HomeMy WebLinkAboutBLD07-111),)
BTJILDING PERMIT
City of Port Townsend
Development Services Department
250 Madison Street, Suite 3, Port Townsend, WA 98368
(360)379-s09s
Project Informution
Permit Type Residential - Single Family - New
Site Address 2404 HENDRICKS STREET
Project Description
New small house to be future ADU
Permit #
Project Name
Parcel #
BLD07-Ill
NEW SFR
96 I 200305
Fee Information Project Details
Dwellings - Type V Wood Frame 768 SQFT
Project Valuation
Site Address Fee
Building Permit Fee
Energy Code Fee - New Single
Family Unit
Mechanical Permit Fee per Dwelling
Unit - New Residential
Plan Review Fee
Plumbing Permit Fee per Dwelling
Unit - New Residential
State Building Code Council Fee
Technology Fee for Building Permit
Record Retention Fee for Building
Permit
$73.090.56
3.00
81 1 .7s
100.00
150.00
527.64
150.00
4.50
16.24
10.00
Total Fees $1,773.13
Conditions
10. Property corner pins must be located at time of foundation inspection to verify setbacks
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 certifo
that the information provided as a part of the application for this permit is true and accurate to the best of my knowledge. I further certify
that I am the owner of the property or authorized agent of the owner.
Date Issued: 07/18/2007
IssuedBy: PWESTERIIELD
Print Name
BUILDING PERMIT
City of Port Townsend
Development Services Department
250 Madison Street, Suite 3, Port Townsend, WA 98368
(360)379-s09s
Project Information
Permit Type Residential - Single Family - New
Site Address 2404 HENDRICKS STREET
Project Description
New small house to be future ADU
Permit #
Project Name
Parcel #
BLD07-Ill
NEW SFR
961200305
Names Associated with this Project
Type Name
Applicant Pellecchia Aran
Owner Pellecchia Aran
Contractor Mcfadin & Davis
Contractor Mcfadin & Davis
Contact Phone #
License
Type License # Exp Date
Zeke Mcfadin
Zeke Mcfadin
(360) 381-51 16
(360) 38r-51 r6
CITY
STATE
5241 12/3U2007
MCFADDI9 691 01 / 0t t2008
X'C* SEE ATTACHED CONDITIONS ***
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 pemrit shall not be construed as approval to violate any provisions of the PTMC or other laws or regulations. I certifi
that the information provided as a the application for this permit is true and accurate to the best of my knowledge. I further certify
that I am the owner of
Datelssued: 07/18/2007
IssuedBy: PWESTER_FIELD
Print Name
aggpt of the owner
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CITY OF PORT TOWNSEND
PERNITT ACTIVITY LOG
PERMIT #
SCOPE OF WORK:
DATE RECEIVED ln-/n -b1
DATE ACTION INITIALS6- b- fl-r ENTERED TNTO CHET v\Attt-
CA - to Planning - No evidence /
CHECKED FOR COMPLETENESS
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frmViewlnspection
Purchase a Permit
Permit
Permit Number
Applied
Total Corrections
Applicant
Permit Holder
Name
Address
City
Special Instructions
15153298 Status
101112007 Fee Due
3
Inspection Site
CRAIGHEAD :LECTRIC INC Company Name
Owner Name
PO BOX:55 Address
CHIMACUM City
Page 1 of2
Active
$0.00
Pellechia,:aron
2404 Hendricks
Port Townsend:/SPAN>
i
'l Return to Main =enu Submit Query
Requests
on
Inspections
=TD>
Comme
Details
=TD>
Comm
Created Requested Reason Status
10/15/2007 10/16/2007 Request Taken
10t3/2007 10/4/2007 Request Taken
10/ 1/2007 10/2t2007 Request Taken
lnspected lnspector lCorrections Written Corrections Compteted
10/16/2007 ANDERSON, MICHAEL IO 0
10/4/2007 ANDERSON, MICHAEL IO 3
10/2/2007 ANDERSON, MICHAEL II 0
lnspected Inspection Resutt
10/16/2007 Service, New, U nderqround, 240V, 1 01 -2004 AC - Approved Complete
10/4/2007 Cover,Circuit,Watls ft Ceitine AC - Approved Complete
10/2/2007 Cover,Circuit,Watls & Ceitine AP - Approved Partial
mhtml:https://mail.olympus.net/cgi-bin/sqwebmail/login/aranYo4}olympus.net/831269D88... 21112008
CITY OF PORT TOWNSEND
DEVELOPMENT SERVICES DEPARTMENT
INSPECTION REPORT
For inspections, call the Inspection Line at 360-385-2294 by 3:00 PM the day before you want
the inspection. For Monday inspectionso call by 3:00 PM Friday.
