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HomeMy WebLinkAboutBLD07-009 (oversized drawings not scanned) • •
eol,Trosyy BUILDING PERMIT
C' co
City of Port Townsend
WAStitf1,77
Development Services Department
— 250 Madison Street,Suite 3,Port Townsend,WA 98368
(360)379-5095
Project Information Permit# BLD07-009
Permit Type Residential -Addition/Remodel Project Name
Site Address 11 VISTA BLVD Parcel# 963700002
Project Description
Renovate existing garage into family room;replace some windows in house
Names Associated with this Project License
Type Name Contact Phone# Type License# Exp Date
Applicant Syverson Kirsten A
Owner Syverson Kirsten A
Fee Information Project Details
Decks–Residential 84 SQFT
Project Valuation $15,723.72 Manual Input 528 DOLL
Plan Review Fee 172.41
Technology Fee for Building Permit 5.31
State Building Code Council Fee 4.50
Building Permit Fee 265.25
Record Retention Fee for Building 10.00
Permit
Total Fees Paid $457.47
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. I further certify
that I am the owner of he proper,r authorized agent of the owner.
Print Name 'NI, ���: L'j/L _-- Date Issued: 02/16/2007
Issued By: PWESTERFIELD
410
CITY OF PORT TOWNSEND
PERMIT ACTIVITY LOG
PERMIT# Loo7 Qp ci DATE RECEIVED: (/A 7/07
SCOPE OF WORK: - '
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DATE ACTION INITIALS
Entered into TRIPS
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Vested Date
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•
11.
SORTp
City of Port Townsend •
es
Development Services Department
Waterman-Katz Building
181 Quincy Street, Suite 301,Port Townsend,WA 98368
(360)385-0644 FAX(360) 385-7675
email:jwalat@ci.port-townsend.wa.us
CITY OF PORT TOWNSEND
SHORELINE SUBSTANTIAL DEVELOPMENT PERMIT EXEMPTION
WASHINGTON STATE SHORELINE MANAGEMENT ACT(RCW 90.58)
Applicant: Gary and Kirsten Syverson Case Number: LUP04-127
7314 Steilacoom Blvd.
Lakewood, WA 98499
Project Location and Legal Description: Lot 2, Island Vista Addition to the City of Port
Townsend; addressed as 11 Vista Blvd.
Proposal: Remodel and expansion of single-family residence on bluff property.
Adjacent Waterbody: _Strait of Juan de Fuca Admiralty Inlet _X_Port Townsend Bay
SMP Shoreline Designation: x Urban Suburban _Natural _Conservancy
Aquatic PT Urban Waterfront Special District
Findings &Conclusions
1. The proposal made by the applicant to undertake construction described above within the
shoreline of the City of Port Townsend and/or its associated wetlands is exempt from the
requirement of a substantial development permit. Specifically, the proposal constitutes:
Normal Maintenance and Repair_Development not exceeding$2,500
x Single-family home for owner's use _Other:
2. The proposal will not materially interfere with the public use of public lands and waters
or the private use of adjacent private lands nor will it result in any material expansion or
change in use beyond that previously existing.
3. The proposal is consistent with the policies of the Shorelines Management Act and the
City's Shorelines Master Program.
In consideration of the above, the proposal is found exempt from the requirement of a shoreline
substantial development permit. The following conditions must be complied with in
development and subsequent use of the property.
Conditions
1. All development shall be in substantial conformance with the site plan submitted with the
shoreline exemption application and with the geotechnical report prepared by Robert
Leach and Bill Payton of NTI Engineering and Surveying for the property(dated
10/21/04).The recommendations listed on page 3 of the geotechnical report are hereby
incorporated as required conditions. (Exhibit A)
2. There shall be no further expansions to or addition of any structures seaward of the
existing permitted development(i.e.,within the allowed setback area)without prior
review for conformance with the Shoreline Master Program and any other applicable
laws and ordinances.
3. This exemption does not excuse the proponent from complying with other local, state and
federal ordinances,regulations, or statutes applicable to the proposed development
including but not limited to the city's environmentally sensitive areas ordinance. The
proposed structures have not been reviewed for compliance with the International
Building Code. That review will take place through a City building permit process.
4. Per the Port Townsend Shoreline Master Program, the setback specified through approval
of a subdivision takes precedence over the other methods of calculating setback for view
purposes. The required setback for Lot 2 as shown on the face of the Island Vista plat is
25 feet. The proposed site plan,with ten-foot extension of the living room, shows a
setback of approximately 60 feet or more and therefore complies with setback
requirements.
5. The building permit shall not become effective until such time as the applicant enters into
a"Hold Harmless Agreement"with the city in a form and manner approved by the City
Attorney. Said agreement shall acknowledge the applicant's awareness of bluff stability
and erosion conditions; shall acknowledge that shoreline defense works shall be
prohibited in the event of continued erosion and land sliding; and shall relieve the City of
Port Townsend of any liability for approval of the development and the engineering
design of the development facilities.
6. The building permit shall not be issued until a Notice to Title regarding presence of an
Environmentally Sensitive Area on site is recorded with the County Auditor. The Notice
to Title may be combined in one document with the Hold Harmless agreement.
7. All development shall be in substantial conformance with an engineered stormwater
management and erosion plan prepared in accordance with the city's Engineering and
Design Standards and approved by the Public Works Director.
8. Any vegetation removal within 25 feet of the bluff is subject to the City's
Environmentally Sensitive Areas ordinance (PTMC 19.05). No vegetation removal in the
25-foot bluff buffer shall be permitted without review by the City for conformance with
all applicable regulations.
9. The Applicant is encouraged to implement the recommendations in the DOE pamphlet
"Vegetation Management: A Guide for Puget Sound Bluff Property Owners. A copy of
the DOE pamphlet has been supplied to the applicant. Native, drought tolerant species,
especially those that provide good habitat, are recommended to help preserve the bluff
habitat. Excessive irrigation of lawn or landscaping may cause bluff instability.
