HomeMy WebLinkAboutBLD2003-00315 itUILDING PERMIT APPLICA lam' N ML Review Ty 259
Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD03-00315 Received Date: 5/22/2003
SITE ADDRESS: 263 BLUEJAY LN
PORT LUDLOW, 98365
OWNER: VINCE B RICHEY PHONE: (360)437-9739
M JANE RICHEY
263 BLUEJAY LN
PORT LUDLOW WA 98365-9570
SUBDIVISION: OLYMPIC SHORES DIV 1 Block: Lot: 2
PARCEL NUMBER: 983300002 Section: 9 Township: 27 N Range: 01 E
CONTRACTOR: OWNER/BUILDER PHONE:
4114141 i eX J 11,4/7
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REPRESENTATIVE: /bOQptfriON:001/40.4), \, ... 15_1
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PROJECT DESCRIPTION DECK
TYPE OF WORK GAR SQUARE FOOTAGE:
TYPE OF IMP DEK MAIN:
VALUATION 4,525.00 ADD'L: HEAT TYPE: UH
CODE EDITION: 1997 HEAT BASE: HEAT TYPE:
OCCUPANCY: UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: GARAGE: SHORELINE:
CONST TYPE: DECK: 192 SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL:
WATER SYSTEM: PARCEL TAGS: YES NO
BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA
Exist: Exist: Wetland Erosion
Prop: Prop: Seismic Streams
Total: Total: Flood Way Floodplain
Routing Date: Landslide
j/0�j 'Pe-4F&W
Shoreline Aquifer
Forest: Commercial Rural
Type Amount Paid By: Date: Receipt: Approved/Date
Permit $111.25 MAM 05/22/03 56326
Plan Check $72.31 MAM 05/22/03 56326
State Building Code $4.50 MAM 05/22/03 56326
Total: $188.06
µ 03/20/03 TUE 10:11 FAX 425i 0�290 AIRTOUCH CELLULAR ®� �006
c,.
4 , ;ch �o �� Jefitersen County Department of Community
mimse�WA 88518 t3801 371-4 ig
`- / It ! a1 Sheridan Street,Past T mar0
Prm ? °
0cacion
, , ,.., ,,,,,,. ,0,,,zitTecs.,-,
,t,, t 1 f�-Pr+�``ect l�escripeo - — — i i
irk� � �•G.1 CC�1I7�Type: r r�.. ... . - - -..
Project Type:
}4 i ! Single Family
�" Frame Type: J
',Ili : Garage Attached/I7etad ed 0 New 4. - , Wood j o i ST SIQAr
' Modular Addition Steel /
! ❑ Alteration/Remodel u Y 2 2 2IJ CA}µ • x Cotntnapal a Repair p1 `Concrete •
' Multi-famjlp/#of Units p '^ ��""� Masonry
0 Demolition \,i, ,r Industrial _-- --'E; Other:CO yl7�ns a�
` Other. �� r•��O ti O l' : ` ''''t w Cr
' , M,x‘i , <throoms: _
B .
Type of:( ' ;:i, Choose one:
Disposal: Type of Heat:
s , -
•� , • ❑ Sewer ❑ Community S 0 Electti Oil
." ed •••
A__
} ��s t '•''444 La_------
14.1d,,,t, Total "' 0 Individual System 0 Woods tov ❑ Propane
If not sewer fill out the foII4 ❑ Heat Pump
44 k} } ❑ Conventional 0 Alternative a Other
Permit# SEP
r+r w `Stet Supply:
} � Private well/ 0 Two ' - a Public:Name of water system: I
e Onlyare Footage: For Office Us
I�, ' Floor —3
f'l Consistency Review
t , " Floor
} Base fee I U I.ZS
1'44 Floor
1� # a Plan Check fee—65% 72-3 l
"` �td Basement
4 State Surcharge fee t f,93
', ;(3smhtcl Basement Subtotal $g•O�
mot
1 e/Cazpor;
Pot Water Review fee CP
becks
911/Rd Approach fee
ercial 'I gg ' D�
TOTAL
ustrial Receipt# - ZC
er Cash/Check# 1-77c
otal Valuation: Initials f
t .
Date 2 o?�
Es ;tcd:Cos' / J5-0 QO
If -:thin 200' of the Shoreline,:
Dictnrce to Bank or Ordinary High MAlter Mark • ft Bank Height
3�3 nti' ,.
.f r 5y st2ns4ng the application fora,the applicant/ that the information provided herein is true and correct to the best of their knowledge. Any material falsehood or any
., on of a material fact mode by the applicant/ow }rwith respect to this application packet may result in this permit being null and void.
e to save,"'^e 7 and hold hantdem P erson County against all liabilities,judgments,court costs,reasonable attorney's fees and expenses which may in any way accrue
t ,st Ieffe*son Co an'y as a result of or in Done ueste Of the granting of this permit
7r agree to provide acres and t of entry to n d it's employees,representatives oragents fox the
c and right of entry to e i is property purpose.of application review and any required later inspections.
FP` s be requested and shall occur during regular business hour
s.'
:-:a>re: _ Date:
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