HomeMy WebLinkAboutBLD08-019CnN'tGvt<f>
Commercial Building it AppliCation
250 Madison Street, suite 3: r: , . :,: Port Townsend WA 98368
.' : ,r. phone:360_379_5095' .' ".. ' ,, I fax: 360-344-4619It www.cityofpt.us
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Development Servr-ces
t#sF Applications accepted by mail must include a check for initial plan
) See the "Commercial Building Permit Application Requirements" for details on
plan submittal requirements.
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Project Ad & Zoning District:o A.vt tt l--
Legal Description (or Tax #):
Addition.
Block:
Lot(s
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Project Description
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Lender lnformation:
Lender information must be provided for projects
over $5,000 in valuation RCW 19.27.095.
Name:
Project Valuation: $_
Name:ft
Address
City/SVZip:
Pho
Em ail
Address:
City/SUZip
Phone:
Email:
Property
Name:
Building lnformation (square feet):
1'tfloor W$O Restrooms
2nd froor I l7 /( Deck(s
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wtr
orh
Rem
Storage
Basement ls it finis
Construction Type:
Occupancy Rating:
3'd floor
New rl ndditior(
Change of Use tr
City Business License
State License #:
Contractor:
Name:
Address
City/SUZip:
Phone:
Email:
Total Lot Coverage (Building
Square re.t'27 SO ,,,
lmpervious Surface:
Square feel:Y
I hereby certify that the information
and that all
Print Name
is corect, that I am either the owner or authorized to act on behalf of the owner
permit will be in accordance with State Laws and the Port Townsend Municipal Code.
adSignature
with th
I
PERMIT #0
, CITY OF PORT TOWNSEND
PERMIT ACTIVITY LOG
DATE RECETVED
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0
SCOPE OF WORK:
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DATE ACTION INITIALS
\')- \btr ENTERED INTO CHET .{r. ,
I CA - to Planning - No evidence
CHECKED FOR COMPLETENESS
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CTTY OF PORT TOWNSEND
DEVELOPMENT SERVICES DEPARTMENT
INSPECTION REPORT
CALL THE INSPECTION LINE AT 360-385-2294 BY 3:00pm THE DAY BEFORE YOU
WANT THE INSPECTION. FOR MONDAY INSPECTION, CALL BY 3:00PM FRJDAY
DATE OF INSPECTION:>3 o PERMIT NUMBER:7
SITE ADDRESS:
CONTACT PERSON:
TYPE OF INSPECTION:
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PHONE:
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tr APPROVED tr APPROVED WITH
CORRECTIONS
Ok to proceed. Corrections will be
at next inspection
I NOTAPPROVED
Call for re-inspection before
proceeding.
t/z= /a ?Inspector Date
/
Acknow Date
Approved plans and card must be on-site and available at time of inspection, A re-inspection fee may
/
be assessed i"f work is not ready for inspection.