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HomeMy WebLinkAboutPermit File 4514 Queen Ann Way - - 1 1 o`S Y 0 CITY OF ANACORTES WASHINGTON coRt'" BUILDING DEPARTMENT CERTIFICATE OF OCCUPANCY This is to certify that the(Description of Building or Structure): rt S Fain:.1 Resi&ettce. Located At: 45 U- Qu.a.en Ann {d._y; STREET&NUMBER Owner: K nn th a>nd PaP: :°+.1T.:a'i2r. . 991 Constructed By: OWNER OR CONTRACTOR Bldg. Permit#: BLO-2005-0181 Date Issued: Apr`i 1 22, try-""" ' Occ. Group: a- Use Zone: Has Been Inspected And Occupancy Is Hereby Authorized. This 10th Day of ji1y 20 'I '1 /' r4 .i11i1 AUTHORIZING OFFICIg&f• SEE REVERSE SIDE FOR SPECIAL REQUIREMENTS. G IFinal Inspection Checklist I Site Address: Iip-7- 0_, et-h Ant) f,/J,;( Permit No.: 0 _4 - D l Y. / Date Issued: // 2 2 0 S Zoning: ! ` 7.- Occ. Group: R 3 Constr. Type: (/ Owners Name: k „ e f h -r f< lri c ,4 A // ti , S e Owners Mailing Address: State: Zip: Variances: No Yes Safety Glass: No Yes Sewer Fee Paid: No Yes Hand Rails: No" Yes o Sewer Inspected: No Yes Guard Rails: No Yes C77 WSEC Compliance: No Yes Traps: No Yes 4,, Attic Access: No Yes G Stove: No Yes Smoke Detectors: No Yes o Water Pressure: No Yes V T&P Drains: No Yes o House Numbers: No Yes / Insulation Cert.: No Yes o Site Drainage: No Yes v' Curb Cut: n�� No Yes - • Crawlspace Insul: No Yes c- Bedroom Windows: No Yes o Water Heater Strp: No Yes V Dior Ranier- Pao— — - D.W. Air Gap: No Yes 1/ 177 Water Meter Box: No Yes Auto Garage Door: No Yes Exterior Decks/Landings: Not Yes o Outside Caulking: No Yes Garage/House Door: No Yes V Inspected By: Cam' JCki -- - pae &^ No Yes Date: /-r/ 1 "2-7 7 O 7 t° /r Exh. Duct/Dryer Vent Dampers: No Yes ✓' /2 7/ 07 `'o a 1 I o < -(o! COat� ,/,� .o / ��^p �1 A Public Works f Engineering and Development Services Residential Inspection Address: 957 4 Mee v7 n vs (/a, , Date: LI 3 -0 7 Owner Contractor: Inspected by: 1. Water Meter Box n J p ❑ Set firm and level to finished grade or backside of sidewalk elevation. { VI Lid and box undamaged. Water meter and customer shutoff installed. NJ No debris. ® Accessible—no landscape obstruction. %4. © Driveway installation has drive-over box and lid. ,sJ Customer gate valve intact ® No leaks at connections. 2. Curb and Gutter ,® No cracks, damage, graffiti, footprints, finishing blemishes, or other objectionable marks. If road frontage improvements: in Expansion joints every 15 feet and at driveways. ( Concrete has broom finish. ® No low spot at curb line, especially at driveway cut. Maximum grade change in 20 feet is % inch. 3. Sidewalk � > No cracks,damage, graffiti, footprints, finishing blemishes, or other objectionable marks. jr, ADA compliant— 1 percent slope to curb. If road frontage improvements: ,® Expansion joints every 15feet and at driveways. '4' Concrete has broom finish 4. Driveway Approaches iNo cracks, damage, graffiti, footprints, finishing blemishes, or other objectionable marks. In ADA compliant. S. Streets Kj No cracks, blemishes. If road or alley improvements: . ❑ Received proctor and sieve analysis of ballast, crushed rock, and asphalt. ❑ Received passing materials testing reports for sub-grade, ballast, crushed rock, and asphalt. ❑ Received tonnage tickets consistent with required thickness per approved plans. 