Loading...
HomeMy WebLinkAboutBLD07-007 (3) CITY OF PORT TOWNSEND OVELOPMENT SERVICES DEPARTMENO einr.,7-04,City Hall,250 Madison Street,Suite 3 yPort Townsend,WA 98368 ' X01 Phone: 360-379-5095 Fax 360-344-4619 \:% i.w, c ,13,., j„_s::,file RESIDENTIAL BUILDING PERMIT APPLICATION op` NEW CONSTRUCTION, REMODELS, & ADDITIONS Property Owner's Name(s) a,e it Ci 66 4 F i n n i e Mailing Address % PO 8ax 48 City,State,Zip f'r Phone 38 �-S L 1 2 - I Permit No. $Loo 1.y 10-7 Property Street Address y ' /3.3 /57/. -----)),9S' 41 Zoning District 1 / t ' Parcel# 9 ((fit 7)( Legal Description: Addition /I_'77y C�y�:v c-'5 Block 1 Lot(s) -7 f-$ `ff, General Contractor's Name C/• L5t9a%-»!�, Mailing Address ; Y6 44---, . Phone '3 9C--,)`.7-"?‘-/ Cell Phone 3) /-/5-37, State License Number ..A„,- y Z City Business License Number 2// Authorized Representative/Contact Person: C1 • es ti Phone: 37 cJ^ cu�cJG� Estimated Value of construction$ �/.006 Financed By ._.,;.`, � Date Work is to Begin /5-7 Date Work is to be Completed Scope of Work: Please check all items that apply for the type of building permit you are requesting: New House /Addition New Garage or Carport Repair/Remodel Garage / Repair/Remodel House Accessory Dwelling Unit Manufactured Home Other(please describe): Floor Area: the proposed structure is to be used for: 6? 63/0 d71/4-/c c ( 6X/3-7/•"r4 4 A P p)7'a NJ) Finished Heated Space sq.ft: Z 2 `T 7 0 Garage sq. ft: Unfinished Heated Space sq ft: Carport sq. ft: Unfinished Basement sq ft: Porches sq.ft: / b' ' Gi.., Semi-Finished Basement sq ft: Decks sq.ft: Storage sq.ft: Other(please describe): 1 � a'i P:1DSD\Forms\Building FormslApplication-Residential Building Permit.doc Page 1 of 2 410 40 CITY OF PORT TOWNSEND RESIDENTIAL BUILDING PERMIT APPLICATION NEW CONSTRUCTION,REMODELS,&ADDITIONS Property Site Area/Coverage Information: 1. The total area of the property in square feet: / 0` 0 p v 97 2. The total area covered by existing and proposed structures in,square feet: (total ground coverage from the outside of walls or supporting members) 2 0 Z-3 Percentage of lot coverage: (2±1) D °A. Impervious Surfaces: Please provide the square footage of the roof area of the proposed and existing structures,and the square footage of the total area covered by porches,walkways,patios and driveways. Do not include decks allowing drainage to earth below. A02_0710 Proposed Roofprmt sq.ft: 9" ( z ;AL- Existing House Roofprint sq.ft: '7 6I Proposed Garage Roofprint sq.ft , Existing Garage Roofprint sq.ft: 1 ,{-` Proposed Porch/Walkway sq.ft: 9 0 �tExisting Porch/Walkway sq.ft: Proposed Driveways sq.ft: Existing Driveways sq.ft: sD Other(describe): Other(describe): Total Proposed Impervious sq. ft: /0 Total Existing Impervious sq. ft: / 7 6 8" Total Proposed+Existing sq. ft: O / `f 40 Percentage Impervious: * c� (Impervious surface-lot sq. ft) G *If total impervious surface is equal to or greater than 40%of the lot area,you must submit a written stormwater plan to address run off. Please check which plans you are submitting with this application (2 sets needed): Site Plan 0JC. Interior&Exterior Wall Bracing(panel locations shown on floor plan) Drainage Plan(if 40%or more impervious) Typical Wall Framing Details(section from foundation V4 "`' through roof) s- Foundation Plan -' Elevations Floor Plan 2003 WSEC*Compliance: Prescriptive_ Component r Floor Framing Plan WSEC Construction Checklist(Washington State Energy Code) Roof Framing Plan Other: Installing Manufactured Home_Yes No Year: Make: Was the manufactured home originally constructed within three(3)years of proposed placement? Yes No 2) Manufactured home must be placed on a permanent foundation with the space from the bottom of the home to the ground enclosed by either load bearing concrete or decorative concrete or masonry blocks so that no more than one foot of the perimeter foundation is visible above grade;and 3) Roof must be composed of composition,wood shake or shingle,coated metal,or a similar roof material;and 4) Title to the manufactured home must be eliminated as a condition of building permit approval. P:\DSD\Forms\Building Forms\Application-Residential Building Permit.doc Page 2 of 2 • CITY OF PORTWNSEND RESIDENTIAL I B I ULD NG PERMIT APPLICATION NEW CONSTRUCTION,REMODELS,&ADDITIONS Special Conditions Please check YES or NO as applicable YES NO 1. Is the property within 200 feet of a fresh or saltwater shoreline? 