o>*L( tDATE OF INSPECTION:
SITE ADDRESS:
PERMIT NUMBER:
f*s*A.u-iqlq->210.-t
PROJECT NAME:
CONTACT PERSON:
TYPE OF INSPBCTION:
CONTRACTOR:
PHONE:
\- *^r-E-
o
*.-9
! APPROVED
ch
Inspector
Approved plans and permit card must be
S4nnnovED wrrH
iCORRECTIONS
ok proceed. Corrections will be
! NOTAPPROVED
Call for re-inspection before
inspection
tDate
be assessed if work is not ready for inspection.
available ot time of inspection. A re-inspection fee may
CITY OF PORT TOWNSEND
DEVELOPMENT SERVICES DEPARTMENT
INSPECTION REPORT
For inspections, call the Inspection Line at 360-385-2294 by 3:00 PM the day before you want
the inspection. For Monday inspections, call by 3:00 PM Friday.
DATE OF INSPECTION: ID - 23 - O7 PBRMIT NUMBER: T3tN N1 . I T I
SITB ADDRESS:
PROJECT NAME:CONTRACTOR:.)AoFa"lin
CONTACT PERSON:Ar r n PH'NE:
TYPE OF INSPECTION:
-['*'(d lQ.{i,"C-(l)
d,&\/4.L/
l-{L
lq(.,
N APPROVED N APPROVED WITH-@--
Ok to proceed. Corrections
! NOTAPPROVED
at next inspection
Call for re-inspection before
proceeding.
ffi
Inspector 't Date
Approved plans and permit card must be on-site and avoilable at time of inspection. A re-inspection fee may
be assessed if work is not ready for inspection.
CITY OF PORT TOWNSEND
DEVELOPMENT SERVICES DEPARTMENT
INSPECTION REPORT
For inspections, call the Inspection Line at 360-385-2294 by 3:00 PM the day before you want
the inspection. For Monday inspections, call by 3:00 PM Friday.
10 PBRMIT NUMBER:DATE OF INSPECTION:
SITE ADDRESS:2404
PRoJECT NAME: Pe I [e ch rO
CONTACT PERSON:
f r"{k[ror t .fV'-r,'is
PHoNE: 3A l- 5llt"
CONTRACTOR:
TYPE OF INSPECTION:
N APPROVED ! NOTAPPROVED
ln
be Call for re-inspection before
proceeding.
Inspector Date
Approved plans and permit card must be on-site and available at time of inspection. A re-inspection fee may
be assessed if work is not ready for inspection.
! APPROVED WITH
CORRECTIONS
Ok to proceed. Corrections
CITY OF PORT TOWNSEND
DEVELOPMENT SERVICES DEPARTMENT
INSPECTION REPORT
For inspections, call the Inspection Line at 360-385-2294 by 3:00 PM the day before you want
the inspection. For Monday inspectionso call by 3:00 PM Friday.
lA- 2-oaDATE OF INSPECTION:
SITE ADDRESS:
PROJECT NAME:
CONTACT PERSON:
TYPE OF INSPECTION:
NUMBER:r
CONTRACTOR: fu1 N
PHONE:.38 l-5ttb
tr
)
N APPROVED WITH
CORRECTIONS
Ok to proceed. Corrections will
checked at next inspection
! APPROVED ! NOTAPPROVED
Call for re-inspection before
proceeding.
