HomeMy WebLinkAboutBLD07-237BI.]ILDING PERMIT
City of Port Townsend
Development Services Department
250 Madison Street, Suite 3, Port Townsend, WA 98368
(360)379-s09s
Project Informstion
Permit Type Residential - Addition/Remodel
Site Address 0 WASHINGTON ST
Project Description
Interior rcmodel
Permit #
Project Name
Parcel #
BLD07-237
SIEBENBAUM ESTATE CO. INC
989104111
Names Associated with this Project
Type Name Contact
Applicant Siebenbaum Estate Co Inc
Owner Siebenbaum Estate Co Inc
Cotrtractor Jackson Building Solutions, InJames Jackson (360) 38s-4424 STATE JACKSBS94TB 12128/2001
Phone #
License
Type License # Exp Date
Fee Information
Project Valuation
Building Permit Fee
Plan Review Fee
State Building Code Council Fee
Technology Fee for Building Permit
Record Retention Fee for Building
Permit
Total Fees
Project Details
Entered Bid Valuation 7,300 DOLI
$7,300.00
53.64
150.00
4.50
5.00
7.75
$220.89
Conditions
10. Property corner suruey pins must be located at time of foooting inspection to verify setbacks
*** SEE ATTACHED CONDITIONS ***
Call 385-2294by 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 infonnation 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 ofthe property or authorized agent ofthe owner.
Print Nam" -J1- -- A. StL h^..- Datelssued: t2tto/2007
IssuedBy: PWESTERFIELD
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CITY OF PORT TOWNSEND
PERMIT ACTIVITY LOG
PERMIT #Bt) o'T - zzry DATERECET'ED l( - z | * 0/7
SCOPE OF WORKT n, -t>tEbE-NbQ urrn 'Re)'YLc.).eL--- ALL J^E fZ: (t t?
DATE ACTION INITIALSll'zl *ot1 ENTERED TNTO CHET 5F
CA-toPl - No evidence
CHECKED FOR COMPLETENESS
lIb -1 b-7 Si^t\
U S'Lo I
o-4 {)O.t t P
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)Inspection Report
Permit# 07 -?7
)
Project
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Date I{sppctor Inspection & Notes
t+LL-+Fc.*-.^e- $- Rf ?\ *^\r.
€IL {-[ I I
2
Development Seruices
250 Madison Street, Suite'3
Port Townsend WA 98368
Phone. 360-379-5095
Fax: 36G344-4619
r,nvw.cityofpt. us
Gommercial Building Permit Application
i Applications by mail must include a for initial plan review fee of $150) See the "Commercial Building Permit Application Checklist" for details on
plan submittal requirements.
Property Owner:
Name t
o 4Hlsa-C
C
Phone
Email l(
Conta
Name:a
Address:ocu 9t .
City/SUZip:*..d,q
-ro
I hereby certify that the inlormation provided is correct. that I am
and thal all activities associated with this permit will be in accord
Print Name
of the owner
ress & Zo ing District:L to
Parcer# qglto* tt\
Legal Description (or Tax #)
Addition:
Block:
Lot(
Office Use Onlv
Project Desc n
M o 6{
Lender lnformation:
Lender information must be provided for projects
over $5,000 in valuation per RCW 19.27.A95.
N o ertL
Project Valuation: $+,7oo , o o
Construction T
Occupancy Rating
Building lnformation (square feet)
1"tfloor
2nd floor
Restrooms:
Deck(s)
3'd fJoor Storage
Basement: ls it finished? Yes No
New ft Addition n Remodel/Repair n
Change of Use D
Gontractor:8",5o (,
Address 2_t I ?
P
Email
State License exp. tztz6lo?
City Business License #6lL\
Total Lot Coverage (Building Footprint):
To
llr
Square feet
SW6'v:i^X'$,:'ffii:rt
cl TY OF Pc|TRi INClWNS
DS flSignature
I
Municipal Code
")
i Exterior elevations (all four) with existing slope of the land in relation to all proposed
structures
lf architecturally designed, one set of plans must have an original signature
lf engineered, one set of plans mrist have one original signature
For new dwelling construction, Street & Utility or Minor lmprovement application
i
i
i
Receipt Number:
BLD0T-237
BLD07-237
BLD0T-237
BLD/JT-237
9897041 I I
9897041 1 1
9897041 1 1
9897041 1 I
$5.00
$4.50
$53.64
$7.75
Total:
$5.00
$4.50
$53.64
$7.75
$0.00
$0.00
$0.00
$0.00
Technology Fee for Building Permit
State Building Code Gouncil Fee
Building Permit Fee
Record Retention Fee for Building P
$70.89
07-1002
CHECK
1112112007 Plan Review Fee
1660
Total
$150.00 BLD07-237
$ 70.89
$70.89
genprntrreceipts Page 1 of 1
')
J.a
Receipt Number
BLDOT-237 989704111 Plan Review Fee $150.00 $rs0.00
Total:
-$tso.oo
$0.00
CHECK 1646 $ 1s0-00
Total $1s0.00
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