HomeMy WebLinkAboutBLD2002-00700 BLD02-00700
p"�` •UILDING PERMIT APPLICA.N Review Type:
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD02-00700 Received Date: 11/27/2002
SITE ADDRESS: 651 E PIONEER DR
PORT LUDLOW, 98365
OWNER: FRANCIS S MARIK PHONE: (360)437-7915
ANDREA MARIK
651 PIONEER DRIVE
PORT LUDLOW WA 98365-9668
SUBDIVISION: PORT LUDLOW NO 2 AREA 3 Block: Lot:
PARCEL NUMBER: 990600326 Section: 9 Township: 28 N Range: 01 E
CONTRACTOR: WHITEY JOHNSON GENERAL CONTR PHONE: (360)779-9884
PO BOX 1110
SUQUAMISH WA 98392
Contractor's License WHITEJG159DN Expires 3/15/2003
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTIOI` CHANGE ROOFLINE AND WINDOWS
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP ALT MAIN: 0
VALUATION 18,500.00 ADD'L: HEAT TYPE: HTP
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: SEW
WATER SYSTEM: LUDLOW PARCEL TAGS: YES NO
BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA
Exist: 4 Exist: 3 Wetland Erosion
Prop: Prop: Seismic Streams
Total: 4 Total: 3 Flood Way Floodplain
) F&W Landslide
Routing Date: 17,Jc 7/D� Shoreline Aquifer
/// Forest: Commercial Rural
Type Amount Paid By: Date: Receipt: /� D t/ o
Permit $307.25 MAM 11/27/02 51427 /�-�
Plan Check $199.71 MAM 11/27/02 51427 DEC 0 6 2002
State Building Code $4.50 MAM 11/27/02 51427
Total: $511.46 Jefferson County Planning
& Building Department
ozv co • Jefferson Counilapartmat of Community Ihmdmiinent
621 Milan Street,Port Townsend WA 88368[3601370-4450
-v-4715 erm° 11- App
no
COTO On
i-iN
Project Description:
Building Type: Project Type: Frame Type:
Single Family ❑ New Wood
Garage Attached/Detached ❑ Addition ❑ Steel
❑ Modular . Alteration/Remodel ❑ Concrete
❑ Commercial LI Repair ❑ Masonry
❑ Multi-family/#of Units ❑ Demolition ❑ Other:
❑ Industrial
❑ Other:
Bathrooms: Bedrooms: Type of Sewage Disposal: Type of Heat:
Choose one:
Existing: Existing: .Sewer ❑ Community System ❑ Electricity ❑ Oil
Proposed: 2) Proposed: 1'I ❑ Individual System ❑ Woodstove ❑ Propane
Total: Total: If not sewer,fill out the following: ,Heat Pump
❑ Conventional ❑ Alternative ❑ Other
Permit# SEP
Water Supply:
❑ Private well , ❑ Two Party Well❑ Public:Nance of water system:01-9 1 '1 1 C__- tLI Y Tt
Square Footage: ' i S"j j ` C1 j'l: il-Vt)il.1°t--1 For Office Use Only
Main Floor V0 0 � ,- I�ok-1 ►1 Consistency Review
2ND Floor _../ Base fee 30
Q q
3rd Floor Plan Check fee—65% 1 "{ 1 - � l
Htd Basement �C O ti State Surcharge fee
Unhtd Basement t L M tz Subtotal S/ I r Lib
Garage/Carport M Pot Water Review fee '-�'-
Decks 3 Q® — 911/Rd Approach fee
Commercial , TOTAL
Industrial Receipt# 5�-+j
Other Cash/Check# (D
Total'Valuation: b'�i 'nit-jab TOQ
Or 400Sr-- SOi—Q t>1✓ 0 1' 'aate
Jul ,� 4)11,j1:111 I
Estimated Cost: �1 o sad.447'
If within 200' of the Shoreline, 111111111111111111111"..-
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 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 d right of entry to Jefferson Colin. and it's employees,representatives or agents for the purpose of application review and any required later inspections.
Access and right of entry to applicant's property orstructure sh I-requested and shall occur during regular business hours.
Signature: Date: (0L
OVR_
H:HOME\PLNCNTR\INFOBLDG\FORMS\BLDpermitApplication 11-8-01
0 BUILDING PERMIT Ant
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD02-00700 Received Date 11/27/2002
SITE ADDRESS: 651 E PIONEER DR Issue Date 12/6/2002
PORT LUDLOW, 98365
APPLICANT: FRANCIS S MARIK PHONE: (360)437-7915
ANDREA MARIK
651 PIONEER DRIVE
PORT LUDLOW WA 98365-9668
SUBDIVISION: PORT LUDLOW NO 2 AREA 3 Block: Lot:
PARCEL NUMBER: 990600326 Section: 9 Township: 28 N Range: 01 E
CONTRACTOR: WHITEY JOHNSON GENERAL CONTR PHONE: (360)779-9884
PO BOX 1110
SUQUAMISH WA 98392
Contractor's License: WHITEJG159DN Expires: 03/15/2003
LOAN LENDER/
BOND HOLDER:
PROJECT DESCRIPTION CHANGE ROOFLINE AND WINDOWS
RE CNS:
SETBACKSREDINSPE/ FootingTIO s: ogle,/
)b6.4 34/e34''
[Vj/�dundation: 12. o
[ ] Underground Plumbing/Underground Insulation:
[ ] Shear Wall:
[ ] Framing/Plumbing: UrC S/B�C5)#
[ ] Propane Tank/Lines:
[ ] Insulation: OK Ms/6 fl .
[ ] Sheetrock: "Al ZI1 n.Y
[ ] Septic System Final Approval:
[ ] Zoning Final Approval:
[ ] Final/Occupancy Approval: t, //-. %.-P'T`1
HEAL 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
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