HomeMy WebLinkAboutBLD2003-00470 BUILDING PERMIT
Jefferson County Department of Community Development
621 Sheridan Street, Port Townsend, WA 98368
(360)379-4450 FAX (360)379-4451
PERMIT #: BLD03-00470 Received Date 07/31/2003
SITE ADDRESS: 170 CARROLL AVE Issue Date 07/31/2003
PORT TOWNSEND, 98368
APPLICANT: JOHN L COOLEY PHONE:
LINDA R COOLEY
141 VICTORIA LOOP
PORT TOWNSEND WA 983689400
SUBDIVISION: GISE'S ADDITION Block: 13 Lot: 1-2
PARCEL NUMBER: 953101301 Section: 16 Township: 30 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
LOAN LENDER/
BOND HOLDER:
PROJECT DESCRIPTION: ROOF REPAIR - FIRE DAMAGE
REQUIRED INSPECTIONS:
[ ] SETBACKS:
[ ] UFFER:
[ ] Footing:
[ ] Foundation:
[ ] Underground Plumbing:
[ ] Underground Insulation:
[ ] Shear Wall :
[ l Framing: ,0E% .4:._. S''• --4-z J�
[ 1 Plumbing:
[ ] Propane Tank/ Lines:
[ ] Insulation: - /� ;,/A-„i.:7 ,25--c
1 1 Sheetrock: ;`,"<M 9 -: e_. :>
[ ] Septic Sytem Final Approval:
[ 1 Zoning Final Approval: •
[ ] Final/Occupancy Approval: t (p„d0 t 0—!� e
HEALT 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
IlkUILDING PERMIT APPLICA)N BLD03-00470
Review Type: I
Jefferson County Department of Community Development
621 Sheridan Street Port Townsend, WA 98368
PERMIT #: BLD03-00470 Received Date: 7/31/2003
SITE ADDRESS: 170 CARROLL AVE
PORT TOWNSEND, 98368
OWNER: JOHN L COOLEY PHONE:
LINDA R COOLEY
141 VICTORIA LOOP
PORT TOWNSEND WA 983689400
SUBDIVISION: GISE'S ADDITION Block: 13 Lot: 1-2
PARCEL NUMBER: 953101301 Section: 16 Township: 30 N Range: 01 W
CONTRACTOR: OWNER/BUILDER PHONE:
REPRESENTATIVE: PHONE:
PROJECT DESCRIPTION ROOF REPAIR - FIRE DAMAGE
TYPE OF WORK RES SQUARE FOOTAGE:
TYPE OF IMP REP MAIN:
VALUATION 2,200.00 ADD°L: HEAT TYPE: EEE
CODE EDITION: 1997 HEAT BASE: HEAT TYPE:
OCCUPANCY: R-3 UNHEATED: #OF STORIES:
OCCUPANCY: OTHER:
CONST TYPE: 5-1HR GARAGE: SHORELINE:
CONST TYPE: DECK: SETBACK:
BANK HEIGHT:
SEWAGE DISPOSAL: CON
WATER SYSTEM: PWELL PARCEL TAGS: YES NO
BEDROOMS: BATHROOMS: STORMWATER: YES NO AREA
Exist: 2 Exist: 2 Wetland Erosion
Prop: Prop: Seismic Streams
Total: 2 Total: 2 Flood Way Floodplain
Routing Date: F&W Landslide
Shoreline Aquifer
Forest: Commercial Rural(
Type Amount Paid Bv: Date: Receipt: A Pi d1�atf
Permit $83.25 MJA 07/31/03 58256 JUL 3 t 2003
Plan Check $54.11 MJA 07/31/03 58256
State Building Code $4.50 MJA 07/31/03 58256 Jefferson County Planning
Total: $141.86 & Building Department /
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soN "Jefferson Countnent of Devt
°6 621 Sheridan Street,Port Townsend WA [3ql 371-4450
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Project Description:
Building Type: Project Type: Frame Type:
,Aiir Single Family ❑ New Ai' Wood
❑ Garage Attached/Detached ❑ Addition ❑ Steel
❑ Modular ❑ Alteration/Remodel ❑ Concrete •
❑ Commercial le Repair — Ft Ps Vt1177/ C ❑ Masonry
❑ Multi-family/#of Units ❑ Demolition ❑ Other:
❑ Industrial
❑ Other:
Bathrooms: Bedrooms: Type of Sewage Disposal: Type of Heat:
Choose one:
Existing. I Z' Existing. stem
Proposed: /`/�i Proposed: 1-. � Sewer ❑ Community System � Electricity ❑ Oil
/d/j� ❑ Individual System ❑ Woodstove ❑ Propane
Total: _ Total: i71" If not sewer,fill out the following: ❑ Heat Pump
(l'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 -,
2ND Floor a--V14: Base fee e 3. �5
3rd Floor Plan Check fee-655% .59 - I /
Htd Basement ,_____- State Surcharge fee "It _5 U
Unhtd Basement = . Subtotal 14 1.
Garage/Carport %•' Pot Water Review fee
Decks 911/Rd Approach fee -1C)-'
Commercial TOTAL /1 '
Industrial Receipt# 5 Qs co
Other 5'>41rD5 '`/ Cash/Check# gi S
Total Valuation: Initials v�
Orfl 8a Date 7/3//aoa 3
Estimated Cost: 2i Zela ,
If within 200' of the Shoreline,
Distance to Bank or Ordinary High Water Mark WA; 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 e applicant's proper or structure shall be requested and shall occur during regular business hours.
Signature: ,./4, k, ili Date: 7 . 0 3
/ OVER
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