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HomeMy WebLinkAboutBLD2002-00551 UILDING PERMIT APPLICIPON MRLA02-00501 Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD02-00551 Received Date: 9/19/2002 SITE ADDRESS: 561 SADDLE DR PORT TOWNSEND, 98368 OWNER: ANDREW W BENSON PHONE: (360)379-3359 KIMBERLY N BENSON 917 FRANKLIN ST PORT TOWNSEND WA 98368 SUBDIVISION: CAPE GEORGE VILLAGE DIV 7 Block: Lot: 28 PARCEL NUMBER: 941500028 Section: 18 Township: 30 N Range: 01 W CONTRACTOR: KIMBALL & LANDIS LLC PHONE: (360)385-4915 151 FREDRICK ST PORT TOWNSEND WA 98368 Contractor's License KIMBALL996D3 Expires 3/25/2004 REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOD SINGLE FAMILY RESIDENCE TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 960 VALUATION 225,000.00 ADD'L: 1,020 HEAT TYPE: PRO CODE EDITION: 1997 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: # OF STORIES: OCCUPANCY: CONST TYPE: 5N GOARAGE:THER: 120 SHORELINE: CONST TYPE: DECK: 169 SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: ALT WATER SYSTEM: CAPE GEO PARCEL TAGS: YES NO_ BEDROOMS: BATHROOMS: STORMWATER: YES____ NO AREA Exist: 0 Exist: Wetland_ Erosion Prop: 3 Prop: 3 Seismic _ Streams Total: 3 Total: 3 Flood Way _Floodplain Routing Date: F&W Landslide Shoreline _Aquifer _ Forest: Commercial Rural Type Amount Paid By: Date: Receipt: Approved/Date Permit $1,699.35 MAM 09/19/02 50979 Plan Check $1,104.58 MAM 09/19/02 50979 State Building Code $4.50 MAM 09/19/02 50979 Potable Water Application $50.00 MAM 09/19/02 50979 Total: $2,858.43 II Jefferson Coulfepartment of Community Development ��g, ' oo 621 Sheridan Strut,Port Townsend WA 08368[3601370-4450 �s G2° ppcfl© r hN ,. Project Description: t Building Type: Project Type: "r Frame Type: t�yf. Single Family X New _� � QX. Wood 1� Garage Attached/Detached ❑ Addition V ❑ Steel ❑ Modular ❑ Alteratio./Remodel O, .( \O ❑ Concrete D Commercial ❑ Rep.' c,4 t �` CI Masonry ❑ Multi-family/#of Units ❑ De :i*�`. , � [IOther: D Industrial �� ❑ Other: Bathrooms: Bedrooms: Type of Sewage Dispose Type of Heat: Choose one: Existing: Existing: ❑ Sewer ❑ Communi*ystem El Electricity ❑ Oil Proposed: Proposed: ' Individual System CI Woodstove Propane Total: ,3 Total: 1 3 'If not sewer,fill out the following: ❑ Heat Pump i ❑ Conventional XAlternative CI Other Permit# SEP a "2 - 1 Water Supply: ❑ Private well ❑ Two Party -ll$Public:Nkrne of water system: (slit. L.tr'�,�tjt (r v k.)✓t 1 k.44-, ''- Square Footage: J For Office Use Only .J r Main Floor gl9Q 51. ., rya' ^ �D° r . Consistency Review 47.00 2ND Floor ►DZO �. Vt. 10LD t ‘eO Base fee I (0(ICI _5 �Floor `iS'7� 3 r z'O 59' -, "\ ' Plan Check fee-65% 1 t OLI • `- IC Htd Basement State Surcharge fee Unhtd Basement ��1q4 Subtotal 5 S^•Li 3 Garage/Carports l. }. �W�` 33 Pot Water R w fed t q� air 7 L�. -60 Decks it0c1 1, ?4- 371- + /'d Approach fee-'?' '{ ` 4- .tee' Commercial TOTAL 1 (p•y 3 Industrial Receipt# ,56 9 79 1 Cash/Check# '/s/ Other r e')� . Total Valuation: 1 Initials �y Or Date CA -\-1 - d2_ Estimated Cost: d 2Z",600, If within 200' of the • _ - - me, 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 rth 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: A —'--eA.- - ---- Date: qi )62_ OVER O H:HOME\PLNCNTR\INFOBLDG\FORMS\BLDpermitApplication 11-8-01 �i 0"1:73 \, (\ (0\110Z, v\:-\.Cfk 5a A "IP". • • • (fi • • .1).1 le)6r %, td 0 , • .) c 711: -rs • , 1-± >1 l:. frAl (,11 r i '1 7 L'-) ,01 4 . - % Lv; • 1)- - ) - ill / • f In . „ ) "I (1 1- 11 ill VIP -71 --I 11 11 (1 I 711 : Gt \ I(.51 ( IP J .)C) cs 7 I 111 cY+ • 0 N 1111T: rqi (pY cy ,v-r. 1RD , q1"1 7 " (../) CD COVATe° OV56 OVI