Inspector Date
Approved plans and permit cord must be on-site and ovailoble at time of inspection. A re-inspection fee may
be assessed if work is not readyfor inspection.
CITY OF PORT TOWNSEI{D
DEVELOPMENT SERVICES DEPARTMENT
INSPECTION REPORT
For inspections, call the Inspection Line at 360-385-2294 by 3:00 PM the day before you want
the inspection. For Monday inspections, call by 3:00 PM Friday.
-ntDATE OF INSPECTION:q -12 -ot PERMIT NUMBER:BLOOT
SITE ADDRESS:
PROJECT NAMB:CONTRACTOR:
CONTACT PERSON:PHONE:
TYPE OF INSPECTION:
i
! APPROVED I ] APPROVED WITH
CORRECTIONS
Ok to proceed. Corrections will be
checked at next inspection
! NOTAPPROVED
Call for re-inspection before
Inspector Date
Approved plans and permit card must be on-site and available at time of inspection. A re-inspection fee may
be assessed if work is not ready for inspection.
CITY OF PORT TOWNSEND
DEVELOPMENT SERVICES DEPARTMENT
INSPECTION REPORT
For inspections, call the Inspection Line at 360-385-2294 by 3:00 PM the day before you want
the inspection. For Monday inspections, call by 3:00 PM Friday.
NUMBBR: B L.I^T O IilDATE OF'INSPECTION:
SITE ADDRESS:
PROJECT NAME:
CONTACT PERSON:
TYPE OF INSPECTION:
CONTRACTOR:
Arn /\ PHoNE:
0
0 UV.L
N APPROVED
Inspector Date z0
Approved plans and permit card must be on-site and available at time of inspection. A re-inspection fee may
be assessed if work is not ready for inspection.
! APPROVED WITH
CORRECTIONS
Ok to proceed. Corrections will be
checked at next inspection
N NOTAPPROVED
Call for re-inspection before
PROJECT NAME:
CONTACT PERSON:
TYPE OF'INSPECTION:
CITY OF PORT TOWNSEND
DEVELOPMENT SERVICES DEPARTMENT
INSPECTION REPORT
For inspections, call the Inspection Line at 360-385-2294 by 3:00 PM the day before you want
the inspection. For Monday inspections, call by 3:00 PM Friday.
PERMIT NUMBER:)-
tt+CONTRACTOR:
PH
tJo r.ovrq0.
i
fl
s\LK\)'rg
oc\j
$\hP,
! APPROVED ! APPROVED WITH
CORRECTIONS
Ok to proceed. Corrections will be
checked at next inspection
Inspector L Date
Approved plans and permit card must be on-site and ovailable at time of
be assessed if work is not ready for inspection.
! NOTAPPROVED
Call for re-inspection before
proceeding.
s/r't/o>
//'
inspection. A re-inspection fee may
Residential' Building Permit Application
> Applications accepted by mail must include a check for initial plan review fee of $150) see the "Residential Building Permit Application Requirements" for details on
plan subm ittal requirements.
Property
Name
Address
?"rl *^^
"
uA v/A 98t /8
Ema
Serrrices
Lender lnformation:
Lender information must be provided for projects
over $5,000 in valuation per RCW '19.22.095.
Nam A'
Project Valuation: $
Total Lot Goverage (Building Footprint):
Square feet: 38{
lmpervious Surface:
Square feet: 3 8t{
owner or authorized to act on behalf of the owner
Townsend Municipal Code.
