HomeMy WebLinkAboutBLD08-201CITY OF PORT TOWNSEND
PERMIT ACTIVITY LOG
PERMIT # _ a _ DATE RECEIVED �._.
SCOPE OF WORK:
. . . ........ "
Inspection Report
Project Permit#
DUI DING PERMIT
City of Port Townsend
Development Services Department
250 Madison Street, Suite 3, Port Townsend, WA 98368
(360)379-5095
Project Information
Permit Type Residential - Re -Roof
Site Address 915 M ST
Project Description
Residential ReRoof
Names Associated with this Project
Type Name Contact
Applicant Louchard Tste Dianne
Owner
Contractor
O'Neill
Louchard Tste Dianne
O'Neill
Jeff Gallant
Fee Information
Project Valuation
Record Retention Fee for Reroof (R- 7.50
3 and U occupancies)
Reroof Permit Fee (R-3 and U 40.00
occupancies)
Technology Fee for Reroof Permit 5.00
(R-3 and U occupancies)
Total Fees $ 52.50
Permit #
Project Name
Parcel #
Phone #
BLD08-201
Residential reroof
985206702
License
Type License # Exp Date
STATE GALLAJS944B 01/30/2010
Units: 0 Heat Type:
Bedrooms: 0 Construction Type
Bathrooms: 0 Occupancy Type:
Call 385-2294 by 3:00pm for next day inspection.
Permits expire 180 days from issuance if work is not commenced, or if work is suspended for a period of 180
days. Work is verified by obtaining a valid inspection.
The granting of this permit shall not be construed as approval to violate any provisions of the PTMC or other laws or regulations. I certify
that the information provided as a part of the application for this permit is true and accurate to the best of my knowledge. 1 further certify
property a:d ag n! of the Will.r.._�.. that 1 am the owner o the �wr ��tudkttaa•sr.�
Print Name � � , � �` ,� �
Date Issued:
j,
Issued By:
Signature Date Expires: es:03/08/2009lttt
Development Services
e VO'Rx toc 250 Madison Street, Suite 3
Port Townsend WA 98368
Phone:360-379-5095
Fax: 360-344-4619
www.cityofpt.us
Roofing Permit Application
office Use Onl
t Addition µon (ors Tax # Nd P
S
Project Address: Legal Descr
iption
._ � ... Block: ��, .....� . ....._.-
Parcel # `, ro �µw Lots) �Associated Permii:
0
SF Residential)d, Commercial ❑ MF Residential ❑ Bed & Breakfast*❑ _... _.-
* B&B's located in Historic District may require design review approval. .._....__._
Property Ow er I
Name: Al
Address " ..
City/St/Zip PIf...T.. dJ :.E'— e! ✓t)
Phone: ...�� .'_ 4 ..... m...- `� ..._
Email:
Contractor
Name:_—
r
Address Cit
Y p f
Phone: � C)
_:.
Email c� ��� 4
.. -
State License # n p 1 '3„vim j 0
.
City Business License # .m t ^j � . -
Is the structure located within 200 feet of a fresh or
saltwater shoreline? Y
Will work take place on or near the public right-of-
way? Y (I
If yes, provide a site plan and pedestrian protection
plan.
Lender Information:
Lender information must be provided for projects
over $5,000 in valuation per RCW 19.27.095.
Name:
ct Valuati �
Project on: 1 �
Scope of Work:
Number of existing roof layers:
Square footage of roof: 0 5o
Tear off?o N
Replacing sheathing? Y(`N�)
Replacing/altering rafters or trusses? Y
If "yes" a roof framing plan is required.
N Roof Type:
�' composition ❑ Metal
❑ Cedar shingles ❑ Cedar shakes
❑ Torchdown or Hot Mop ❑ Other
Venting type (car
❑ Roof
,P -Ridge
e End ❑
I hereby certify that the information provided is correct, that I am either the owner or a(ilh( (zed to at G ri1i't�.11 If' q nt r
and that all activities associated with this permit will be in accordance with State Laws and th,F,�q R ao e.
wcr e , uni i a o .. .
Print Nam
Signature
l�
Date: " )
9 HT to
Receipt Number RPM
MONO
cc I 4 gar , walum4wo %o111U14 rrWIVII W=aar-4 m as tern
; rioinal Fee Amount F"
" rp (t Parce(. Fee cp ipttcri `,Arw nt Paid � lell e
I=
BLD08-201
985206702
Re roof Permit Fee (R-3 and U occup;
$40.00
$40.00 $0.00
BLD08-201
985206702
Technology Fee for Reroof Permit (1
$5.00
$5.00 $0.00
BLD08-201
985206702
Record Retention Fee for Reroof (R-
$7.50
$7.50 $0.00
Total:
$52.50
fti us PAynient History
Receipt Date
FeCcrifptlon
Amount Paid
Perrralf
m ..
P ymeP °" e
heck
Payment
at o ll
umber
Amount
CASH
WA
$ 52.50
Total $52.50
genpritrreceipts Page 1 of 1