CITY OF PORT TOWNSEND
DEVELOPMENT SERVICES DEPARTM
` City Hall,250 Madison Street,Suite 3 t�
Port Townsend,WA 98368 -
Phone: 360-379-5095 Fax 360-344-4619
fir-
RESIDENTIAL �
BUILDING PERMIT APPLICATION
NEW CONSTRUCTION,REMODELS,&ADDITIONS
Property Owner's Name(s) - .S4y6 /y,
Mailing Address 27- .--Vet,(466
-
City,State,Zip i)PLIA6* r n
Phone —I Permit No. .33 L,b0T - 009
Property Street Address _ ;2;tvi
1>tn
Zoning District Parcel# q623 3 7o0 C
Legal Description: Addition.15\A440 V 1i; Block Lot(s) Z
General Contractor's Name (/ Sq%JRs- LJ
Mailing Address ti 1 V ,. "1-11B I,V C
Phone / Q .3 11 !' ) (0,C Cell Phone 26-tor 3 r ' t L 0
State License Number City Business License Number
3 tI"4O
Authorized Representative/Contact Person: Phone:
Estimated Value of construction$ 3�,
Financed By (�/bf-
_
Date Work is to Begin MpAtte .�-- Date Work is to be Completed 21DP q-
Scope of Work:
Please check all items that apply for the type of building permit you are requesting:
New House Addition I
New Garage or Carport Repair/Remodel Garage
Repair/Remodel House Accessory Dwelling Unit
Manufactured Home Other(please describe):
Floor Area: the proposed structure is to be used for:
Finished Heated Space sq.ft: 5 2 i Garage sq.ft:
Unfinished Heated Space sq ft: Carport sq.ft:
Unfinished Basement sq ft: Porches sq.ft �,�.
Semi-Finished Basement sq ft: Decks sq.ft
Storage sq. ft: Other(please describe):
n.n__...�__a_ __a o_aa:_�✓_LL..n..��u..__i n_u:___ r��.._.__.i_a_-__a ra__\/%__a_�a,r cun,u%naan111_..C__a:__
CITY OF PORTtOWNSEND RESIDENTIAL BUILDING ALT APPLICATION
NEW CONSTRUCTION,REMODELS,&ADDITIONS
Property Site Area/Coverage Information:
1. The total area of the property in square feet 2. 1
2. The total area covered by existing and proposed structures in square feet: �[
(total ground coverage from the outside of walls or supporting members) I O fl
Percentage of lot coverage: (2=1) ' 'IV
Impervious Surfaces:
Please provide the square footage of the roof area of the proposed and existing structures,and the square footage of the total area
covered by porches,walkways,patios and driveways. Do not include decks allowing drainage to earth below.
IProposed House Roofprint sq.ft
l /3 Existing House Roofprint sq.ft: It-t(Q V
Proposed Garage Roofprint sq.ft: Existing Garage Roofprint sq.ft: 4 01
Proposed Porch/Walkway sq.ft: Existing Porch/Walkway sq.ft:
Proposed Driveways sq.ft: Existing Driveways sq.ft:
Other(describe): Other(describe):
Total Proposed Impervious sq.ft: Lq 7 3 Total Existing Impervious sq:ft: `i 13
Total Proposed+Existing sq.ft to 1612 Percentage Impervious:* Q� I
1" (Impervious surface=lot sq.ft) V I P
*If total impervious surface is equal to or greater than 40%of the lot area,you must submit a written stormwater plan to address run-
off.
Please check which plans you are submitting with this application (2 sets needed):
Site Plan PUTT 4' 1)g4437.0 Interior&Exterior Wall Bracing(panel locations shown
on floor plan)
Drainage Plan(if 40%or more impervious) Typical Wall Framing Details(section from foundation
throng,h roof)
Foundation Plan �," Elevations 0IQ1(at AkLA
h Floor Plan O�,�j1,44 4 Mao k 2003 WSEC*Compliance: Prescriptive_ Component_
Floor Framing Plan WSEC Construction Checklist(Washington State Energy Code)
Roof Framing Plan Other.
Installing Manufactured Home Yes><No Year: Make:
Was the manufactured home originally constructed within three(3)years of proposed placement? Yes No
2) Manufactured home must be placed on a permanent foundation with the space from the bottom of the home to the
ground enclosed by either load bearing concrete or decorative concrete or masonry blocks so that no more than one foot of the
perimeter foundation is visible above grade;and
3) Roof must be composed of composition,wood shake or shingle,coated metal,or a similar roof material;and
4) Title to the manufactured home must be eliminated as a condition of building permit approval.
C:\Documents and Settingslkathy Reed\Local Settings\Temporary Internet Files\Content.IES\KKEJGPMR\Application-
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CITY OF PORWNSEND RESIDENTIAL BUILDING ALT APPLICATION
NEW CONSTRUCTION,REMODELS,&ADDITIONS
Special Conditions
Please check YES or NO as applicable . YES NO
1. Is the property within 200 feet of a fresh or saltwater shoreline? D
2. Is the property within the Port Townsend Historical District? 1 X
3. Is the property located within or adjacent to an environmentally sensitive area? I X
4. Will this proposal involve any sewer,water or other utility extensions that will,or could serve vacant
properties other than the project site?If yes,please attach information identifying the utility extensions and �/
sites. vdvtboe1 me- 1 q ECC:M t4� — IfirOr4tNt-Ge- 1�
5. Have any special conditions been placed on this property,or has the property been subject to any
conditions on any prior action of the City(if"Yes"to any of the following,attach copies of appropriate
documents): X
Subdivision/Short Plat/Boundary Line Adjustment?
SEPA(environmental review)?
Variance?
Conditional Use Permit?
Street Vacation?
Planned Unit Development?
Restrictive Covenant?
Easement?
6. Are any properties within 800 feet of the site owned or controlled by the applicant,any relative or
business associate,or any parte ,corporation�,Pr other entity affiliated with`e applicant? (If yes, �/
attach list) , V I STA A j1
7. Have any of the properties listed in item#6 been developed within the last two years?(If yes,attach list.)
8. Have you previously discussed this prot' with a i staff member? If ye ,who and when?
Gr._ i Jul 2vetf- b
Applicant Certification
The applicant hereby certifies to have knowledge of those sections of the International Residential Code and the Port
Townsend Municipal Code pertinent to the above project and that the applicant is responsible for constructing in conformance with
these codes;the applicant understands that the permit,if issued,expires in six months unless work is started;that the permit,after
construction has started,will expire after one year if an inspection is not made to show significant progress on the structure;the
applicant agrees to abide by the ordinances,codes,regulations,restrictive covenants,deed or plat restrictions,and water and sewer
plans attached hereto;the applicant certifies that all information given above and on accompanying plans is complete and accurate to
the best of their knowledge; and the applicant understands that this information will be relied upon in granting permits and that if such
information is later found to be inaccurate any permits may be withdrawn.