2. Is the property within the Port Townsend Historical District? 3. Is the property located within or adjacent to an environmentally sensitive area? 4. Will this proposal involve any sewer,water or other utility extensions that will,or could serve vacant properties other than the project site?If yes,please attach information identifying the utility extensions and sites. 5. Have any special conditions been placed on this property,or has the property been subject to any conditions on any prior action of the City(if"Yes"to any of the following,attach copies of appropriate documents): Subdivision/Short Plat/Boundary Line Adjustment? SEPA(environmental review)? Variance? Conditional Use Permit? i- Street Vacation? Planned Unit Development? �J Restrictive Covenant? Easement? 6. Are any properties within 800 feet of the site owned or controlled by the applicant,any relative or business associate,or any partnership,corporation,or other entity affiliated with the applicant? (If attach list.) 7. Have any of the properties listed in item#6 been developed within the last two years?(If yes,attach list.) ✓ 8. Have you previously discussed this project with a City staff member? If yes,who and when? Applicant Certification The applicant hereby certifies to have knowledge of those sections of the International Residential Code and the Port Townsend Municipal Code pertinent to the above project and that the applicant is responsible for constructing in conformance with these codes;the applicant understands that the permit,if issued,expires in six months unless work is started;that the permit,after construction has started,will expire after one year if an inspection is not made to show significant progress on the tructure;the applicant agrees to abide by the ordinances,codes,regulations,restrictive covenants,deed or plat restrictions,and water and sewer plans attached hereto;the applicant certifies that all information given above and on accompanying plans i complete and accurate to the best of their knowledge; and the applicant understands that this information will be relied upon in granting permits and that if such information is later found to be inaccurate any permits may be withdrawn. P:\DSD\Forms\Building Forms\Application-Residential Building Permit.doc Page 3 of 3 • • CITY OF PORT TOWNSEND RESIDENTIAL BUILDING PERMIT APPLICATION NEW CONSTRUCTION,REMODELS,&ADDITIONS The undersigned hereby saves and holds the City of Port Townsend harmless from any and all causes of action,judgments, claims,or demands,or from any liability of any nature arising from any noncompliance with any restrictive covenants,plat restrictions,deed restrictions,or other restrictions which may have been established by parties other than the City of Port Townsend. Complete Application Port Townsend Municipal Code,Section 16.04.140,Vested Rights-Substantially Complete Building Permit Application: applications for all land use and development permits required under ordinances of the city shall be considered under the zoning and other land use control ordinances in effect on the date a fully complete building permit application,meeting the requirements&entified in this section,is filed with the Development Services Department. Until a complete building permit application is filed,all applications for land use and development permits shall be reviewed subject to any zoning or other land use control odinances which become effective prior to the date of issuance of a final decision by the city on the application. An application for a building permit shall be considered complete when an application meeting all of the requirements of Section R105.3 of the International Residential Code,2003 