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HomeMy WebLinkAboutBLD2002-00593 •BUILDING PERMIT APPLICJON MLA02-00529 Review Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD02-00593 Received Date: 10/8/2002 SITE ADDRESS: 615 COYOTE RD BRINNON, 98320 OWNER: RALPH B LOCHRIDGE TRTE PHONE: (949)651-1576 KATHERINE VAN GIFFEN TRTE 9 MORNING DOVE I RVI N E CA 92604-3220 SUBDIVISION: Block: Lot: T 6 PARCEL NUMBER: 502074008 Section: 7 Township: 25 N Range: 02 W CONTRACTOR: CASCADE CUSTOM BUILDERS PHONE: (360)867-4116 5940 BUCKTHORN CT NW OLYMPIA WA 98502 Contractor's License CASCACB980LJ Expires 6/11/2004 REPRESENTATIVE: C D GALLUP PHONE: (800)888-8715 3726 PACIFIC HWY E FIFE WA 98424 PROJECT DESCRIPTIOr SINGLE FAMILY RESIDENCE TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP NEW MAIN: 1,138 VALUATION 135,000.00 ADD'L: 424 HEAT TYPE: HTP CODE EDITION: 1997 HEAT BASE: HEAT TYPE: OCCUPANCY: R-3 UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: 5N GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: 44 BANK HEIGHT: 26 SEWAGE DISPOSAL: OSS WATER SYSTEM: PWELL PARCEL TAGS: YES NO BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA Exist: Exist: Wetland Erosion Prop: 3 Prop: 2 Seismic Streams Total: 3 Total: 2 Flood Way Floodplain Routing Date: filly F&W Landslide �4� "3.A._., pg Shoreline Aquifer Forest: Commercial Rural Type Amount Paid Bv: Date: Receipt: Approved/Date Permit $1,189.75 MAM 10/08/02 51023 Plan Check $773.34 MAM 10/08/02 51023 State Building Code $4.50 MAM 10/08/02 51023 Potable Water Application $50.00 MAM 10/08/02 51023 Total: $2,017.59 i-7, 9 \\7 7,-2, r-,-,-N, • 1 VI1..' " , J J . OCT — 8 2002 021 Sheridan Street,Port Term WA KU INIO 370-4458 t, ., PErm,.-10 con Project Description: Building Type: Project Type: Frame Type: aSingle Family ew (Wood'-,> ge Attached/Detached A dition Steel Modular Alteration/Remodel Concrete Commercial Repair Masonry Multi-family/#of Units Demolition Other: Industrial Other: Bathrooms: Bedrooms: Type of Sewage Disposal: Type of Heat: Choose one: Existing. Existing Sewer f m El ty Systeectricity Oil Proposed: Proposed: i i ttai Systean ) Woodstove Propane Total: Total: If not sewer,fill out the following: eat G:rauv ,ttionail Alternative Other Permit# SEP Z Water Su rivate well Two Part Well Public:Name of water a`ys errs: Square Footage: ((''' �( For Office Use Only �r Main Floor Sy l(Z •� ( Consistency Review ~ 4 t -00 2ND Floor 412ti 8r + .1 276.7 •7Z Base fee (t Sq`1� . c, 713 .34 3�Floor Flan Check fee tOt46�• ' I. Htd Basement State Surcharge fee Unhtd Basement Subtotal 14 *S.� Garage/Carport Pot Water Review fee I?i. 00 ' Decks 911/Rd Approach fee �—1`j-�' Commercial TOTAL 20 5. 51 Industrial Receipt# 5( ® 3 Other Cash/Check# ';21 Total Valuation: 1 — Initials ' 7 :11./ Or � _ l Date t Q f ~ © 2.� Estimated Co . /.S s C"O 49 �. ` If within 20 PRIM T `liUT1 ! Distance to Bank or Ordinary High Water Mark Li`Lf ft.Bank Height 2+CO 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 pen-nit 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 appli- T roperty or structure shall be requested and shall occur during regular business hours. v Signature: -- Date: <%' d-'"-� OVER ► H:HOME\PLNCNTR\INFOBLDG\FORMS\BLDpesmitApplication 11-8-01 . w 1 • 1c/ ``\` >e.. 1.(?-:!'") .C.) .. .' I i V v 1 1 tenr, .9 7 00 A. , o� zoo• \f IV0 cic>. ....).4„ 5 ..______ ,c,,.„,. , . ------ , \ Aso`:',. N. A/ /-- '''' sue\ p ,���, 00 /' �`\_ ._.,. . �.._ ._�.r� s b 4. `'� i \ j/ / i i rd / V \ I ` - \ x:k I /3 - �,\ ....4,. ).(e_...... . �� \ E L. / CJ ...(..,,,,' V �N ��� � -1-2 \ . WALE LocuoiD`'G- K. ett-(G I FF' J ,P .SOZ- 674- OO6 ‘/$ Co yoT o g4/.1Y aN , a/a, IECIFIWED Dues ) _ vim' h`�: r t. L p CIS C. Q,\1 MAR 7 Z0� � 'e. SC- /� L I �0 �--Q DEPT. O!' C+O,W.4',zli.Y DE. � LC�PNIENT j ,�nJ v 1 , ., s _. /, tocH„e/D66 //'. l/)Y , / FF6,y , , ---77 P, Sae - 0 74 -- 008 6 / s. Co y oT6". /V 1::,. 8�, oiy (,,4. 98 3 z4, _ 5c P sc . 7 _ DL ) ZSiy R— ZLA) • sa.e- / /oo ' 1 ,1 0 \ c� \ \ o a V ,.... i � / U t 14 / .. ti LL 5 g�56gU6 0 �`" Nod'6 so or IL ' `L u u g n, ,p , . .._ , . vi , \.:, I \in,' ,1MAR - 72003 f L..„) _1 �.�" _ , 4. fz 4 \\,. Li f if > / f ..„---21_, . C)-:- . ' . ..,,,....„ / e