C:1Documents and Settings\Kathy Reed\Local SettingslTemporary Internet Files\Content.iE51KKEJGPMR\Application-
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CITY OF PORT1LNSEND RESIDENTIAL BUILDING PILIT APPLICATION
NEW CONSTRUCTION,REMODELS,&ADDITIONS
The undersigned hereby saves and holds the City of Port Townsend harmless from any and all causes of action,judgments,
claims,or demands,or from any liability of any nature arising from any non-compliance with any restrictive covenants,plat
restrictions,deed restrictions,or other restrictions which may have been established by parties other than the City of Port Townsend.
Complete Application
Port Townsend Municipal Code,Section 16.04.140,Vested Rights-Substantially Complete Building Permit Application:
applications for all land use and development permits required under ordinances of the city shall be considered under the zoning and
other land use control ordinances in effect on the date a fully complete budding permit application,meeting the requirements identified
in this section,is filed with the Development Services Department. Until a complete building permit application is filed,all
applications for land use and development permits shall be reviewed subject to any zoning or other land use control ordinances which
become effective prior to the date of issuance of a final decision by the city on the application.
An application for a building permit shall be considered complete when an application meeting all of the requirements of
Section R105.3 of the International Residential Code,2003 Edition,is submitted which is consistent with all then applicable
ordinances and laws. In addition,to be considered complete,such an application must be accompanied by complete applications for a
subsidiary land use or development permits needed,such as a complete shoreline management permit application and/or complete
applications for other discretionary permits required under the ordinances of Port Townsend. An application for a partial permit under
Section R105.3.1 of the International Residential Code,2003 Edition,shall not be considered complete unless it meets all requirements
stated above and contains plans for the complete structural frame of the building and the architectural plans for the structure.
- _ � 1,t---- d ,Z �—
Signature of A;. to .rized Representati e Date
s>
. • \(Lica-
For Official Use Only
Permit No. Building Official Approval Date Issued
Balance Due$ Date Validation Stamp below:
Owner/Representative Signature Date
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•
City of Port Townsentfb
Development Services Department -"
ENVIRONMENTALLY SENSITIVE AREAS QUESTIONNAIRE
Permit applications are reviewed by our staff to make a preliminary determination of the presence or
absence of an Environmentally Sensitive Area on the property,pursuant to Chapter 19.05 ofthe Port
Townsend Municipal Code. To help us make this determination, please supply the following
information.
General Information:
Applicant Name: t�1"77r Phone ,• ,
Mailing Address: ,t
Property Address(if different):
•
Description of Proposal(include site plan): ZIL5Aintlat4EWISTite ' +140
The proposed new construction creates - sq. ft. of impervious surface. What best
management practices are proposed?
Sensitive Qio
L Is anyArea portionuestof the ns:property within or near a mapped Environmentally Sensitive Area?
(Maps are available a e Building and Community Development Department)
YES NO
2. Is there any standing r running water on the surface of the site at any time during the year?
Yes No If YES,please describe:
3. Has any portion of the site been identified as a wetland? YES NO
If YES,please describe:
4. Is the site characterized as:
Forest Meadow .°)Z%C,leafed Mixed
C:\Documents and Settings\Kathy Reed\Local Settings\Temporary Internet
WSEC Residential Construction Checklist
T. City of Port Townsend
Development Services Department
a = - ''t 250 Madison Street,Suite 3
'; - Port Townsend,WA 98368
=- (360)379-5095 Fax:(360)344-4619
Ast
Washington State Energy Code (WSEC)
2001 Residential Construction Checklist
Complete this form in addition to WSEC forms. Please answer the following questions:
TYPE OF PROJECT:
-1.New construction,or addition over 750 square feet
Must meet whole house and spot ventilation requirements, and show full WSEC compliance as
a stand-alone project. A detached, habitable structure such as an Accessory Dwelling Unit
regardless of size must also meet these requirements.
-o House addition under 750 square feet
Possible trade-offs are allowed with the existing building for WSEC compliance, such as
increasing ceiling insulation. See WSEC component performance forms.
NOTE: A house addition less than 500 sq.ft. does not require whole house ventilation.
Spot ventilation is still irequired.
TYPE OF HEATING—Please check all that apply:
Electric
L-o Wall Heater "Baseboard -ii Forced Air Furnace u Radiant Floor(Boiler)-o Other
Non-Electric:
Propane:-o Radiant Floor/Baseboard(Boiler) } PG Stove -o LPG Furnace -a Other LPG
-;Heat Pump i Oil Furnace -i Woodstove an only be used as secondary heat source)
VAPOR RETARDERS:
Vapor retarders shall be installed toward the warm surface as represented below. Select one
option for floors,walls, and appropriate ceilings:
• Floors:
i Plywood with exterior glue
Poly plastic(greater than or equal to 4 millimeter thick)
1 Backed baits
• Walls:
1 Poly plastic (greater than or equal to 4 millimeter thick)
1 Face-stapled,backed batts
Low-perm paint
• Ceilings:
I Not required where ventilation space averages greater than or equal to 12 inches above
insulation
Face-stapled, backed batts
I Poly plastic (greater than or equal to 4 millimeter thick)
I Low-perm paint
SEE BACK
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WASHINGTON STATE VENTILATION AND INDOOR AIR QUALITY(2000 Code):
4 1110.