Edition,is submitted which is consistent with all then applicable ordinances and laws. In addition,to be considered complete,such an application must be accompanied by complete applications for a subsidiary land use or development permits needed,such as a complete shoreline management permit application and/or complete applications for other discretionary permits required under the ordinances of Port Townsend. An application for a partial permit under Section R105.3.1 of the International Residential Code,2003 Edition,shall not be considered complete unless it meets all requirements stated above and contains plans for the complete structural frame of the building and the architectural plans for the structure. Signature of Applicant or Authorized Representative Date For Official Use Only Pe t No. Building Official Approval • Date Issued Balance Due$ Date Validation Stamp below: Owner/Representative Signature Date P:\DSD\Forms\Building Forms\Application-Residential Building Permit.doc Page 4 of 4 t • I Residential Building Plans Checklist o�QORr roil, City of Port Townsend ��04) �� Development Services Department ciz250 Madison Street, Suite 3 �� Port Townsend,WA 98368 43,4 zsty. (360)379-5095 Fax: (360)344-4619 Name F/A i !C Permit# This checklist is for new dwellings,additions,remodels and garages. The purpose is to show what you intend to build,where it will be located on your lot, and how it will be constructed. In addition to this form,please submit: • Residential Building Permit Application form • Sensitive Areas Questionnaire 10),2001 Washington State Energy Code forms. Use either prescriptive forms, or component performance forms with calculations. , Washington State Energy Code Construction Checklist • Two sets of plans. 18"x 24"plan sheet size is preferred. Plans must be to scale. t/4"= 1 ft. is preferred. • If an architect has signed your plans,one set must have an original signature and wet stamp on each page. • For structures that require engineering(including pole structures, sunrooms, dormers of a certain size, Gjv "irregularly shaped"structures)provide two copies of calculations from a Washington Licensed Architect or engineer. One set must have an original signature and wet stamp. For New Residential Dwelling Construction also submit: • Street/Utility Development Permit application, or Minor Improvement Permit application if water and sewer are already stubbed to the property. For any utility extensions, provide engineered plans. • Two additional copies of the site plan for Public Works (three sets if a septic system is proposed). Please also include one reduced 8-1/2' x 11"size site plan. NOTE: Electrical Permits are required by the State of Washington Department of Labor&Industries (L&I). Contact L&I at(360) 417-2700 for more information. P:\DSD\Department Forms\Building Forms\Application-Residential Building Permit Plans Checklist.rtf Page 1 of 4 Rev. 1/25/06 • 4 List the pggg number in the left column for each item that you have included on your plans. • PAGE# SITE/PLOT PLAN 5 Legal description,parcel number,name, address and telephone number of property owner/applicant, including cellular phone if available. S Property lines and dimensions,including all interior lot lines. S All building lines and exterior dimensions(including all dwelling and accessory structures). 5 Setbacks from property lines and buildings including structures on neighboring lots. (Indicate roof overhang. Overhang may extend into setback area a maximum of two feet.) Driveways,walkways,patios, decks and porches. S On-site parking(Two 9'x 19' spaces required for new residential construction. These spaces may be provided in a garage.) NI A Trees: Diameter, species name, location and canopy of existing significant trees in relation to proposed and existing structures,utility lines, and construction limit line. "Significant trees"are those with a minimum diameter of 12 inches measured at 4-1/2 feet above average grade. Identify all significant trees to be removed by placing an"x"on them, and circle those trees that