6. Sanitary Sewer Inspection card signed off and/or verified in Building Department database. As-built record filed in the address file. �, Screw cap(s) installed on clean-out(s). NI Clean-out(s)set at finished grade. 7. 'torm Drainage ❑ Inspection card signed off and/or verified in Building Department database. As-built record filed in address file. j\ja ❑ Not blocked or diverted to adjacent parcel. 8. Public Utilities Out of Traveled Way WA ❑ Concrete collars around Cityutilities_ IN Final grading ok. ❑ Restored to prior condition or better. 9. `tan pe ❑ Bonded o pletion at later date. Verified against approved landscape plan: ❑ Installation. - ❑ Type and quantity of plants. gr Sod or seed in place. ❑ Root barrier(receipt filed). 10. Erosion Control Measures - ® BMPs removed. 154 All debris removed. Site dean. 4 Permanent vegetation established. INSULATION CERTIFICATE A & E Insulation, Inc. 15205 39th Ave NE Marysville,WA 98271 (360)651-1058 1761 Vt h,4- Co n^,si-ittc+ion. Contractor-Builder!Homeowner's Name i1514j QU -fl , Wit i j ADDRESS J Pnweviim WA. 90,21 CITY STATE ZIP RECORD OF INSTALLATION BLOWING WOOL BATTS AND ROLLS AREA ❑ NEW CONSTRUCTION IF RETROFIT: R-VALUE THICKNESS INSULATED ❑ RETROFIT CEILINGS 7 IoC. IN I700 SQ FT DEPTH OF PREVIOUS 3b Io IN I ItSS SQ FT NUMBER OF BAGS USED INSULATION IN ,,__ pp WALLS �I CJIN )1o�/JSQFT AREA INSULATED ESTIMATED R-VALUE OF SQ FT PREVIOUS INSULATION IN SQ FT THICKNESS OF INSULATION TYPE(S)OF PREVIOUS FLOOR Sc'3 )D IN U94 SQ FT INCHES INSULATION IN ATTIC IN SQ FT R-VALUE OF INSULATION INSULATION CONTRACTOR SIGNATURE c�ksk L(1 Lka DATE a HOME BUILDERS SIGNATURE DATE COMPANY PHONE ADDRESS A& E Insulation, Inc. does guarantee that all work performed is free from defective material and is constructed in accordance with sound construction standard, in a workmanlike manner in compliance with all laws currently applicable to the work. In addition, we guarantee to repair or replace any or all of the work and/or material which may prove to be defective in workmanship and/or material: except for ordinary wear and tear and unusual abuse or neglect for a period of one (1)year from Date of Substantial Completion. �r G Anacortes Planning & Community Development Dept. ;,r Permit Center aSt P.O.Box 547,Anacortes,WA 98221-0547 PH(360)293-1901 Ian Munce,Director • Edwin Frank,Building Official FAX(360)293-1938 April 30, 2007 Kenneth and Patricia Alluise 4514 Queen Ann Way Anacortes, WA 98221 RE: 4514 Queen Ann Way Temporary Certificate of Occupancy This letter will stand as a "Temporary Certificate of Occupancy" for the above referenced address, and will expire within 60 days from the above date, at which time the corrections will be completed and a permanent certificate will be issued. If you have any questions, please contact me at 293-1901. Thank You, CITY OF ANACORTES Paul Ingalls Building Inspector Acknowledgement: Sign re ate Lac 108124-1 ii .5 04118/2. 