Prescriptive Approach—Simple Form
For the Washington State Energy.Code(2001 Edition)
Climate Zone 1
IA, Site Information Building Department Use Only
1; 2 - .51- Vts-rn A 012
Addrips: liAl l%); P)kvx5. Notew
City: o1%c 1r31i) .2tM) VaiL.
state&IJ A. . mix cj t 3 tvR
contact CQ t.ttiE:
Phone: 3tt o .m"t 11(er"
Pry 411 t D
Fax: d 3 ) j i _! t�_
Table 6-1
PRESCRIPTYE REQUIREMENLS°"FOR GROUP R OCCUPANCY
CLIMATE ZON1
(Unlimited Glazing Option Only)
Glazing GlazingU-Factor Doot2 Wall Wall Wall Slab'
Option Aiea10 - U- Cduing3 Vaulted Above Into le' Floors On
I
%of Floor Vertical Overhead" factor Ceiling3 Grade Below Below Grade
—., Grade Grade
III Unlimited
Group R 3 ft 0 ,.1 0.58 0.20 R-38 R-30 R-21 R-21 R-10 R-30 R 10
Occupancy 6i /
Only
See the code text for footnote references
This project complies with the following:
1 The project is a single family residence or duplex.
✓ The project is wood frame OR all of the insulation is interior or exterior of the framing.
1 All bulling components meet the requirements listed in Table 6-1,Option HI.
✓ The project will meet all other provisions of the WSEC and VIAQ.
The project will take advantage of-the following exceptions to the prescriptive option:
❑ 682.6 Exception 1.One door,that is 24 lt.2 or less,that does not meet the standards is allowed.
Location of the door taking this exception
Cl 602.6 Exception 2.Doors with a U4actor of 0.40 allowed without calculations,Option til only.
Location of the door(s)taking this exception
Copyright 2002,wsUCEEPO2-056
Copied by permission from the Washington State University Cooperative Extension Energy Program
Prescriptive—ale Forth—Ornate Zone 1 5/31/2002
• • 2001 EDITION
TABLE 61
PREESCIMPTIVE °"FORrUP R OCCUPANCY
CLl1IiATE ZOI§E
•
��rn U-Factor Walk.. Wag. g�4
OpSan swain ° c Vaulted
beed4 Fbors en
%ofFloor Vertical Overhead" U-Factor came Grade � tirade
I. Grade
12% 0.35 0.58 0.20 - R-38 R-30 1 R15 R-15 R-10 R-30 R-10
II.* 15% 0.40 0.58 020 R-38 R-30 'R 1 R-21 R-10 R-30 R-10
EU.' Unlimited - 0.40 0.58 0.20 R-38 R-30 R-21 R-21 - 1t 10 ' R-30 R10
Group R-3
Occupancy.
Only
* Refer Case
0. Nominal R-values are for wood frame assemblies only or assemblies built in accordance with Section 601.1.
1. liormimum requirements for each option listed. For example,if a proposed design has a glazing ratio to the conditioned floor
area of 13%,it shall comply with all of the requirements of the 15%glazing option(or higher). Proposed designs which cannot
meet the specific requirements of a listed option above may calculate compliance by Chapters 4 or 5 ofthis Code.
2. Requirement applies to all ceilings except single rafter or joist vaulted ceilings. `Adv`denotes Advanced Framed Ceiling.
3. Requirement applicable only to single rafter or joist vaulted ceilings.
4. Below grade walls shall be insulated either on the exterior to'a minimum level of 12-10,or on the interior to the same level as
walls above grade. Exterior insulation installed on below grade walls shall be a water resistant material,manufactured for its
intended use,and installed according to the manufacturer's specifications. See Section 602.2.
5. Floors over crawl spaces or exposed to ambient air conditions.
6. Required slab perimeter.insulation shall be a water resistant material,manufactured for its intended use,and installed
according to manufacturer's specifications. See Section 602.4.
7. Int.denotes standard framing 16 inches on center with headers insulated with a minimum of R-5 insulation.
8. This wall insulation requirement denotes R-19 wall cavity insulation plus R-5 foam sheathing.
9. Doors,including all fire doors,shall be assigned default U-factors from Table 10-60.
10. Where a maximum glazing area is listed,the total glaring area(combined vertical plus overhead)as a percent of gross
conditioned floor area shall be less than or equal to that value. Overhead glazing with U-factor of U0.40 or less is not included
-in glazing area limitations. •
11. Overhead glazing Shat!have U factors determined in accordance with NFRC 100 or as specified in Section 502.1.5.
12. Log and solid timber walls with a minimum average thickness of 3S"are exempt from this insulation requirement
•
Effective 7101/02 - 33 •
•
11 •
• In what room is your whole house fan located?
• What size is the whole house exhaust fan? U 50-75 CFM(1-2 bedroom house)
�+80-120 CFM(3 bedroom house)
`0100-150 CFM(4 bedroom house)
LI 120-180 CFM(5 bedroom house)
Note:the whole house fan shall be readily accessible and controlled by a 24-hour clock timer
with the capability of continuous operation,manual and automatic control. At the time of final
inspection,the automatic control timer shall be set to operate the whole house fan for at least 8
hours a day, and have a sone rating at 1.5 or less measured at 0.10 inches water gauge.
Spot Ventilation:
Source specific exhaust ventilation is required in each kitchen,bathroom,water closet,laundry
room,indoor swimming pool,spa and other rooms where excess water vapor or cooking odor is
produced. Bathrooms,laundries or similar rooms require fans with a minimum 50 cfm rating at
0.25 inches water gauge;kitchens shall have a fan with a minimum 100 cfm rating at 0.25 inches
water gauge.
Outdoor Air Inlets:
Outdoor air shall be distributed to each habitable room by means such as individual inlets,
separate duct systems,or a forced-air system. Habitable rooms include all bedrooms,living and
dining rooms but not kitchens,bathrooms or utility rooms. Where outdoor air supplies are
separated from exhaust points by doors,undercutting doors a minimum of i/2 inch above the
surface of the finish floor covering,distribution ducts,installation or grilles,transoms or similar
means where permitted by the Uniform Building Code. When the system provides ventilation
through a dedicated opening, such as a window or through-wall vent,these openings must:
• Have controlled and secure openings
• Be sleeved or otherwise designed so as not to compromise the thermal properties of the wall or
window in which they are placed.
• Provide not less than 4 square inches of net free area of opening for each habitable space.
What type of fresh air inlet will be installed? (See figure below)
U Window Ports
U Wall Ports
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'WINDOW REPLACEMENT PERMIT
City of Port Townsend
Development Services Department
• 250 Madison Street
a r Port Townsend,WA 98368
(360)379-5095 Fax:(360)344-4619
A window replacement permit is not required if ALL of the following conditions exists:
• You are replacing existing glass with like glass. For example, the neighbor's
baseball went through your window, and you need to replace the windowpane.