will remain. Significant trees removed in relation to and necessary for the construction of buildings,parking and driveways in connection with the issuance of a building permit are exempt. Exempt activity requires a written exemption issued by the Director of Building and Community Development. Street names, road easements and easements of record. Existing and proposed utilities, service lines and pipe size. N / Slope of land(grade and direction). N A If there is 40%or more impervious surfaces on the lot, submit an impervious drainage system, indicating square footages on drainage site plan and method of detention. Waterfront property: indicate bank height,setback between building and top of bank or bluff, all 1' creeks,drainage corridors, etc. For new exterior construction, include all structures on either side within 300 feet, and their setbacks. p, Existing and/or proposed septic system, if applicable. Please provide an extra set of plans for the County Health Department. PAGE# FOUNDATION PLAN ?j Footings,piers, and foundation walls (including interior footing or pier locations). Post and beam sizes and spans; detail beam/post and post/pier(or footing)positive connection. Beam pockets or method of securing beam ends. Floor joist size,material grade, layout and spans. Foundation venting and calculations(1 square foot of vent/150 square feet of crawl space). Crawl space access& dimensions. le Plumbing sizes and locations of foundation penetration. Vapor retarder on crawlspace ground(6 mil black polyethylene). P:\DSD\Department Forms\Building Forms\Application-Residential Building Permit Plans Checklist.rtf Page 2 of 4 Rev.1/25/06 r- • • PAGE# FLOOR PLAN 2 Room use, size and square footage by floor level. All room dimensions. 1..;t Braced wall panel locations per UBC Section 2320.11.3 and Table 23-IV-C-1 (if multi-story include length per story per Table 23-IV-C-1). 2 Smoke detector locations. '41 Stairways: width,rise, run,handrails, guardrails,landings,etc. Window, skylight and door locations and sizes,with egress and safety glazing, if applicable. (Include brand/model and U factor on energy application.) `._ Rafter and ceiling joist size,material grade, layout and spans. Roof framing plan required if rafters, optional if trusses. 2 Attic access location and dimensions. Plumbing fixtures. Hot water tanks, furnaces, fireplaces, solid fuel appliances and combustion air ducts. Location of whole house ventilation fan,controls and timer. Location and cfm of all other exhaust fans(i.e. bathroom, kitchen and laundry). Type of exhaust duct material,duct path and exterior termination point of appliance vents and environmental exhaust ducts. VI AC Type and location of all WSEC outside fresh air inlets. ` ^//NJD>S -4/5 Fire blocking. 164 1-hr. construction between dwelling & garage on garage side(UBC Sec. 302.4, exception#3). PAGE# WALL SECTION IA- Footing size,reinforcement(include vertical rebar) depth below natural and final grade. 1 ( Foundation wall,height,width and reinforcement(rebar),hold-downs if applicable. --- Anchor bolts,washers(2 x 2 x 3/16 square, steel) and pressure treated plates. 1.1 1 Thickness of floor slab. Floor joist size and spacing,under floor clearance from crawl space grade for joists and beams. Floor sheathing,type and size. ": Wall stud size, grade and spacing. Framing to be used: standard, intermediate or advanced. } ' Header, size, grade, spans and insulation(if applicable). • A Wall sheathing and siding and material. Type& location of weather-resistive barrier(UBC Section 1402). Type and location of vapor retarder(WSEC 502.1.6). Sheetrock: thickness,type and location. -- c Insulation material and R-value in walls above and below grade, floor, ceiling and slab. Rafters, ceiling joists,trusses, with blocking and positive connection of roof system to wall. Ceiling height. Roof sheathing,roofing material,roof pitch, attic ventilation(provide calculations). P:\DSD\Department Forms\Building Forms\Application-Residential Building Permit Plans Checklist.rtf Page 3 of 4 Rev. 1/25/06 .