ContacURe
1...h,'nName: A ro. ,^
Address t
City/SVZi
Phone:
{e €
36t>-,<l- 5 tlA
Email
I hereby certify that the information provided is correct, that I am
and that all aclivities associated with this permit will be in
Print Name
Project Address: LqOq
llenf r;r kr ,9. (rzc' snrlh,of z5'u.st
Parcer# lLit'cio3oz "'
Legal Description (or Tax #):
Addition: H ussev
Lot(s
I
le f.*, lu reo iAence (frl,:re ADU)
Project Description:c,. ) tlld
1't floor
2d floor
3'd floor
Building lnformation (square feet):
38 '1I Deck(s):_
Porch(es
Basement:_ ls it finished? Yes No
Carport: Other:_
Manufactured Home ! ADU D
New F Addition Il Remodet/Repair IContractor:
Name
Address Zll To.
P t-t
Email:r'c.I
State License I n:-1/ r /o€
City Business License #: OOSZul1 Any known wetlands on the
Any steep slopes (>15%l? Y
Y@
Signature:
fa v1
state UaIilF anqlhgjmf
a
: " r.t r'tr1irr..l/rra;: i./.
i st:
ICATION
intend to build, whgre it will be loated on'your lot,aid how it will be constructed
, Residential permit application.
Washington State Energy & Ventilation Code forms
D,Two (2) sets of plans with Nofth arrow and scaled, no smaller than Ya" = l foot:
l'A site plansllowing:
, , '' 1. Legald€iirtptiop,anO p6icetnirmber-(iir;tax rumbey), r:
2. Property lines and dimensions' : I ::3.' 'setbac*s from all sldes of the proposed structure to the property lines in accordance with a,.:,.,,,," pinnedboundary,line,survey,., . .i: ., ,
, : , , !. O+site parking
"qpd driyeyygy,with dimenqhrs
:,::,5. S-treet names and,any,gasqmen[g.orvacationsi;, ' ",.:;, .i6., ;Location.€tnd diarneter of 'eisting trees, ,.
,.,.,,,,:, ",;.. ;7. Utility lines , . . .'-- : ' ,,. ''r i,1; : . 8. " lf applici6l5, existing or proposed septic system location' , , 9. . Delineated critical areas boundaries and buffers
, ! Foundation plan:
' ' :, .. 1. Footings and foundation walls
; : .: : 3. Floor joist size and layout
. ,,. '.....,. '4. Holdowns
: , . 5. Plu4bing and mechanicalfixturesi. , , 6. Occupancy sepqration betwqen dwelling and garage (if applicable)l" . -j'''.; 7. Window, siylight; and door tocations, iniludini'esLpL *inoows and safety glazing
,.: ,,. rl Wall section: .
" ;'.' ' : ' 1. Footing size, reinforcement, depth below grade
| ," 2. Foundation wall, height, width, reinforcement, anchor bolts, and washers' 3. Ffoer joist size and spacing
,.,. ii.'i.'. "':"'4: Wallstud size and,spacing ., , ... 5, Header size and spans6 Wallsheathing, weather resistant barrier, and siding material, '' '' '7. Sheet rock and insulation' i: ;" $. Rafters, ceiling joists, trusses, with blocking and positive connections
all proposed structures
dwelling construction,' '. ':,StreetA Utility or Minor lmprovement applicationI '' ..-,r,,,"...'.
') City of Port,ifownsenr-
Buililing and Comnunity Dwelopment
ENVTRONMENTALLY SENSrInE:.'
''t,1 ,,, .
AREAS
Permit applications are rwiewed by our
absence of an Environme,lrtally Sensitive
Townscnd Municipal Codg To helpinformation. . , ,,
General Infomation:
Scnsitive Arce
\Eit5pao[motPm5ndnCOFcu\ScrjtivrAcleuclicurriq&o . :., .
,.'..
staffto make a preliminary determination ofthe presen@ or ' ' "
Area on the propcrty, purstrant to Chapter 19.05 oftheport
us makc this dctcrminatioq please supply the following'i'", : . ..
i :. :.- ., , _" , - .. i ,1 :r'r .1 !{i, :..: , i ,:'
i!I,
MailingAddress:it .J:,,'' :
Property Ad&ess (if ditrerent):LoL 5
DescriptionofProposal(includcsrtcplan): gi.{'tg, ,,fru^i!y {cliJence (rrlur.ADu),,
2.timo dnring
Yes
thqcIs Erry rt.any trcyrr?