• There is no change to the window frame(s)or sash(s).
This window replacement permit is required if ANY-of the following conditions exist in
your project:
• A different kind of glass in being installed,for example single-pane glass replaced
with double-pane glass.
• The window frame is being replaced.
Please complete a residential building permit application, rather than this permit,IF:
• The window size is being increased or decreased.
• A new window with a new opening in the building wall is being installed.
If your project includes electrical work, we provide Labor & Industries (L&I) electrical forms in
our office. Call L&I at(360)417-2700 for more information about electrical permits.
A detailed floor plan of the dwelling is required. Label all rooms, and indicate door and
window locations and sizes. If you are replacing all the windows, check here
otherwise indicate on the floor plan which one(s) you are replacing. (NOTE: A door with
50% or more glass is considered a window.)
Please verify that the replacement doors and windows meet the minimum U-factors required by
the 2004 Washington State Energy Code:
.40 or better U-Factor for Windows: Yes ,No
.20 U-factor for Doors: Yes ./ No
NOTE: the International Building Code (IBC) has specific requirements regarding safety
glazing at hazardous locations, emergency escape windows in sleeping rooms, and smoke
detectors. See attached IBC section to determine if any of your glass needs to be safety glazed.
Name of Legal Owner(s): I ULA
Mailing Address: 2 Z '/} crj} \ --�(�PC(-
1
City, State,Zip: •-L� ¢ _ D24"1$'
Phone: 317o -3 1 C( �� � iz )
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http://www.cityofpt.us/DSD/Forms/NeedsToBeGrouped/APPlication-Window Replacement Permit.doc
Page 1 of 3
01/11/2007
Property Street Address: l l A -
Zoning District: Parcel#
Legal Description:Additionle[ Z 351410 Utclitock Lot(s)
Contractor's Name:
Mailing Address:
City, State,Zip:
Phone:
Labor and Industries License#: Expiration Date:
City Business License#: Expiration Date:
Estimated Value of Construction: $
Estimated Start Date: Estimated Completion Date:
Applicant Certification
The applicant hereby certifies to have knowledge of those sections of the International Residential Code
and the Port Townsend Municipal Code pertinent to the above project and that the applicant is responsible for
constructing in conformance with these codes; the applicant understands that the permit, if issued, expires in six
months unless work is started; that the permit, after construction has started, will expire after one year if an
inspection is not made to show significant progress on the structure;the applicant agrees to abide by the ordinances,
codes, regulations, restrictive covenants, deed or plat restrictions, and water and sewer plans attached hereto; the
applicant certifies that all information given above and on accompanying plans is complete and accurate to the best
of their knowledge; and the applicant understands that this information will be relied upon in granting permits and
that is such information is later found to be inaccurate any permits may be withdrawn.
The undersigned hereby saves and holds the City of Port Townsend harmless from any and all causes of
action,judgments, claims,or demands, or from any liability of any nature arising from any non-compliance with any
restrictive covenants, plat restrictions, deed restrictions, or other restrictions which may have been established by
parties other than the City of Port Townsend.
Complete Application
Port Townsend Municipal Code, Section 16.04.140, Vested Rights - Substantially Complete Building
Permit Application: Applications for all land use and development permits required under ordinances of the City
shall be considered under the zoning and other land use control ordinances in effect on the date a fully complete
building permit application, meeting the requirements identified in this section, is filed with the Development
Services Department. Until a complete building permit application is filed, all applications for land use and
development permits shall be reviewed subject to any zoning or other land use control ordinances which become
effective prior to the date of issuance of a final decision by the City on the application.
An application of a building permit shall be considered complete when an application meeting all of the
requirements of Section 105.3 of the currently adopted International Residential Code is submitted which is
consistent with all then applicable ordinances and laws. In addition, if applicable,to be considered complete, such
an application must be accompanied by complete applications for a subsidiary land use or development permits
needed, such as a complete shoreline management permit application and/or complete applications for other
discretionary permits required under the ordinances of Port Townsend.
�--- (k°13 12 b -I
Signa o Ap ' ant or Authoriz Ppr eigtative Date
For O ial Use Only • -'' �1 ��
Building Official Approval Permit#: Date Issued
http://www.cityofpt.us/DSD/Forms/NeedsToBeGrouped/Application-Window Replacement Permit.doc
Page 2 of 3
01/11/2007
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City of Port Townsend
Development Services Department
BUILDING FEE SCHEDULE
1. To find your project's valuation,multiply the square footage by the appropriate values below.*
2. Go to the Fee Table below to determine your Building Permit Fee.
3. Multiply the Building Permit Fee by .65 to determine your Plan Review Fee. This is the minimum fee due
upon submittal of your application. You may pay all the fees at submittal time if you wish.
4. Your project may have additional fees,such as Public Works. Please see the Public Works permit fees sheet.
RESIDENTIAL FEES Note: Fees quoted before the time of permit application may be subject to change.
Separate structures will be valued separately.
Foundations: $14.98 x Patio Slab: $4.92 x =
Manufactured Homes:$7.15 x = Garages:
(Includes slab/runners,blocking,hold-downs,skirting,utility Wood Frame $25.03 x =
connections,etc.A separate electrical permit is required)
Carports:
Dwellings (includes finished basements): Gable $16.10 x
Wood Frame $95.17 x 52.8 =65fg 2.4q:74.Flat $12.12 x =
Masonry $99.81 x =
Storage Room $56.62 x = Storage Sheds: (Over 200 sq. ft. floor area)
Unfinished, unheated,to be finished in future Insulated $25.84 x =
$37.15 x = Un-insulated $20.49 x =
Basements: Pole Buildings:
Semi-Finished $22.50 x = Slab(<300 sq.ft.) $3.94 x =
Unfinished $17.17 x = Slab(>300 sq.ft.) $2.94 x =
PLUS Building $13.27 x =
Covered Porches: $25.84 x =
Townhouses: $71.38 x =
Decks: $12.49 x 54 =)p99.0 1p PLAN REVIEW FEE: 4.27. S1
Stairs, per lineal ft.$129.88 x = BUILDING PERMIT FEE: 5 7. 7Lc
�O
Railings," " $15.43 x = HOUSE NUMBER: $3.00 per address
TOTAL VALUATION: �j � 'Aq g, 92 STATE BUILDING CODE SURCHARGE: $4.50
TOTAL FEES: RECORD RETENTION FEE: $3.00-$10.00
TOTAL VALUATION BUILDING PERMIT FEE
$1 to$500- $23.50
$501 to$2,000 $23.50 for the first$500,plus$3.05 for each additional$100 or fraction thereof.