002 8 r illst r. 006335 $3_6.`0 G'iir ' 0 ., City of Anacortes Permit#: BLD-2006-0279 904 6th Street Issue date: 04/18/2006 "Paali esor P.O.Box 547 "" Anacortes, WA 98221-0547 Expire date: 04/18/2007 '. irk (360) 293-1901 "7't?O . '.: Job Address: 4514 QUEEN ANN WAY Permit Type: Renew Building Permit ANACORTES WA 98221-3226 Project: APN: P59260 Remarks: Renew permit BLD-2005-0181 Owner: KENNETH/PATRICIA ALLUISE Contractor: Address: 6010 PARKSIDE DR Address: APT 2 ANACORTES WA 98221-4805 Phone: (360)299-8684 Phone: License#: General Information: Fees: Renew Building Permit Fee 356.50 Total Calculated: 356.50 Deposits/Receipts: 0.00 Total Due: 356.50 li THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL HE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION --Net SIGNATURE ER AUTHORIZED AGENT ISSUED BY r&t Y 0 City of Anacortes Permit#: BLD-2005-0181 904 6th Street Issue date: 04/22/2005 w P.O.Box 547 ,:, Expire date: 04/22/2006 Gj Anacortes, WA 98221-0547 (360) 293-1901 Job Address: 4514 QUEEN ANN WAY Permit Type: Single Family Residence Permit ANACORTES WA 98221-3226 Project: APN: P59260 Remarks: New single family residence Owner: KENNETH/PATRICIA ALLUISE Contractor: Address: 6010 PARK SIDE DR Address: APT 2 ANACORTES WA 98221-4805 Phone: (360)299-8684 Phone: License#: General Information: Fees: Lot Area 9996 Plan Review Deposit 100.00 I 1st Floor Square Footage 344 Building Permit Fee 713.00 2nd Floor Square Footage 1749 Plan Review Fee 363.45 Garage Square Footage 574 Mechanical Permit Fees 107.40 Deck Square Footage 598 Plumbing Permit Fee 111.00 Building Valuation 211164 State Building Code Fee 4.50 # Forced Air Furnace<=1,000 1 Sewer Inspection Fee 50.00 #of Backflow Devices 2 Storm Drain GFC-Residential 1,126.00 #of Bathtubs 2 Sewer GFC-Residential 5,646.00 #of Clothes Dryers 1 Park Impact Fee 615.00 #of Dishwashers 1 Traffic Impact Fee 900.00 #of Gas Fireplace 1 Total Calculated: 9,736.35 #of Gas Piping 1 Deposits/Receipts: 100.00 #of Gas Water Heaters 1 #of Water Piping 1 Total Due: 9,636.35 #of Hose Bibbs 2 #of Kitchen Sinks 1 #of Lavatories 2 #of Range Hoods 1 #of Showers 1 #of Ventilation Fans 3 #of Water Closets 1 II THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE Off/LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. i SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSU BUJ 0507704-1 0005 03/18/2005 002 4 Permit Fass 006335 $100.00 1 .t �":'Bw='� S'.".,." ^� lY.'��,%i4''" ,',+,I Y- .gym :.`6:�P;: syd.rn` ...r,� .: $' `. .,� C '�.1' 3. '..a';:•:.:%..• v, sr I } + ,..- .,;.�Yx� fir' "?