• • PAGE# EXTERIOR ELEVATIONS Exterior views on front,rear and sides; show all windows and doors. 1. Decks, steps,handrails,guardrails,landings. 14A- Height of building per UBC Section 209. CX/ IIA, Chimneys: show required height above roof per UBC Section 3102.3.6. f5`?: Final grade. 9J A Retaining walls, if applicable. P:\DSD\Department Forms\Building FormslApplication-Residential Building Permit Plans Checklist.rtf Page 4 of 4 Rev.1/25/06 • WSEC Residential Construction Checklist cony Tom City of Port Townsend y� Development Services Department 250 Madison Street,Suite 3 file (360) Townsend,WA 98368 3. (360)379-5095 Fax: (360)344-4619 Washington State Energy Code (WSEC) 2001 Residential Construction Checklist Complete this form in addition to WSEC forms. Please answer the following questions: TyPE OF PROJECT: New construction, or addition over 750 square feet Must meet whole house and spot ventilation requirements, and show full WSEC compliance as a stand-alone project. A detached, habitable structure such as an Accessory Dwelling Unit regardless of size must also meet these requirements. ❑ House addition under 750 square feet Possible trade-offs are allowed with the existing building for WSEC compliance, such as increasing ceiling insulation. See WSEC component performance forms. NOTE: A house addition less than 500 sq.ft. does not require whole house ventilation. Spot ventilation is still required. TYPE OF HEATING—Please check all that apply: Electric ❑ Wall Heater ❑ Baseboard ❑ Forced Air Furnace ❑ Radiant Floor(Boiler) ❑ Other Non-Electric: Propane::.:Radiant Floor/Baseboard(Boiler) ❑ LPG Stove ❑ LPG Furnace ❑ Other LPG. ❑ Heat Pump ❑ Oil Furnace ❑ Woodstove(can only be used as secondary heat source) VAPOR RETARDERS: Vapor retarders shall be installed toward the warm surface as represented below. Select one option for floors, walls, and appropriate ceilings: • Floors: .'Plywood with exterior glue ❑ Poly plastic (greater than or equal to 4 millimeter thick) ❑ Backed batts • Walls: ❑ Poly plastic (greater than or equal to 4 millimeter thick) ❑ Face-stapled, backed batts f Low-perm paint • Ceilings: ❑ Not required where ventilation space averages greater than or equal to 12 inches above insulation ❑ Face-stapled, backed batts ❑ Poly plastic(greater than or equal to 4 millimeter thick) ' Low-perm paint SEE BACK P:\DSD\Department Fonns\Building Forms\Application-Residential Energy Code Checklia,doc Page 1 of 1 111) WASHINGTON STATE VENTILATION AND INDOOR AIR QUALITY(2000 Code): Type of ventilation used throughout the house: ❑ HVAC Integrated Option ❑ Exhaust Option Whole House Fan for"Exhaust Option": • In what room is your whole house fan located? /it • What size is the whole house exhaust fan? ❑ 50-75 CFM(1-2 bedroom house) X80-120 CFM(3 bedroom house) ❑ 100-150 CFM(4 bedroom house) ❑ 120-180 CFM(5 bedroom house) Note: the whole house fan shall be readily accessible and controlled by a 24-hour clock timer with the capability of continuous operation, manual and automatic control. At the time of final inspection, the automatic control timer shall be set to operate the whole house fan for at least 8 hours a day, and have a sone rating at 1.5 or less measured at 0.10 inches water gauge. Spot Ventilation: Source specific exhaust ventilation is required in each kitchen,bathroom, water closet, laundry room, indoor swimming pool, spa and other rooms where excess water vapor or cooking odor is produced. Bathrooms, laundries or similar rooms require fans with a minimum 50 cfm rating at 0.25 inches water gauge; kitchens shall have a fan with a minimum 100 cfm rating at 0.25 inches water gauge. Outdoor Air Inlets: Outdoor air shall be distributed to each habitable room by means such as individual inlets, separate duct systems, or a forced-air system. Habitable rooms include all bedrooms, living and dining rooms but not kitchens, bathrooms or utility rooms. Where outdoor air supplies are separated from exhaust points by doors, undercutting doors a minimum of%2 inch above the surface of the finish floor