$2,001 to$25,000 $69.25 for the first$2,000,plus$14 for each additional$1,000 or fraction thereof
$25,001 to$50,000 $391.25 for the first$25,000,plus$10.10 for each additional$1,000 or fraction thereof
$50,001 to$100,000 $643.75 for the first$50,000,plus$7 for each additional$1,000 or fraction thereof
$100,001 to$500,000 $993.75 for the first$100,000,plus$5.60 for each additional$1,000 or fraction thereof
$500,001 to$1,000,000 $3,233.75 for the first$500,000,plus$4.75 for each additional$1,000 or fraction theteof
$1,000,000 and up $5,608.75 for the first$1,000,000 plus$3.15 for each additional$1,000 or fraction thereof
* The Building Department establishes building permit fees based on Section 108 of the International
Codes. The
fees are calculated using the estimated fair market value of the project (material + professional labor costs). The
value includes the total value of all construction work, including finish work. The Plan Review Fee, which is 65%
of the Building Permit Fee, is paid at the time of application submittal. The Building Permit Fee,and any additional
fees, is paid at the time the permit is issued.
All fees are based on fair market values. The values may be adjusted to coincide with the quality and individual
characteristics of your project. The Building Department will establish an estimate using"good"values per square
foot for similar buildings in the region. These estimates are updated on a regular basis. The valuations were taken
from the MARSHALL& SWIFT Residential Cost Handbook and Building Standards, March/April 2002, and are
estimated square footage values for residential and accessory buildings.
P:\DSD\Department Forms\Building Forms\Fee Schedule-Buildings.doc/3/1/2006
Grantor(s): Syverson Grantee: City Hold Harmless Indemnification Covenant Page 1
Jean M.Walat
City of Port Townsend
Waterman&Katz Building,Suite 301
181 Quincy Street
Port Townsend,WA 98368
HOLD HARMLESS INDEMNIFICATION COVENANT
AND NOTICE TO TITLE
Grantor(s): SYVERSON, Gary and Kirsten
Grantee: City of Port Townsend, a Washington municipal corporation;
Shorelines Exemption# LUP04-126
THIS COVENANT is made on this day of , 2004,
By Gary and Kirsten Syverson (hereinafter "Owners"), residing at 7314
Steilacoom Blvd., Lakewood, WA 98499. This Covenant shall constitute a burden
upon, and run with the real property described herein.
Legal description: Owners own the following described real property that is currently vacant,
legally described as
Lot 1, Island Vista Addition, City of Port Townsend, Jefferson County.
Assessor's Property Tax parcel no. 963-700-001
NOTICE IS HEREBY GIVEN to the Grantor(s)/Owner(s)of the above-referenced real
property,to potential purchasers and future owners,to agents or representatives, and to any other
concerned person or entity:
1. A BLUFF IN EXCESS OF 100 FEET HEIGHT IS PRESENT ON THE SUBJECT
PROPERTY. THE PROPERTY IS THEREFORE SUBJECT TO CHAPTER
19.05, ENVIRONMENTALLY SENSITIVE AREAS (ESA's),PORT
TOWNSEND MUNCIPAL CODE. THERE IS A 25 FOOT BUFFER FROM THE
EDGE OF THE BLUFF; LIMITATIONS ON ACTION IN OR AFFECTING THE
BUFFER OR STABILITY OF THE BLUFF MAY EXIST.
Grantor(s): Syverson Grantee: City Hold Harmless Indemnification Covenant Page 2
2. IN ADDITION,THE SUBJECT PROPERTY IS WITHIN A HALF-MILE OF AN
ACTIVE BALD EAGLE NEST. BALD EAGLES ARE KNOWN TO USE
LIVING AND DEAD TREES IN THE VICINITY. SPECIAL CONDITIONS
REGARDING DEVELOPMENT AND USE OF THE PROPERTY ARE
DOCUMENTED BELOW:
In accordance with and in consideration of the Shoreline Substantial Development Permit
Exemption LUP04-126 and conditions contained therein, Owners acknowledge, covenant, and
agree as follows:
1. Owners propose to construct a single-family residence on a lot situated on an
approximate 100+ foot bluff, approximately 90 feet from the edge of the bluff.
Owners agree that they are fully aware of the risks inherent in building at close
proximity to the bluff.
2. The bluff along the property facing the Port Townsend Bay has not experienced
significant slope failure or stability problems; however, construction and site
development can seriously affect slope/bluff stability. Development of the property
is subject to the provisions of a geotechnical report dated 10/21/04 prepared for the
property owners by NTI Engineering and Surveying, 717 S. Peabody Street, Port
Angeles, WA 98362. Bluff erosion in the general area provides sediment for sand
nourishment for beaches below the bluff.
3. Owners, as their free and voluntary act, accept and assume all risks of loss or damage
arising out of the conditions described herein, and further agree to relieve and hold
harmless the City of Port Townsend, its officers, agents, and employees, of any
liability for approval of the development and the engineering design of the
development.
4. Owners agree to and shall hold harmless and indemnify the City of Port Townsend, its
officers, agents, and employees, from and against any and all liability, loss, claims,
suits, damages, costs or expenses(including attorney's fees)that may at any time arise
or be set up because of reduction in value or damage to property or personal injury by
reason of the conditions existing now or hereafter on or around the property, or due to
any construction or development or design pursuant to the Shoreline Exemption or any
building or other development permits issued there under.
5. Owners agree that their representation herein and agreement to hold harmless and
indemnify the City of Port Townsend shall be binding upon Owners, Owners'
heirs, successors and assigns, and shall run with the land described herein.
Grantor(s): Syverson Grantee: City Hold Harmless Indemnification Covenant Page 3
6. Under the Port Townsend Shoreline Master Program, shore defense works such as
bulkheads or seawalls may not be constructed on spits,hooks, bars, barrier beaches or
similar accretion terminals or accretion shore forms.