3. Has any portion of the sitc bcen identificd as a wctland?
If YES, plcase describc: .
, I'ES _l_NO
* Ocuoa
.a
_Fqtst _Mcado$'
4. Is thc sitc c.haractcrizod rs:
)l
5: Isltcslopcofthcpropcrty, I flut *: ,,, ,_garttcslopa
--critical slope - oo# n:l*
(5%- r5%),'l
steeo slooe
(ts%-&A)
Gdo]r-f59t
ni-a-
cllilc.raroF.
aogt .r IFG-.a
Dat€
>4OYo
l5o/o
byauyother
Code. Any
4U/o
@/o
t.' '
It.p.LnfryHby certifies that all of thc above stat€ments and thc information contained in any other
transmittals midc herewith arc truc, and th€ applicant aclsrowledges that any action taken by the City of fort
Toqmsendbasod in whole olinparton this applicationmaybcrwersed if it develops that anyiuch state,ment or
otbcr information contained herein is falsc.
0
of
FOR I}EPARTMENT USE ONLY:
Rcviowedby:
SitevisitR€quird? NO YES Sitcvisitmade on:
Exe,mpt per PTMC 19.05.040 (B)?NO YES
Threshold Determination (prescncetabsence of ESd tpeofESA):
Shorelincs Jurisdiction? NO ,yES
\Eit5rp&Soo\PoyuiBCD Fcm\soritiw Anu eu*i<nufuadoo
250 Madism
PortTown*n4
;. :': :, r'' '': ,(360)379-51195 Farl
ii.:,' ' ., r'.:,,1.:'..i :1,.1
Washington State E-nergy Code CWSEC)
2001 Residential Construction Checklist
Complete this form in addition to WSEC forms. Please answer the following questions:
' -! ''i' :. 'r. i", .:.'
'';
showfull WSEC compliance as
a stand-alone project. A detached, habitabile structure such as an Accessory Nelling tlnit
regardless of size must also meet these requirements. , ,
TYPE OF PROJECT:
tr New construction, or addition over 750 square feet
Must meet whole house and spot ventilation requiremients, and
D House addition under 750 square feet
Poisible trade-offs are allowedwith the
increasing
NOTE: A
Spot ventilation is still required"
E F'
WSEC cornpliance, sucih as
house ventllatiqt.
Electric
n Wall
Non-Electric:
Propane:D
VAPOR R-ETARDERS:
E Baseboard orced Air Furnace D Radiant Floor (Boilei) I Other_
loor/Baseboard
;
(Boiler) n LPG Stove ! LPG Fumacc O! Heat Pump ! oil Furnace 0 Woodstove (ian only be used as secondary heat
,'f "
Vapor retarders shall be installed toward the warno
option for floors, walls, and appropiiate ceiliiigii,:'
surface as reDresented betow, "$elect',.-'r.: i.,':.
' '.. .: ,..; ,,.; ,f:; ,......, .
one
o Floors: , ,I Plywood with exterior glue
I Poly plastic (greater than or bqual
D Backed batts
o Walls:
D Poly plastic (greater than or equal to 4 millimeter thick!I Face-stapled, backed batts
E Low-perm paint I
o Ceilings: /
I Not required where ventilation space averages greater than or eqtral to 12 inches above
insulation
! Face-stapled, backed batti
tr Poly plastic (greater than or equal to 4 millimeter thick)
E Low-perm paint
SEE BACK
,a{,r
P:\DSD\Dcpartmcnt Forms\Building Forms\Appticarion-Rcsidcrthl Ercrg codc chccktiltdoc
Pagc I ofl -- :
' :,
WSEC Residential Construction Checl<list
t',: ':'1
' r"...'..i, i.11.' , Whole House Fan for (Exheust
window in which they are placed.
o Provide not less than 4 square
What type of fresh air inletwill
D Window Ports
E Wall Ports
o In what room is your whole house,fan
o What size is the whole house
:i
',
'..