covering, distribution ducts, installation or grilles, transoms or similar means where permitted by the Uniform Building Code. When the system provides ventilation through a dedicated opening, such as a window or through-wall vent,these openings must: • Have controlled and secure openings • Be sleeved or otherwise designed so as not to compromise the thermal properties of the wall or window in which they are placed. • Provide not less than 4 square inches of net free area of opening for each habitable space. What type of fresh air inlet will be installed? (See figure below) AI/Window Ports ❑ Wall Ports P:\DSD\Department Focros\Building Forms\Application-Residential Energy Code Checkli3.doc Page 2 of 2 • • Prescriptive Approach—Simple Form For the Washington State Energy Code(2001 Edition) Climate Zone 1 Site Information Building Department Use Only Lot Permit#: Address: Notes: City: State: Zip: Contact: Phone: Phone 2 Fax: Table 6-1 PRESCRIPTIVE REQUIREMENTS°':FOR GROUP R OCCUPANCY CLIMATE ZONE 1 (Unlimited Glazing Option Only) Glazing Glazing UFactor Doo? Wall Wall Wall Slab4 Option Area10 U- Ceiling2 Vaulted Above Into Ead° Floors On %of Floor Vertical Overhead'r factor Ceiling3 Grade Below Below Grade Grade Grade ' Unlimited /-Th Group R-3 0.40 R-38 0.58 0. R 30 R-21 R 21 R-10 R 30 R-10 Occupancy C� Only See the code text for footnote references Thisj roect complies with the following: : P P ✓ The project is a single family residence or duplex. ✓ The project is wood frame OR all of the insulation is interior or exterior of the framing. ✓ All building components meet the requirements listed in Table 6-1,Option Ill. ✓ The project will meet all other provisions of the WSEC and VIAQ. The prct will take advantage of the following exceptions to the prescriptive option: U 602.6 Exception 1.One door,that is 24 ft.2 or less,that does not meet the standards is allowed. Location of the door taking this exception ✓ 602.6 Exception 2. Doors with a LI-factor of 0.40 allowed without calculations, Option Ill only. Location of the door(s)taking this exception Copyright 200Z WSUCEEP02 056 Copied by permission from the Washington State University Cooperative Extension Energy Program Prescriptive—Simple Form—Cimate Zone 1 531/2002 • • 2001 EDITION TABLE 6-1 PRESCRIPTIVE REQUIREMENTS" FORAROUP R OCCUPANCY CLIMATE ZONE�J Glazing Giazint, U-Factor 9 wall Wall. WaltSlab° Option Area Door Ceiling2 Vaulted AboveS int ext on %of Floor Vertical Overhead" U-Factor Ceiling Grade Below Below FIGrade Grade Grade L 12% 0.35 0.58 0.20 R-38 R-30 (R15 R-15 R-10 R-30 R-10 II.* 15% 0.40 0.58 0.20 R-38 R-301 R-21 R-10 R-30 R-10 III. Unlimited 0.40 0.58 0.20 R-38 R-30 R-21 R-21 R-10 R-30 R-10 Group R-3 Occupancy. Only * Reference Case 0. Nominal R-values are for wood frame assemblies only or assemblies built in accordance with Section 601.1. 1. Minimum requirements for each option listed. For example,if a proposed design has a glazing ratio to the conditioned floor area of 13%,it shall comply with all of the requirements of the 15%glazing option(or higher). Proposed designs which cannot meet the specific requirements of a listed option above may calculate compliance by Chapters 4 or 5 of this Code. 2. Requirement applies to all ceilings except single rafter or joist vaulted ceilings. 'Adv'denotes Advanced Framed Ceiling. 3. Requirement applicable only to single rafter or joist vaulted ceilings. 4. Below grade walls shall be insulated either on the exterior to a minimum level of R-10,or on the interior to the same level as walls above grade. Exterior insulation installed on below grade walls shall be a water resistant material,manufactured for its intended use,and installed according to the manufacturer's specifications. See Section 602.2. 5. Floors over crawl spaces or exposed to ambient air conditions. 6. Required slab perimeter insulation shall be a water resistant material,manufactured for its intended use,and installed according to manufacturer's specifications. See Section 602.4. 7. Int denotes standard framing 16 inches on center with headers insulated with a minimum of R-5 insulation. 