7. Heavy construction equipment and/o materials shall be kept away from the edge of the
bluff. Excavated soils shall not be stored on site without engineering approval for
location and amount.
8. Owners shall maintain groundcover and revegetate disturbed areas. Native, drought-
tolerant vegetation should be used for landscaping. Heavy irrigation or other
activities that would contribute large quantities o f water to the soil should be
avoided, as excessive water may cause slope erosion and instability.
9. Any vegetation removal within 25 feet of the bluff is subject to the City's
Environmentally Sensitive Areas ordinance(PTMC 19.05). No vegetation removal in
the 25-foot bluff buffer shall be permitted without review by the City for conformance
with all applicable regulations.
10. Surface water shall not be allowed to flow over the face of the bluff and cause erosion
of the bluff face. This can be controlled with vegetation and using berms or swales to
direct runoff to a drainage system.
11. Surface runoff from hard surfaces such as roofs, driveways, walkways and patios must
be controlled as specified in an engineered stormwater control plan.
12. Silt fences or other sediment control devices may be needed during construction to
avoid sediment runoff, erosion and silting of stormwater facilities.
13. An engineered stormwater control plan must be approved by the City to ensure
compliance with the above conditions. All drainage control devices must be
maintained in good working order and inspected at least once a year.
14. The Applicant is encouraged to implement the recommendations in the DOE
pamphlet"Vegetation Management: A Guide for Puget Sound Bluff Property
Owners. A copy of the DOE pamphlet has been supplied to the applicant.Native,
drought tolerant species, especially those that provide good habitat, are recommended
to help preserve the bluff habitat. Excessive irrigation of lawn or landscaping may
cause bluff instability.
Grantor(s): Syverson Grantee: City Hold Harmless Indemnification Covenant Page 4
15. The property is subject to the City's tree conservation ordinance. No trees may be
removed prior to issuance of a building permit. Additionally,because the property is
within one half mile of an active bald eagle nest, and because eagles are known to use
large trees along the subject bluff as perching sites,no trees shall be removed from
the property without prior review by the City. Replacement of removed trees may be
required.
16. Owners shall record this Hold Harmless Indemnification Covenant and Notice to
Title with the Auditor of Jefferson County, Washington.
17. This Covenant shall not be revoked or amended without the consent of the City of Port
Townsend, pursuant to an adopted resolution by the Port Townsend City Council
entered during an open public meeting.
HIS COVENANT is in effect on the same day and year as first written above.
��
• A t, 8 U
• d Wright, (erim Director Date
Development S- ices Department
City of Port Townsend
Grantor(s): Syverson Grantee: City Hold Harmless Indemnification Covenant Page 5
GRANTORS/OWNERS
Gary Syverson Date
Kirsten Syverson Date
STATE OF WASHINGTON)
) ss.
COUNTY OF JEFFERSON)
I certify that I know or have satisfactory evidence that Gary Syverson and Kirsten Syverson
signed this Hold Harmless Indemnification Covenant and acknowledged it to be their free and
voluntary act for the uses and purposes mentioned therein.
DATED this day of , 2004.
Print name:
NOTARY PUBLIC in and for the State of
Washington, County of Jefferson, residing at
My commission expires:
[Pre-ink notary stamp 1" from margin]
STATE OF WASHINGTON )
) ss.
COUNTY OF JEFFERSON )
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o*°°RrrOw CITY OF PORT TOWNSEND
c3 '_',,`i1 i DEVELOPMENT SERVICES DEPARTMENT
INSPECTION REPORT
N¢
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: (G.- 8 - 0.1 \ PERMIT NUMBER: 6 0- —0�
/ SITE ADDRESS: 1 \/ i3t&
PROJECT NAME: CONTRACTOR: /
CONTACT PERSON: ,GIS C.p
PHONE: 13 32`S C)
TYPE OF INSPECTION: S h�e f r-cciC flat 1 (-).5
AWKroU te,)\
❑ APPROVED ❑ APPROVED WITH ❑ NOT APPROVED
CORRECTIONS
` Ok to proceed. Corrections will be Call for re-inspection before
checked at next inspection proceeding.
Inspector ` �g Date k4Vo Qi
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.
i 0
°i°°pTrOw CITY OF PORT TOWNSEND
aiiiy
6" '_ ''t i DEVELOPMENT SERVICES DEPARTMENT
.� � INSPECTION REPORT
CP
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.
ATE OF INSPECTION: �p - ) O�` / PERMIT NUMBER: ) .0 C)7-- DO
SITE ADDRESS: I 1 V I S'i—Gt
PROJECT NAME: CONTRACTOR:
CONTACT PERSON: �G,56h PHONE: (Q 1 Q_5-6
TYPE OF INSPECTION: ) f 5 U t aj^(cYL&.
7tkPike,V(k,-A
0 , /-g- T ,----, -(( ,"f izbe
I.
0
/ ❑ APPROVED ❑ APPROVED WITH ❑ NOT APPROVED
---------V
I,�- CORRECTIONS
--- Ok to proceed. Corrections will be Call for re-inspection before
checked at next inspection proceeding.
Inspector e i ' Date
e 7
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.
• •
4v0FITrow CITY OF PORT TOWNSEND
li s E lit
DEVELOPMENT SERVICES DEPARTMENT
‘5 -r---
•••`:._4'1w:0-4:W-
.� 1, INSPECTION REPORT
w 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: 5- j-p7 PERMIT NUMBER: e LT 07 - D 0 c
SITE ADDRESS: I I V is-f-&.
PROJECT NAME: CONTRACTOR:
CONTACT PERSON: 3GSS3t PHONE: (p 4 3 3.5O
TYPE OF INSPECTION: RQ IL I n 1010► f vU 1 h Ci YY) pAl a v i - O J
' (:CkTri I L,i 4t- Y tAtk_71 `? C)klAtl?,C__ 0.17477tti
'.-Pit fc.;c":=J;Li VLK_,
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❑ APPROVED ❑ APPROVED WITI ' ❑ NOT APPROVED
( CORRECTIONS �,,.
Ok to proceed. Corrections wul be Call for re-inspection before
4r) / . checked at next inspection proceeding.
