HomeMy WebLinkAboutBLD2003-00430 •
BUILDING PERMIT APPLICA ON ML 385
Revviewiew T Tyype:I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT#: BLD03-00430 Received Date: 7/11/2003
SITE ADDRESS: FAWN MEADOW RD
CHIMACUM, 98325
OWNER: ERICA E ISEMINGER PHONE: (206)782-2258
8602 29TH AVE NW
SEATTLE WA 98117-3825
SUBDIVISION: FAWN MEADOW Block: Lot: 9
PARCEL NUMBER: 901225009 Section: 22 Township: 29 N Range: 01 W
CONTRACTOR: ED BROWN PHONE:
PO BOX 1801
POULSBO WA 98370
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION DETACHED SHOP
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP NEW MAIN:
VALUATION 40,000.00 ADD'L: HEAT TYPE: PRO
CODE EDITION: 1997 HEAT BASE: HEAT TYPE:
OCCUPANCY: R-3 UNHEATED: #OF STORIES:
OCCUPANCY:
CONST TYPE: 5N OTHER: 384 SHORELINE:
CONST TYPE: GARAGE: SETBACK:
DECK: BANK HEIGHT:
SEWAGE DISPOSAL: CON
WATER SYSTEM: PWELL PARCEL TAGS: YES NO
BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA
Exist: Exist: Wetland Erosion
Prop: Prop: Seismic Streams
Total: Total: Flood Way Floodplain
J F&W Landslide
Routing Date:
/� / �3 � Shoreline Aquifer
Forest: Commercial Rural
Type Amount Paid By: Date: Receipt: A ^Ortocil/paje
Permit $525.85 MJA 07/11/03 58122 /�(-+ VE r
Plan Check $341.80 MJA 07/11/03 58122 AUG 2 $ 2003
State Building Code $4.50 MJA 07/11/03 58122
Total: $872.15 Jefferson County Planning
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BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD03-00430 Received Date 07/11/2003
SITE ADDRESS: 293 FAWN MEADOW RD Issue Date 08/28/2003
CHIMACUM, 98325
APPLICANT: ERICA E ISEMINGER PHONE: (206)782-2258
8602 29TH AVE NW
SEATTLE WA 98117-3825
SUBDIVISION: FAWN MEADOW Block: Lot: 9
PARCEL NUMBER: 901225009 Section: 22 Township: 29 N Range: 01 W
CONTRACTOR: ED BROWN PHONE:
PO BOX 1801
POULSBO WA 98370
LOAN LENDER/
BOND HOLDER:
PROJECT DESCRIPTION: DETACHED SHOP
REQUIRED INSPECTIONS:
[ ] SETBACKS 9-3-c'3
[ ] UFFER:
[l,j Footing: ` - � 5
[ ] Foundation: OK gills/o3
[ ] Underground Plumbing:
[ ] Underground Insulation:
[ ] Shear Wall : 3/3�a�
[ ] Framing: ,Q Q�
11 Plumbing:
[ ] Propane Tank/ Lines:
[ ] Insulation:
11 Sheetrock:
[ ] Septic Sytem Final Approval:
1 Zoning Final Approval:
[ ] Final/Occupancy Approval: e4806.4.1 et/
HEALTH DEPARTMENT APPROVAL REQUIRE 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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• Jefferson Countyiartment of Community Development
,���� c°� 621 Sheridan Strait,Port Town nd WA 8836813601370-4450
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Project Description:
Building Type: Project Type: Frame Type:
❑ Single Family lotb, New It Wood
❑ Garage Attached/Detached ❑ Addition ❑ Steel
❑ Modular ❑ Alteration/Remodel ❑ Concrete •
❑ Commercial ❑ Repair ❑ Masonry
❑ Multi-family/#of Units ❑ Demolition ❑ Other:
❑ Industrial
",Other: �P
Bathrooms: Bedrooms: Type of Sewage Disposal: Type of Heat:
Choose one:
Existing: Existing: ❑ Sewer ❑ Community System ❑ Electricity ❑ Oil
Proposed: Proposed: • 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:Name of water system:
Square Footage: For Office Use Only
Main Floor
Consistency Review 47:00
2ND Floor Base fee 6-Ei, $b
3rd Floor Plan Check fee—65% 31 1 a 8C'
Htd Basement State Surcharge fee 1 . b 0
Unhtd Basement Subtotal la, 16._-
' Garage/Carport Pot Water Review fee
Decks 911/Rd Approach fee
.
Commercial TOTAL 1 . '
Industrial loop Receipt# I 2.,
Other 54+c 384. 6I,0st,' Cash/Check# J czy O
Total Valuation: Initials
Or Date 7/ /i / 0 ?
Estimated ost: '�! o C 6
If withi C
n 2 e Shoreline,
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 acc••. •d 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 .the ap hcant's•ro.- .r- cture shall be requested and shall occur during regular business hours.
Signature: ■ ll_ t� Date:
OVER
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