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HomeMy WebLinkAboutBLD2003-00561 110 BUILDING PERMIT 4111 Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD03-00561 Received Date 09/8/2003 SITE ADDRESS: 1473 THORNDYKE RD Issue Date 09/15/2003 PORT LUDLOW, 98365 APPLICANT: LAYMONE K JEUNE PHONE: (360)437-3791 AGNES N JEVNE 1473 THORNDYKE RD PORT LUDLOW WA 98365-822 SUBDIVISION: TRAILS END HOMESITES Block: 3 Lot: 23&24 PARCEL NUMBER: 950100323 Section: 16 Township: 27 N Range: 01 E CONTRACTOR: OWNER/BUILDER PHONE: LOAN LENDER/ BOND HOLDER: PROJECT DESCRIPTION: DORMER ADDITION REQUIRED INSPECTIONS: [ ] SETBACKS: [ ] UFFER: [ ] Footing: [ ] Foundation: [ ] Underground Plumbing: [ ] Underground Insulation: [ ] Shear Wall : [ ] Framing: I yk' /24,,A3 C�� 11 Plumbing: [ ] Propane Tank/ Lines: [ ] Insulation: 11 Sheetrock: [ ] Septic Sytem Final Approval: 1 Zoning Final Approval: s°[ ] Final/Occupancy Approval: a// IN /a /D z/�D3 • HEALTH DEPARTMENT APPROVAL f�EQUIR' 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 iltSEP94-00019 ILDING PERMIT APPLTI Review Ty pe: Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT#: BLD03-00561 Received Date: 9/8/2003 SITE ADDRESS: 1473 THORN DYKE RD PORT LUDLOW, 98365 OWNER: LAYMONE K JEVNE PHONE: (360)437-3791 AGNES N JEVNE 1473 THORNDYKE RD PORT LUDLOW WA 98365-822 SUBDIVISION: TRAILS END HOMESITES Block: 3 Lot: 23&24 PARCEL NUMBER: 950100323 Section: 16 Township: 27 N Range: 01 E CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTION DORMER ADDITION TYPE OF WORK RES SQUARE FOOTAGE: TYPE OF IMP ALT MAIN: VALUATION 7,550.00 ADD'L: HEAT TYPE: PRO CODE EDITION: 1997 HEAT BASE: HEAT TYPE: EEE OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: BRIDGEHVN 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 91(e.1.03 Shoreline Aquifer Forest: Commercial Rural Type Amount Paid By: Date: Receipt: J\ / a v r Permit $153.25 MJA 09/08/03 58481 Plan Check $99.61 MJA 09/08/03 58481 SEP 1 5 2003 State Building Code $4.50 MJA 09/08/03 58481 Jefferson County Plannin, Total: $257.36 & Building Department eAsaus2,r, Sr,,04. O • • JeffersonâtY1rtment of Community Development ..1" Q 1 621 Sherklan Street,Port Townsend WA 88368[360]378-4450 ` '\- ' 4 ' ; ©rmat A cp?o ITING 1 F.) P- d Ca a 0 n 04 Project Description: Building Type: Project Type: Frame Type: X Single Family CO i,. c ❑ New )(Wood ❑ Garage Aied/Detached o ❑ Addition ❑ Steel ❑ Modular a X Alteration/Remodel ❑ Concrete • ❑ Commercials =_ o ❑ Repair ❑ Masonry ❑ Multi-family/#of Units ❑ Demolition ❑ Other: ❑ Industrial ❑ Other: Bathrooms: Bedrooms: Type of Sewage Disposal: Type of Heat: ll Choose one: Existing: Existing: '-�C ❑ Sewer ❑ Community System Electricity ❑ Oil Proposed: Proposed: j 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: .-v '; _-,ry-.--- Square Footage: For Office Use Only Main Floor Consistency Review 2ND Floor Base fee /S3. Z S 3rd Floor Plan Check fee—65% ! / • I/p Htd Basement State Surcharge fee 9 _S o Unhtd Basement Subtotal a s��',3 Garage/Carport Pot Water Review fee TJyy Decks 911/Rd Approach fee --el Commercial TOTAL . 25•17• 36 Industrial Receipt# 5 P LJ '' f Other Cash/Check# ) . .,`I Total Valuation: Initials 4' (Or � ' Date 9 J c+�' )Z�3 ( Estimated Cost: I ii oreline 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 thp/a t lY ' property or structure shall be requested and shall occur during regular business hours. moo' Signature: Date: L .%A , l ) L'e, } OVER 0. H:HOME\PLNCNTR\INFOBLDG\FORMS\BLDpermitApplication 11-8-01 AI lt ) . , , ! ,. , i : ; , .• .„. ik . • . , , • . , , . . . . . . .. . .. . 1 . ..-• , . : . ; . . , , . . . , - . .,_ , ; ;• , .. . • , ; .-r• . • . I . • . a. . .. I i ! 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