8. This wall insulation requirement denotes R-19 wall cavity insulation plus R-5 foam sheathing. 9. Doors,including all fire doors,shall be assigned default U-factors from Table 10-6C. 10. Where a maximum glazing area is listed,the total glazing area(combined vertical plus overhead)as a percent of gross conditioned floor area shall be less than or equal to that value. Overhead glazing with U-factor of U41.40 or less is not included in glazing area limitations. 11. Overhead glazing shall have U-factors determined in accordance with NFRC 100 or as specified in Section 502.1.5. 12. Log and solid timber walls with a minimum average thickness of 3.5"are exempt from this insulation requirement. Effective 7/01102 33 • RESIDENTIAL CHECKLIST For 1-2Residences) Family NAME OF APPLICANT: Date Received with all necessary paperwork: By: BUILDING REVIEW BUILDING PERMIT# / Zoning= Impervious Surface%_ V Lot Coverage= OK w/zoning? Septic? If yes, contact County Env. Health NIn a PUD? Yes/No .-- Parking—need dimensions on site plan ✓ Site Plan, all setbacks shown Address needed? iv' Completed Plans Checklist _FAADU?Prepare Notice to Title V Energy Code Checklist& Compliance Form ✓ If architect/engineer, plans wet stamp/signed 2 Sets of Plans Submitted? 1,1 Garage? Attached Detached / Type of Heat ane- If a new detached garage or ADU, give copy �/ of site plan to Francesca / Floor Plan: Number of bedrooms ,Z ‘z Typical framing details/section ✓ Number of bathrooms Z _ Foundation plan; if calcs, holddown symbol ✓ Floor framing plan; if calcs, shear wall & verbiage must be shown on plans symbol&verbiage must be shown on plans Floor framing plan try iv Roof framing section plan PLANNING REVIEW (if applicable) LAND USE PERMIT# ROUTED TO: DATE: Critical Area Map checked. If in CA, what is it mapped? Slope: Within 200 ft of Shoreline Ordinary High In Flood Plain? Fill out FEMA forms if yes Water Mark? Lots of Record review(all 3 must be true): 9 or fewer lot(s), plat created pre-1937, AND development requires water, sewer, or street to be extended; OR if a block is owned with one SFR& wants to build another residence. CHECK for prior Public Works permit if it was already issued! PUBLIC WORKS REVIEW MIP# ($53 due) or SDP# ($330 due) ROUTED TO: DATE: Submittal Checklist attached 8-1/2 x 11 Site Plan reviewed for all items All trees in ROW identified Septic? Need County OK FIRST Pre-app Conference? Date held: PRE#: Impervious Checked Any work in ROW beyond a driveway apron needs Engineered Plans. DO NOT ACCEPT PERMIT WITHOUT THEM! Water, sewer, and/or streets being extended? Need 4 sets of engineered plans. Any existing or proposed easements for shared utilities or driveway w/adjacent property owners? We must have the licensed contractor's name and information for ANY right-of-way work. P:\DSD\Forms\Building Forms\Checklist-Residential Building Plans-Front Counter Sep 06.doc Revised 9/27/06 • • BUILDING PERMIT FEES CHECKLIST i3 Loo"--7- DO-7 Fees Based on Fair Market Valuation or Submitted Amount Valuation = , is j S 3 . 23 4 ► FEES DUE AT SUBMITTAL d 7c i o Plan Review Fee (2010) MIPSSO (2164) .# {00 MIP Record Retention Fee$'3.(9992)di SDP Fees: Street$62.50 (2164) Water$62.50 (1201) Sewer$62.50 (1361) Storm$62.50 (1401) SDP Record Retention Fee$10 (9992) PW Inspection Fee $70 (2140) Other Other 67 q )d TOTAL DUE AT SUBMITTAL FEES DUE AT PERMIT ISSUANCE Building Permit Fee (2000) Propane Tank/Piping Inspection$47 (2000) State Building Code Surcharge$4.50 (2005) Plus $2/unit for multi-family House Number$3 (2200) $3 per unit if multi-family Hamilton Heights Recreation Fee$200 (5030) Hamilton Heights Transportation Fee$156 (2167) Lynnesfield Off-site Transportation Fee$231 (2168) Record Retention Fee$3 to $10 (9992) Other Other TOTAL DUE AT PERMIT ISSUE % ImpeMous ] Jotified Permit is Ready to be picked up (Who/Date/Initials): calculation to Finance sent (Date): 2/6/LI k)i K— P:\DSD\Forms\Building For s\Checklist-Residential Building Plans-Front Counter Sep 06.doc Revised 9/27/06