`L;' ,'yif; '"Er " '' 5;. - `�i 9:11W u, is,:' ;. I.-;-. a , "7. : }mot„-'/' n wP ± 4/ YY2. 1 " \}" d 9:rR::�:r 7$ a s .54,' Y >e - '-, "u?-I:dG"a.-�5:�'$".a:,', '.:. i% t :Rv ay- irW nip . 4 "R`''„, .h...... ve . :. ,, w yy `" $iz"' ::R < May ,,yam, v,sAlerSix. aii .x. ^r.;hrk. 4'M" .''2. ` + S'>'..'FC''a rd i" i�.,:b bx`'" :. .r yq oid Site Address: qc 1 ,1 Queer AN Na (AM-tf Parcel No,: Lot: Li S Block: Div: LI Addition: ;ma�x'", x k. . ,: w 'nfi. T.�J ,,,,p... .,y.,x.'.�t`G�iJt.,G _;e3 Ar� •..e�°.S s".i' h.11T." n�b,.^L,�:7' +'ip''::.:•,.-.,kkµ.�ly, ���.,i . ;;.S��.FS'r�;u'ti=-"'rirel� �R,Y4'y:,�:+�%:r�"ya�id�, �"�, , .. :u.:.1:`:::(2 3, v?.,_ :..1.'... ,.. .. ., .,.., M1..ri r ,. _..e... -.� 'z_ ...4Nc�'�f?..,.V.;fi xta.,.�..SC."J ...,, Name aK�lu NcT"ti t RiT RA C.tra Name Name Kc.pi N or ft J (a LL Ls"$C ALL-LiISa. -- ptNIvc2 Mailing Address Apr Mailing Address Mailing Address (oblo FrARKSWE 1J2 City: State: Zip: City: State: Zip: City: State: Zip: ANACORI-CS WA 98aa1 Contractor Lic.No.: Phone No.: a 9 c( g(o g t f Phone No.: Phone No.: Exp Date: Contact Person: S rim C. Phone No.: s r. (Check One) Single Family:V/ Multi-Family: Apartment: Condominimum: Senior Housing: Retail: Office: Restaurant: Manufacturing: Storage: Bank: Assembly: Accessory: Automotive Repair: Other(Specify) DESCRIPTION OF WORK: 11UtI0\ HOUSE .,, :..., : :x:D...':.,•:.i:x is^.::.::'-c a'�:-z; �"ti�'�s._h. .. . .. ..'�.y�.. ...e... 7 . < --F,. Y. .. -_ t`?'.ov;.9.4;i:_J.',:y^:°-a•:` -. . iii)ni it-8 Street Setback: (od ft. 2nd Floor: 1 1 •-9 sf. (Circle Y or N) lst Side Setback: S ft. 3`d Floor: sf- Shoreline/Wetlands Y i 2nd Side Setback: 17 ft. Basement: sf Water on/Adj.To Property Y Rear Setback: 2.3 ft. Occ. Group: Soils Report Y Use Zone: Carport Area: se Sensitive Area Y 1 Type of Construction: c2Tc . Garage Area: S'7 L'{t sf. Latecomers Agreement Lot Area: q 49(y sf. No.of Stories: 2/0?, to a j Fire Hydrant(250 Feet) 61 No.of Dwellings: I Building Height: 4.3. 9 Variance � Lot Coverage: 3g00 Deck Area: 5 9 g sf Coven. n ry'f, Y N ls'Floor I- .fl se3g4 �_-!, f.,* GHQ -) ( to Pub 1'!! \PN_I_�_i AE VE Project Valuation(Labor and Material Cost): I I i/ 1011 I .l o e a B 9 7UQi ' Ill., fir8 rq'pa THIS APPLICATION IS RECEIVED BY THE BUILDING OFFICIAL UNDER THE PROVISIONS OF TILE u •ORNI BUI AI�l OREIrR'N 11,EXPIRE BY LIMITATION AND BECOME NULL AND VOID IF PERMIT IS NOT OBTAINED WITHIN 180 DAYS OF THIS APPLIC 4 '' °Y-kFFI�I0 MY SIGNATU.B I HEREBY CERTIFY THAT I AM THE LEGAL OWNER OF THE PROPERTY FOR WHICH THIS APPLICATION IS ISSUED OR AN AUGIIORIZED AGENT OF THF.OWNER. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE EEICOMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT,INCLUDING CALLS FOR INSPECTIONS. SIGNATURE: ` � Y cam' DATE: 3/ 1 c' CJ c Sid - 2onS- o//J J O E= 122.42. r �- R= 1345. - �� N ^ram" N 1 -� i (� !0— \ 1 ' ,'��'�.,^ r' .,-may' ll i HIGHEST POINT ON j �i LOT +124.4$' f sit -- 5• SYSB / STEPPED '�� --� \i/ ` RETAINING WALL _..r" ea- -------- \ 16.9S 1 1 �f / \ RE5IDEHCE it/ 0 1 \ \ i 1 f 1C T RED DECK AREP I. Ilk . �g 'o_o COVE o/ 7.7.