Note: the whole house fan shall
exhaust
be readily accessible and
the automatic control timer shall
Spot Ventilation:
Source specific exhaust ventilation is required in each kitchen,
roonL indoor swimming pool,
cI'M (l-2 ,house),.
house)
clock timer
'r ii i L;. f i-{;lj.;,(
inches of
'. ;_.
' l :1't'
I
'ri;t: i,,
' ,; ;", ",
.a, ar
t.''
P:\DSD\Dcpartncn Forms\Building
For the
Site lnformatlon
F Fu.m
Lot
Addres:
City:O -+" -{i Of I I^rrJt/r te!^)
State:V/A 4:98r68
Contad:A r,.* ?ol
Phone:l Lo- 3Sl -Stll'
Phone 2:
o-jBb-
PREIYCRIPIflE
Option
%o ofFloor
Area
Vertical
UI
CrtoupR-3
Occupancy
0.40
'':. ]. , l
,:,.'...
{ Anbuilding componenb rtreetthe{ tne project will rneet all otrer provtdohs_of
Localion of the door taking this excepUon
tr OOZ.0 Exceflion 2. Doors wi0r a llfador of 0.40
': .,1 1 i" ''
The proiect wlll take adventagc ofd em.e Exception 1. One door, that ls 24 or less; tlmttp
O$on lllonlj.
Copyti;ile, UTSUCEEP@-Gt6
Copbd by pcmidon ftom thc l/lh*llaOon Sffi
.a
': J;|,:'".,','.
Ghzho
Option
Glazlno
Arearq
% of Floor Vertiital o*ft";att
'' l/Vall:'
,.Abore
'Grade
lllall.:'
inf
Below
Grade
.lih[.'
ertl
Belort
Gnade
j,... j: ,"'l
FkoRi
l_l2!/o 0.35 0.58 R:38 R-30 i'nrsJ R-15 R-10 RJO.'n)l5o/o 0.,$0 0.s8 0.20 R-38 R-30 rc{r R-10 f,rJfl,,:,m Unlimied
Group R-3
Onlv
0.40 0.20 R-30 R-21 R:10
7 - InL denotes standard framing 16 inches on center with headers insulated with a minimum of R-5 insulation.
8. This wall insulation requirement insulation plus R-5 foam sheathing.
. 9. Doors, including all fire doors,
in glazing area limitations.
I l. Overhead glazing shall have U-factors
12. Log and solid timber walls
I rl :f iii
in Section
'. i" i'
'' ,' '..,':j:
Eft<iive 7n1ft2
Kirk Boike ARCHITECT a 4601 Mason Stscct o PortTotnrand WA 98368 a 3C0 38S 6140 ,.ffi
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Kirk Boike ARCHITEFT a 4601 Mason Street <} PortTownsend.[,1{8368 a 360 385 6140-'"-l architect@surfbest.net l
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ll,B1?" hct 4ooo 1.1 e tb" o,c,
Suzanne Wassmer
From:
Sent:
To:
Cc:
Subiect:
F2
Francesca Franklin
Thursday, June 28, 2007 1:51 PM
Suzanne Wassmer
Alex Angud; Jan Hopfenbeck
RE: Permits for Aran Pellechia BLD07-111 and SDP07-017
Suzanne,
I don't think Hendricks would need to be extended. I believe this is the part of Hendricks that is subject to Statutory
Vacation. The Pre of 05 would no longer valid, however. I believe a Notice to Title for the private maintenance of
Hendricks Street would be required in the PW permit.
