HomeMy WebLinkAboutBLD2003-00432 • BUILDING PERMIT APPL•TION BL 432
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Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD03-00432 Received Date: 7/14/2003
SITE ADDRESS: 201 E HORTON ST
PORT HADLOCK, 98339
OWNER: MICHAEL P BOWEN PHONE: (360) 385-9344 e:
TERESA NOMURA
380 E MOORE ST
PORT HADLOCK WA 98339-9622
SUBDIVISION: IRONDALE Block: Lot:
PARCEL NUMBER: 961801411 Section: 35 Township: 30 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION CHANGE OUT WINDOWS
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP ALT MAIN: 1,095
VALUATION 2,500.00 ADD'L: HEAT TYPE: WOD
CODE EDITION: 1997 HEAT BASE: HEAT TYPE:
OCCUPANCY: R-3 UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: 5N GARAGE: SHORELINE:
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: CON
WATER SYSTEM: 2WELL PARCEL TAGS: YES NO
BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA
Exist: 2 Exist: 1 Wetland Erosion
Prop: Prop: Seismic Streams
Total: 2 Total: 1 Flood Way Floodplain
Routing Date: 7
F&W Landslide
OS I D Shoreline Aquifer
Forest: Commercial Rural
Type Amount Paid By: Date: Receipt: A pp ROV/EteD
Permit $83.25 MJA 07/14/03 57948
Plan Check $54.11 MJA 07/14/03 57948 JUL 1 8 2003
State Building Code $4.50 MJA 07/14/03 57948 Jefferson County Planning
Total: $141.86 &Building Department
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o E C g sON • Jefferson Ay Department of Community Development
%� °, 621 Sheridan Street,Port Town,;nd WA 88368[360]318-4450
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i11o,�vtitG4 pLErte) +i Description: i ii c t1 ✓ U Vyt/ clotAbre h€ wotdo Gd5 Ir,) CcV Building Type: Project Type: Frame Type:
Single Family ❑ New
Wood
❑ Garage Attached/Detached ❑ Addition ❑ Steel
❑ Modular K 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: I Existing: ❑ Sewer ❑ Community System 10 Electricity 813 ❑ Oil
Proposed: Proposed: )if Individual System ❑ Woodstove ❑ Propane
Total: I Total: If not sewer,fill out the following: ❑ Heat Pump
g Conventional ❑ Alternative Vi. Other Pe-1 I ef- 5-1-Dv c
Permit# SEP
Water Supply:
❑ Private well 0 Two Party Welly Public:Name of water system: ID C_\D # I
Square Footage: For Office Use Only
Main Floor / Consistency Review -
2ND Floor Base fee eS- 2,S
3rd Floor Plan Check fee—65% St/. 1
Htd Basement State Surcharge fee 11,-s p
Unhtd Basement Subtotal /CI 1 a g
Garage/Carport Pot Water Review fee
Decks 911/Rd Approach fee ---S.
Commercial TOTAL I y d ' Pc'
Industrial Receipt# j 9 T
Other Cash/Check# -7 93 I
Total Valuation: Initials � I
Or � Date \/---;1/
/ iL.)3
t
Estimated ost: 257)0 '
If within '`" e-Sfioreline,
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 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 applicant's property
yo�structure shall be requested and shall occur during regular business hours.
Signature: 1,1° �i :& / b4J Date: 7 ch ��' 3
M t c I t, t f r `
H:HOME\PLNCNTR\INFOBLDG\FORMS\BLDpermitApplication 11-8-01
BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT#: BLD03-00432 Received Date 07/14/2003
SITE ADDRESS: 201 E HORTON ST Issue Date 07/18/2003
PORT HADLOCK, 98339
APPLICANT: MICHAEL P BOWEN PHONE: (360) 385-9344 e:
TERESA NOMURA
380 E MOORE ST
PORT HADLOCK WA 98339-9622
SUBDIVISION: IRONDALE Block: Lot:
PARCEL NUMBER: 961801411 Section: 35 Township: 30 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
LOAN LENDER/
BOND HOLDER:
PROJECT DESCRIPTION: CHANGE OUT WINDOWS
REQUIRED INSPECTIONS:
[ ] SETBACKS:
[ ] UFFER:
[ ] Footing:
[ ] Foundation:
[ ] Underground Plumbing:
[ ] Underground Insulation:
[ ] Shear Wall :
[ ] Framing:
f 1 Plumbing:
[ ] Propane Tank/ Lines:
[ ] Insulation:
f 1 Sheetrock:
[ ] Septic Sytem Final Approval:
f 1 Zoning Final Approval:
[ ] Final/Occupancy Approval tobvOows S4aokr Ac>7L� 1' `f t- ooV
HEAL DEPARTMENT APPROVAL REQUIRED RIOR 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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