50 MAM 09/13/02 49640 Total: $78.50 Jefferson County Department of Community Development k4.C'. c°� 621 Sheridan Strut,Port Townsend WA 88368[3601318 4450 ti `y�e prmrt t 'OnrgiE--,7 )). it ''��1e� u iProject Description: ,',; ., _ IBidding Type: Project Type: Frame Type: ; V Single Family ❑ New - fi:• 7 ?�X ot?c} ❑ Garage Attached/Detached ❑ Addition ©E8ffP2�(�F C(J�t ElTlScei l/E LOPME*NT ❑ Modular (Alteration/Remodel ❑Concrete ❑ Commercial ❑ Repair ❑ Masonry ❑ Multi-family/#of Units ❑ Demolition ❑ Other: ❑ Industrial ❑ Other: Bathrooms: Bedrooms: Type of Sewage Disposal: Typ of Heat: Choose one: Existing: 3 Existing: '-- ❑ $ewer ❑ Community System Electricity ❑ Oil Proposed: Proposed: .Individual System ❑ Woodstove ❑ Propane Total: 3 Total: If not sewer,fill out the following: ❑ eat Pump ❑ Conventional ❑ Alternative re Other Fr te -ja.:.c_ Permit# SEP Water Supply: ❑ Private well ❑ Two Party Well S.1 Public:Name of water system: Square Footage: For Office Use Only j Main Floor Consistency Review ®' 2ND Floor Base fee 41p'.8� 3rd Floor Plan Check fee—65% 2_q . i Lc Htd Basement State Surcharge fee E Unhtd Basement Subtotal / p • Garage/Carport Pot Water Review fee 45 Decks 911/Rd Approach fee Commercial TOTAL -7 g•So Industrial Receipt# 4ri 6 v Other K II x el) Cash/Check# I(LK Total Valuation: /2 0 0 Initials 2 V Q Or �/ Q Date _i /1 3 / 0Z -.. Estimated Cost: l ll If within 200' of the Shoreline, Distance to Bank or Ordinary High Water Mark ft. Bank Height ft. r 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 a plicant's property or structure shall be requested and shall occur during regular business hours. ��7 Signature: �` „��'t'(� Date: �'/3 —L OVER- , H:HOME\PLNCNTR\INFOBLDG\FORMS\BLDpermitApplication 11-8-01 rtet-ce. fiA re:44,1) 2,7 417 esatiikel cap/ 0-tale 0 Of- 477 01-e- cfrie1 5044" 160 For At et) bt 7: „atm_ 94el< 7)'e) ;J SEP 2 5 2002 F77"T4-1—Y Ov'COt,V,' ill i 1 i • kl,s __.. . 0 1--- ...-c4 i 1 , --• RI SEP 1 3 2602 . .„ , -71 L , \ ....- t- \ ,-, 2,"2.: ,-.- ,„,,, DEPT nc- -- ,- -,T.,:-1 ,-',-.,,„_,. . \% - . ..... o_ 1 , -4- , I t , I I 1 I 1 <----------- °- I . 4 ‘ IN 1 - 1 --r's 1 , i 0 ca Jk., i 1 , 0 I i , - '17\ ‘`.• 1 i t - ...- ..- .... .. \-11, - ...- ....'-- r. tit 4,, _•-, . si ----. e''' ...., r'l , .., ..... .-5 ... '1 \ Cil \St ----- .„„.---- t--1-1 4. 77/ ----- 1-4, ./•( 4_,.. ' -----------i . ill pi \ IN/ >•• Z. , ci. tt, '.›,... --I 7c° - S"-- ...-- 71 - r- -- o x r- q• f' "I— 0 o "I Z Th-1-1 -- --- r•- c•-• cr) 1, -.-.N r" A. t15 °'• r- 0--• g v > _S) f•. 'C.- -.A.Z. \il ti\ .). 71, t•) v4 c., u., ...- .4,.. ...... .......,.......,_ • ,f