---Original Message----
From: Suzanne WassmerSentr Thursday, June 28, 2007 1:36 PMTo: Francesca FranklinSubjecU Permits for Aran Pellechia BLD07-111 and SDP07-017
Hi Francesca,
I looked at this and the Pre-app PRE05-028 that said they need to extend Hendricks street - do they still need to? They
are just showing a driveway on the plans. lf they do I'll tell them they need a Lots of Record,
Thanks!
Suzanne
Suzanne Wassmer
Land Use Development Specialist
City of Port Townsend
250 Madison Street, Suite 3
Port Townsend, WA 98368
Phone: 360) 385-0644
Fax: (360) 344-4619
')')
>€€ (Reos*oL&
Land Use Checklist
Legal Description:s
16t-Lo0-30i
J Loh 6
Location:
Zoning
c/cs
Recorded Plat Shows Lot Size as: 51, f X I 3l ,{ '
Streets
It 1
( izV' + ,,:tlz iac, u1
-f 7.5 = i:1.9
q\
Assessor Shows: \,/ S dN-.
ArcReader Shows: \/
Critical Area?
Other Permits?
Part of a Plat or BSP or PUD? (Conditions, Tree Conserv.. .)
Site Visit?
Building meets lot coverage ?
Notice to Title needed?0-
Building
Lots of Record needed?
meets setbacks?Jla (
/j b"t lt
\L J/hr's
Restrictive Covenarit rieeded?
a/^ A4 U.
t{
Q c LaTJDIComments:
bl(
fI
' -'City of Port Townsend ' -r -)
D- relopment Services Departnrent
BUILDTNG NUMBBR APPLICATTON
r ///
5Wa7-o /rf
Name of Property Owner:Arnn e ller., h,n
Mailing Address:,
lort 1;heoJ, Wl g€7dc
Telephone: 160'781-5116
ProperW is located in:
3Block(s):t,ot(s):5t64
FaceVAccess is from
Parcel Nuinber
dh4*---/ :,./t St(e€t
Directions to the Propertv (draw vicinity map on back)
Zt=A i /&*1';4-
If this is a new ADU, has a building permit treen apptied for? yes No Date
Notes:
HOUSE NUMBER ASSTGNED:{90 ,'cL3
Date of k,,^-(
For Depqrtment Use Onlv:
Application Fee Received ($3.00, TC 2200):.{: wsh Date:7
C.opyto:tr Finance B Fire Dept
D Sheritr tr Police .
O Public Works tr DSD database
C Post Offrce
N GTS
I Assessor's Office
For address clianges: tr Qwest Address Managernent Center -206-504'1534
a .,N
(^),
H
(:)0 208
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14
206HENDCKS5
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r*"4 $4
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Receipt Nunber:
BLD07-111
BLD07-111
BLD07-111
BLD07-1 11
BLD07-i 1 1
BLD07-111
BLDOT-Itl
BLD07-1 1 1
BLD07-ltt
961200305
961200305
961200305
961200305
961200305
961200305
961200305
961200305
961200305
$527.64
$16.24
$100.00
$4.50
$150.00
$150.00
$811.7s
$10.00
$3.00
Total:
$377.64
$16-24
$100.00' $4.50
$150.00
$150.00
$811.75
$10.00
$3.00
$0.00
$0.00
$0-00
$o.oo
$0-00
$0.00
$0.00
$0.00
$0.00
Plan Review Fee
Technology Fee for Building Permit
Erergy Code Fee - New Single Famil
State Building Code Council Fee
Plumbing Permit Fee per Dwelling L
Mechanical Permit Fee per D,velling
Building Permit Fee
Record Retention Fee for Building P
Site Address Fee
$1,623.13
-050607
CHFCK
06/06/2007 Plan Review Fee
1079
$150.00 BLD07-111
Total
$ 1,623.13
$1,623.13
genprntrreceipts Page 1 of 1
ReceiptNunber, ffi
BLD07'111 961200305 Plan Review Fee $527.64 !l!0:00Total: $150.00
$377.64
CHECK 1457 $ 1s0.00
Total $150.00
genprntrreceipts l?age 1 of 1
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