--'7. rem iDi SVN DECillesie K AREA - I r T7 T 0 114' 4" DRAIN PIPE TO �n ! 4 Z STORM DRAIN III l 110'" DRIVEWAY I - 1 1 BRUSHY WOODS AREA \ E= 1 01 .35 • ---------` `= $3.55' L. i.„:„.j.-7.240) .--- E= 105.57' c.,, 0 'o 0 I �n� n QUEEN ___________A --- ..--fir 1 yea--- �.- PLOT PLAN SCALE: 1 " = 10' I CITY OF ANACORTES "AS-BUILT" P sewer y 77 r Storm CONTRACTOR: Jan �kr CUn,$ t 1, 3h PLAT/DIVISION: /� BLOCK Sft LOT ADDRESS: J tjl a flont.J4y DATE: ?�1L1 /0 6 PERMIT# CIO-2o' S'=U I B I SCALE 916 = I i S TREET t lank 146vNS r P‘WR Q LA. 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' f •,-/: ,.A. ... , .•!* • * ii.t.: ,... * - f ' •.. j ' ' l ! . ' .• . 4NT r • . . ,, i 10.•*, , p• ' .) ',1•'— te '4 -f4 , ., t .,; .. - ,, , ..• - .. ,,,,, • . ... . . a • ,. . •„if t o r ALI ,Aair,„ 4 '.'4, • . . •.% ' % _ ... I . . , .. i 4,- •-i14.•• . , � r►' � !. " ' it r41746. .I. .t - . �� $ . s: 1�;a- a a a• • .� i + - - # - • '"� • .lit h h . -4- A , k • tit �' J 1 ti L. 4' 11 I' _is4rd �T • /+ 11 L F •r a • Y ' ' 4, 400,.iz..l .r.i - + .' r :r I Gas: p 0 ♦ .r . a " r ] 1 .. ro r. �g• '.I. �.S Y i iS M!• i t. e P.c 46* X iii, 11 i •4. 6- :4 je Ill 44' .r .a 3 Aill. e fr it,`�t .. • i1 . ...F ,a r },►, �j' a,�_ « ,c. . . ; L} l • tip. ' A , •...r ' • *• • • • A ! F' a . `App, 1• ttp_ 11 444 40 .4 i • . . �; . .4.. r` . (: f 40044� • *0 Or ibir . ,.,,:?• ,s • -• 4 •�' r , . . . _ I t• . , 61.... •,, -, , ,,, vt 't.t ' , P.. ..- • .:',*:. .r.. i",,..47.c'•t-r • .., v•...*Iirtk• ii4r-• Vita 0011101 :. i I 1,';.-.;s•' 30$1! '- ' Nr.ats . .,''!•'4P'7-..--.:.--f,. ..10...._al: ' -' -a-' ' '.-• - _ . _ 0. • tA .„._ ---,'"0. rii ".""46,., 01111W.V. 44.1111140115kh lit ,,...,_ . . .. ,-- -01 . low 'f• 1111.0. .0,„' 0 ,.....„ _0'._.-...... - t. . .. - • lik. -. is• ..„. . -- -....,. - --,, . _ ... I w"IIIIIIIIIIIIIIIIIIIII'lloftrHHHIH.'" - .... r ' '4 .. - - \, . \ _ 'SI, '""‘''t-,,. t. '..,.. -i. i. • • Y 1 y • ' + yEa • .. : 4,-, Y 6 1 ` it tit k. i .--1 •4 I, ..".. &lit— . ,:p:\,. k It ` �� ; kl+r ;11 "` lk 11 a ' 4 t -ii , lip, !i 1. NI P J 0, Lac 108124-1 ii .5 04118/2. 002 8 r illst r. 006335 $3_6.`0 G'iir ' 0 ., City of Anacortes Permit#: BLD-2006-0279 904 6th Street Issue date: 04/18/2006 "Paali esor P.O.Box 547 "" Anacortes, WA 98221-0547 Expire date: 04/18/2007 '. irk (360) 293-1901 "7't?O . '.: Job Address: 4514 QUEEN ANN WAY Permit Type: Renew Building Permit ANACORTES WA 98221-3226 Project: APN: P59260 Remarks: Renew permit BLD-2005-0181 Owner: KENNETH/PATRICIA ALLUISE Contractor: Address: 6010 PARKSIDE DR Address: APT 2 ANACORTES WA 98221-4805 Phone: (360)299-8684 Phone: License#: General Information: Fees: Renew Building Permit Fee 356.50 Total Calculated: 356.50 Deposits/Receipts: 0.00 Total Due: 356.50 li THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL HE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION --Net SIGNATURE ER AUTHORIZED AGENT ISSUED BY r&t Y 0 City of Anacortes Permit#: BLD-2005-0181 904 6th Street Issue date: 04/22/2005 w P.O.Box 547 ,:, Expire date: 04/22/2006 Gj Anacortes, WA 98221-0547 (360) 293-1901 Job Address: 4514 QUEEN ANN WAY Permit Type: Single Family Residence Permit ANACORTES WA 98221-3226 Project: APN: P59260 Remarks: New single family residence Owner: KENNETH/PATRICIA ALLUISE Contractor: Address: 6010 PARK SIDE DR Address: APT 2 ANACORTES WA 98221-4805 Phone: (360)299-8684 Phone: License#: General Information: Fees: Lot Area 9996 Plan Review Deposit 100.00 I 1st Floor Square Footage 344 Building Permit Fee 713.00 2nd Floor Square Footage 1749 Plan Review Fee 363.45 Garage Square Footage 574 Mechanical Permit Fees 107.40 Deck Square Footage 598 Plumbing Permit Fee 111.00 Building Valuation 211164 State Building Code Fee 4.50 # Forced Air Furnace<=1,000 1 Sewer Inspection Fee 50.00 #of Backflow Devices 2 Storm Drain GFC-Residential 1,126.00 #of Bathtubs 2 Sewer GFC-Residential 5,646.00 #of Clothes Dryers 1 Park Impact Fee 615.00 #of Dishwashers 1 Traffic Impact Fee 900.00 #of Gas Fireplace 1 Total Calculated: 9,736.35 #of Gas Piping 1 Deposits/Receipts: 100.00 #of Gas Water Heaters 1 #of Water Piping 1 Total Due: 9,636.35 #of Hose Bibbs 2 #of Kitchen Sinks 1 #of Lavatories 2 #of Range Hoods 1 #of Showers 1 #of Ventilation Fans 3 #of Water Closets 1 II THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE Off/LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. i SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSU BUJ 0507704-1 0005 03/18/2005 002 4 Permit Fass 006335 $100.00 1 .t �":'Bw='� S'.".,." ^� lY.'��,%i4''" ,',+,I Y- .gym :.`6:�P;: syd.rn` ...r,� .: $' `. .,� C '�.1' 3. '..a';:•:.:%..• v, sr I } + ,..- .,;.�Yx� fir' "?`L;' ,'yif; '"Er " '' 5;. - `�i 9:11W u, is,:' ;. I.-;-. a , "7. : }mot„-'/' n wP ± 4/ YY2. 1 " \}" d 9:rR::�:r 7$ a s .54,' Y >e - '-, "u?-I:dG"a.-�5:�'$".a:,', '.:. i% t :Rv ay- irW nip . 4 "R`''„, .h...... ve . :. ,, w yy `" $iz"' ::R < May ,,yam, v,sAlerSix. aii .x. ^r.;hrk. 4'M" .''2. ` + S'>'..'FC''a rd i" i�.,:b bx`'" :. .r yq oid Site Address: qc 1 ,1 Queer AN Na (AM-tf Parcel No,: Lot: Li S Block: Div: LI Addition: ;ma�x'", x k. . ,: w 'nfi. T.�J ,,,,p... .,y.,x.'.�t`G�iJt.,G _;e3 Ar� •..e�°.S s".i' h.11T." n�b,.^L,�:7' +'ip''::.:•,.-.,kkµ.�ly, ���.,i . ;;.S��.FS'r�;u'ti=-"'rirel� �R,Y4'y:,�:+�%:r�"ya�id�, �"�, , .. :u.:.1:`:::(2 3, v?.,_ :..1.'... ,.. .. ., .,.., M1..ri r ,. _..e... -.� 'z_ ...4Nc�'�f?..,.V.;fi xta.,.�..SC."J ...,, Name aK�lu NcT"ti t RiT RA C.tra Name Name Kc.pi N or ft J (a LL Ls"$C ALL-LiISa. -- ptNIvc2 Mailing Address Apr Mailing Address Mailing Address (oblo FrARKSWE 1J2 City: State: Zip: City: State: Zip: City: State: Zip: ANACORI-CS WA 98aa1 Contractor Lic.No.: Phone No.: a 9 c( g(o g t f Phone No.: Phone No.: Exp Date: Contact Person: S rim C. Phone No.: s r. (Check One) Single Family:V/ Multi-Family: Apartment: Condominimum: Senior Housing: Retail: Office: Restaurant: Manufacturing: Storage: Bank: Assembly: Accessory: Automotive Repair: Other(Specify) DESCRIPTION OF WORK: 11UtI0\ HOUSE .,, :..., : :x:D...':.,•:.i:x is^.::.::'-c a'�:-z; �"ti�'�s._h. .. . .. ..'