HomeMy WebLinkAboutBLD2003-00157 • BUILDING PERMIT APPLgTION B RD03N0op157
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD03-00157 Received Date: 3/12/2003
SITE ADDRESS: 41 LIBBY CT
PORT LUDLOW, 98365
OWNER: GARY Y ROBIN TSTE PHONE: (360)437-0600
SALLY ANDERSEN ROBIN TSTE
41 LIBBY CT
PORT LUDLOW WA 98365-9639
SUBDIVISION: PORT LUDLOW NO 2 AREA 1 Block: Lot: 45/46
PARCEL NUMBER: 990600145 Section: 9 Township: 28 N Range: 01 E
CONTRACTOR: PHONE:
PHONE:
REPRESENTATIVE: DOUGLAS RIGBY PHONE: (206)275-3275
5327 WEST MERCER WAY
MERCER ISLAND WA 98040
PROJECT DESCRIPTIOt BATHROOM ADDITION TO BASEMENT
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP ADD MAIN:
VALUATION 14,875.00 ADD'L: HEAT TYPE: EEE
CODE EDITION: 1997 HEAT BASE: 85 HEAT TYPE: HTP
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: 3 Exist: 3 Wetland Erosion
Prop: Prop: 1 Seismic Streams
Total: 3 Total: 4 Flood Way Floodplain
Routing Date: F&W Landslide
3 i� Shoreline Aquifer
Forest: Commercial Rural
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $251.25 MAM 03/12/03 55144
Plan Check $163.31 MAM 03/12/03 55144
State Building Code $4.50 MAM 03/12/03 55144
Potable Water Application $50.00 MAM 03/12/03 55144
Total: $469.06
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Project Dcecd tioi:
S$uildlttg Type:
pto�t t Pontiac'type:)21,,Single Family
0 Now
0 Oars Attached/Detached J Addition 0 Steel
0 Modular
o
d C 00 Altuation/Remodel 0 Concrete
S / Iof Ui
0 ,Minaa-faatil na Repair ❑ Masonry
'"` y 0 Demolition
0 .Industrial Otttcr
Rai brooms: Ransoms: Type of
one:
Disposal: Type of Heat
Choose o
. Exiatink S Existing Sewer d
Proposed: A pm Comrnw»q SystemElectricity 0 Oil Total;
Total �� 0 Individual System 0 Woodstove ❑ Prone
If apt sewer.fill out the following: 15t,Hest Pump
0 Conventional 0 Alternative 0 Other
P SEP
Water Supply: ®.
0 PrivatavmeU � �
0 Two Pan;Well❑ Public Name of arot�tetn: _Ritr'r> Sgnu'e Footage:
For Office Use Only
Main Floor
�`':. ---- Consistency Review
', 2N1s Floor Base fie tea'• . —�
t t.'4,
3'1 Floor
Plan Check fee-65% 161.11
1-Xtd Basesneut Plan•r„� State Surcharge fee � -4.5C)
Unhta Basement Subtotal 419 . Ob
' �g's/C�n ' ' I. �o
I Pot Water Review fee
i. Decks r: 911/Rd Approach fee
Commercial 1 4
TOTAL . 0 co
Incle,trial Receipt Ji ��7
i:. '#
Cash/Check#
Total Valuation: /
; Or IaJ0815 _ �>'7
Date —3// `I 0 3
Estimated Cost �, pc'
ailirj i#'Within 200'of the:S
, DistItnce to Bank an Ordinary High Water Maw ft.Bank Height
?l i' `O7e d— terra.the epplicnat/osmer seem diet irL don provided hertin is uw an rd macaw soare their
r; ne.ni of a material fees awlo by the appicent/oa,aer with respect eo dole appi don pae>:er may"
ay aaeuk:due peemrtec bdshe bag msusi and voidk.nowladae. Any fikahoai or any
fiat',egi"n,"ve'iedeennly eed bold himils0qaccoom net ea fabJi
against Jerk-not+Comity tie a testa ore,MI eente CO.n"wain �°ladgrileatei mart earn.ceaetNWblt uto[eey'e Case and enemas which way in Try way sate
tY gnome of the g.anpes of this permit'
;: I farther agree to peoeide access and�htact try toJelfeiaoo County and ate eta e
jt Aeeeas and eight fil yam•ra mar
er in os for the appliq'6�•ttlftaety dtea M's �~ putpOSCOf nonecures.andMyrt:gW[GdWrtrStcpxtioru.
PPS a e6ag bem�qu/aged and shall oetotrr dosing regular business hewn_
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Signature:
<M� Date; 2.-�`�-�3
1' x:r�o{vE\nunlg\�N QED' lE►':.sounc\FoRms$ BLDnem.ieAnnlira6,...t i-k M
ZO/Z0 3Jbd QOQ 00 dd3f Z5bh6L£09E £Z:9T £00Z/6I/Z0
• .
4 JEFFERSON COUNTY
,: q DEPARTMENT OF COMMUNITY DEVELOPMENT _ ,4u
41, 0' 621 Sheridan Street • Port Townsend • Washington 98368
"4` -INC 360/379-4450 . 360/379-4451 Fax MAR 1 2 203
http://www.co.jefferson.wa.us/commdevelopment/
Stormwater Calculation Sheet JEFFEROON COUNTY DOD
MLA# PROJECT/APPLICANT NAME: cA2 LL- '�ai:tN
This stormwater calculation sheet should accompany stand-alone stormwater management permit applications, building permit
applications,and other land use approval applications that involve stormwater review.
STORMWATER CALULATIONS-IMPERVIOUS SURFACE
NEW - tANVAW E-XtS1ANV, I Eg...'J OL,5 . EXISTING
Structures(all roof area) ?),5 sq/ft Structures(all roof area) ��`1 sq/ft
Driveway sq/ft Driveway (?),SO sq/ft
Sidewalks sq/ft Sidewalks sq/ft
Patios sq/ft Patios 3'7C, sq/ft
Solid Decks sq/ft Solid Decks.WCP—D b bC) —12- sq/ft
Other sq/ft Other GIDScit kkou% ;'>'G. sq/ft
Total New sq/ft , Total Existing ,O)9 82 sq/ft
TOTAL NEW+TOTAL EXISTING* Ia:142)2 sq/ft
*This amount will be used to check total lot coverage
Please also indicate the amount of land-disturbing activity, in addition to the creation of impervious surface, that will take
place:
LAND DISTURBING ACTIVITY
Drainfield area cleared sq/ft Well,Structures, Utilities, etc. sq/ft
Driveway sq/ft Other sq/ft
Total Land Disturbance No N . sq/ft
STORMWATER MGMT PERMIT.DOC REV.12/20/02
Ill I
. 40October 1, 2004 r
OCT 5 2004
Mr. Peter Bonyun
Department of Community Permits
621 Sheridan St JEFFERSON COUNTY DCD
Port Townsend, WA 98368
Gary Robin
41 Libby Ct
Port Ludlow, WA 98365
Re Cancelation of Permit BLD03-157
Dear Mr. Bonyun,
As we discussed over the phone this week, please cancel the above building permit.
None of the work has been done.
Very truly yours,
2,-. 0/(--;s7
Gary Robin
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