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Reoling trermit APPIi**tion
Address:
s
F
Lender lnformation:
Lender informatio'n rnust be provided for projects
over $5,000 in velualion per R*W 1S.?7,095.
Itlame:
Prcject Valuation
Scope of Work:
Number of existing roof layers:
Square ft*tage of
rearonrg$ N
Replaeing shaathing? Y s
r-;-A
L"/,
vg$Replaringlaltering rafiters or trusse,a?
lf "yes" a roof framing plan is raquired.
ls the structure located
seltwater shqreline? Y ffi-
300 fser of a fre*h *r
H?i'iift]- place cn +r riearthe pubtic risht-or-
lf yes, pra\|f,e a site plan and partestrian pruteclion
plan.
New Roaf Type;
E4omposition E Metal
0 Cedar +hingles I Cedar shak-es
il Tsrchdswn 0r l-JDt MEp il Other
I nereby csdifo thHt the infsrmation prr:vided is uTrrecl, lhat t am Bither the Dwner or
and ihat al! aclivitie-q a{socisted
Frint Name
Legat DescriPtion {or Tax #}1 |
Rooition: ff hfilfffi-frftH!fi8Fr+jee.t Address:
Lot{sParce[ #
SF Rssid*ntial Ef Cammerrial il fillF Resi#e'ntial U Bed & Breakfast*il
' B&B's tocated in Histori* Dislrict may require denign review eppi*val-
Add
Phone:
Cont
Nam
City Eu*iness License #:
Stale Licensq
E
Vanti*g typ+ fc&eclr all fial
Efioof
n Ridge
6cl on bahalf +f th{]
T
CIIY OF PORT TOWNSENO
DSD
Signatu
with this S*rrqit wil! be in e*cordsn*e r*ilh Slate Laws
CITY OF PORT TOWNSEND
PERMIT ACTIVITY LOG
PERMIT #- 2L40 DATE RECEIVED 6 o
SCOPE OF WORK:
DATE ACTTON INITIALS
ENTERED INTO CHET
CHECKED FOR COMPLETENESS
4A+
I A)('1Kl (1, -Ylrlil-' *xtwL! t r I tf,-a.,rA-t nvr\\/?){' l
t't
/49\o9/
EU n >f-
/- -r r t<xl
Zoning:
Setbacks OK?
Lot Size:
Building Size
Lot Coverage
FAR OK?
Height OK?
Parking OK?
Critical Area?
Demo?
Historic Rev?
Notice to Title?
Lots of Record?