�.y�.. ...e... 7 . < --F,. Y. .. -_ t`?'.ov;.9.4;i:_J.',:y^:°-a•:` -. . iii)ni it-8 Street Setback: (od ft. 2nd Floor: 1 1 •-9 sf. (Circle Y or N) lst Side Setback: S ft. 3`d Floor: sf- Shoreline/Wetlands Y i 2nd Side Setback: 17 ft. Basement: sf Water on/Adj.To Property Y Rear Setback: 2.3 ft. Occ. Group: Soils Report Y Use Zone: Carport Area: se Sensitive Area Y 1 Type of Construction: c2Tc . Garage Area: S'7 L'{t sf. Latecomers Agreement Lot Area: q 49(y sf. No.of Stories: 2/0?, to a j Fire Hydrant(250 Feet) 61 No.of Dwellings: I Building Height: 4.3. 9 Variance � Lot Coverage: 3g00 Deck Area: 5 9 g sf Coven. n ry'f, Y N ls'Floor I- .fl se3g4 �_-!, f.,* GHQ -) ( to Pub 1'!! \PN_I_�_i AE VE Project Valuation(Labor and Material Cost): I I i/ 1011 I .l o e a B 9 7UQi ' Ill., fir8 rq'pa THIS APPLICATION IS RECEIVED BY THE BUILDING OFFICIAL UNDER THE PROVISIONS OF TILE u •ORNI BUI AI�l OREIrR'N 11,EXPIRE BY LIMITATION AND BECOME NULL AND VOID IF PERMIT IS NOT OBTAINED WITHIN 180 DAYS OF THIS APPLIC 4 '' °Y-kFFI�I0 MY SIGNATU.B I HEREBY CERTIFY THAT I AM THE LEGAL OWNER OF THE PROPERTY FOR WHICH THIS APPLICATION IS ISSUED OR AN AUGIIORIZED AGENT OF THF.OWNER. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE EEICOMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT,INCLUDING CALLS FOR INSPECTIONS. SIGNATURE: ` � Y cam' DATE: 3/ 1 c' CJ c Sid - 2onS- o//J J O E= 122.42. r �- R= 1345. - �� N ^ram" N 1 -� i (� !0— \ 1 ' ,'��'�.,^ r' .,-may' ll i HIGHEST POINT ON j �i LOT +124.4$' f sit -- 5• SYSB / STEPPED '�� --� \i/ ` RETAINING WALL _..r" ea- -------- \ 16.9S 1 1 �f / \ RE5IDEHCE it/ 0 1 \ \ i 1 f 1C T RED DECK AREP I. Ilk . �g 'o_o COVE o/ 7.7.--'7. rem iDi SVN DECillesie K AREA - I r T7 T 0 114' 4" DRAIN PIPE TO �n ! 4 Z STORM DRAIN III l 110'" DRIVEWAY I - 1 1 BRUSHY WOODS AREA \ E= 1 01 .35 • ---------` `= $3.55' L. i.„:„.j.-7.240) .--- E= 105.57' c.,, 0 'o 0 I �n� n QUEEN ___________A --- ..--fir 1 yea--- �.- PLOT PLAN SCALE: 1 " = 10' I i ------ y, • I `I r • _ • N \ t I. / STEPPED - -�I•uriR L ? cv IETAINING WALL pOING LINES PROaaVo 4. 16.93' 9�� t \ 11 1 It\/ RESIDENCE ' ' I r t o I o� o L ‘ aI COVERED DECK AREA o I. 1 C•I \ LCT u) 7 w` z \ 2 . '1., ` M DEC 'ifirPro ..._.--......_.—gib REA" p.. 1'14' ` I SUN K 15' PUBLIC o • • 4" DRAIN PIPE TO BEACH ACCESS IIISTORM DRAIN EASEMENT c SILT FENCE I i�r 1 - 1 \ ,.:' �=� I 10' `t _. SILT FENCE PROPOSED GRAVEL • PARKING AREA SEE NOTE 2 - • TEMP ra •CKPILE AREA I . n I o BRUSHY WOODS AREA • ovaraW. • :/:/ ' -- E. 101.38' y T 83.55 1 E= 105.57' j ✓ VO R= 1470.00' b -w _ A Opp QUEEN UVA O AN [yl ���� ...... — is ie 4