Inspector IC -` Date '57 6 0
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 ins ection.
76 I.1 ��LIOAt
• •
.L0*p°RTrw CITY OF PORT TOWNSEND
DEVELOPMENT SERVICES DEPARTMENT
INSPECTION REPORT
"t� rFor 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: -(77/ 7 PERMIT NUMBER: /06-D 07- O 07
SITE ADDRESS: 8/ 11 --1-A- &DV
PROJECT NAME: CONTRACTOR:
CONTACT PERSON: 04l PHONE: 10V"—3Z S7)
TYPE OF INSPECTION: L/L//EIZ,GOO. /41e-/ZyXO&.
fl
❑ APPROVED ❑ APPROVED WITH ❑ NOT APPROVED
CORRECTIONS
Ok to proceed. Corrections will be Call for re-inspection before
checked at next inspection proceedi g.
Inspector t (;. ��.._ 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.
• 0
04QORTTO4,4,
CITY OF PORT TOWNSEND
=f ' ',,` i DEVELOPMENT SERVICES DEPARTMENT
'--et,3. Olt/ INSPECTION REPORT
Q`w For inspections,call the Inspection Line at 360-385-2294 by 3:00 PM the day before you want
the !f31---- C inspection. For Monday inspections,call by 3:00 PM Friday.^
DATE OF INSPECTION: '/3/( , / PERMIT NUMBER: f3 " C6?
V/
SITE ADDRESS: /1 `5(t
PROJECT NAME: CONTRACTOR:
CONTACT PERSON: j( k.-- PHONE: b (/ --3 Z
TYPE OF INSPECTION: , ,tt, r ` Cit-d'� 11q /AJ
GJ /rte L. LtAcTit I
❑ APPROVED__) LI APPROVED WITH ❑ NOT APPROVED
CORRECTIONS
Ok to proceed. Corrections will be Call for re-inspection before
checked at next inspection proceeding.
Inspector ( C Date —/- /e) 7
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.
....
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Receipt Number:
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BLD07-009 963700002 Building Permit Fee $265.25 $29.93 $235.32
Total: $29.93
CASH N/A $29.93
.....------_----
Total $29.93
Page 1 of 1
genpmtrreceipts
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RESIDENTIAL CHECKLIST (For 1-2 Family Residences)
NAME OF APPLICANT:
Date Received with all necessary paperwork: By:
BUILDING REVIEW BUILDING PERMIT# L007- 009
Zoning= R . - Impervious Surface% =
Lot Coverage= OK w/zoning? Septic? If yes, contact County Env. Health
In a PUD? Yes/No Parking—need dimensions on site plan
1.7 Site Plan, all setbacks shown -- Address needed?
Completed Plans Checklist ADU?Prepare Notice to Title
Energy Code Checklist& Compliance Form If architect/engineer, plans wet stamp/signed
17 2 Sets of Plans Submitted? Garage?
Attached Detached
Type of Heat p If a new detached garage or ADU, give copy
✓ p of site plan to Francesca
t, Floor Plan: Number of bedrooms ev,-- Typical framing details/section
Number of bathrooms
Foundation plan; if calcs, holddown symbol Floor framing plan; if calcs, shear wall
&verbiage must be shown on plans symbol &verbiage must be shown on plans
Floor framing plan Elevation(s)
V" Roof framing section plan
PLANNING REVIEW (if applicable) LAND USE PERMIT#
ROUTED TO: DATE:
Critical Area Map checked. If in CA, what is it mapped? Slope:
Within 200 ft of Shoreline Ordinary High In Flood Plain? Fill out FEMA forms if yes
Water Mark?
Lots of Record review(all 3 must be true): 9 or fewer lot(s), plat created pre-1937, AND
development requires water, sewer, or street to be extended; OR if a block is owned with one SFR&
wants to build another residence. CHECK for prior Public Works permit if it was already issued!
PUBLIC WORKS REVIEW MIP# ($53 due) or SDP# ($330 due)
ROUTED TO: DATE:
Submittal Checklist attached 8-1/2 x 11 Site Plan reviewed for all items
All trees in ROW identified Septic? Need County OK FIRST
Pre-app Conference? Date held: PRE#:
Impervious Checked
Any work in ROW beyond a driveway apron needs Engineered Plans. DO NOT ACCEPT PERMIT
WITHOUT THEM! Water, sewer, and/or streets being extended? Need 4 sets of engineered plans.
Any existing or proposed easements for shared utilities or driveway w/adjacent property owners?
We must have the licensed contractor's name and information for ANY right-of-way work.
P:\DSD\Fomis\Building Forms\Checklist-Residential Building Plans-Front Counter Sep 06.doc Revised 9/27/06
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BUILDING PERMIT FEES CHECKLIST 43L00-2 - 009
Fees Based on Fair Market Valuation or Submitted Amount Valuation = 5).) .2.18. q 2_
FEES DUE AT SUBMITTAL
,t2 7' 5.4 Plan Review Fee (2010)
MIP $50 (2164)
MIP Record Retention Fee$3 (9992)
SDP Fees:
Street $62.50 (2164)
Water$62.50 (1201)
Sewer$62.50 (1361)
Storm$62.50 (1401)
SDP Record Retention Fee$10 (9992)
PW Inspection Fee$70 (2140)
Other
Other
TOTAL DUE AT SUBMITTAL
FEES DUE AT PERMIT ISSUANCE
625-7. 75 Building Permit Fee (2000)
.€17, to Propane Tank/Piping Inspection$47 (2000)
4. 50 State Building Code Surcharge $4.50 (2005)
Plus $2/unit for multi-family
House Number$3 (2200)
$3 per unit if multi-family
Hamilton Heights Recreation Fee$200 (5030)
Hamilton Heights Transportation Fee$156 (2167)
Lynnesfield Off-site Transportation Fee$231 (2168)
Record Retention Fee$3 to $10 (9992)
13. 11,0 Other -re chnoIpay dee - 2%
Other
7 2Z• 4 TOTAL DUE AT PERMIT ISSUE
Notified Permit is Ready to be picked up (Who/Date/Initials):
I I Impervious calculation to Finance sent (Date):
P:\DSD\Fonms\Building Fonns\Checklist-Residential Building Plans-Front Counter Sep 06.doc Revised 9/27/06