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HomeMy WebLinkAboutBLD1977-00455 f 1 t " • • ••••• - ‘ \vo • JEFFERSON COUNTY COMMISSIONERS 1—Health Dept. V Port Townsend, Washington BUILDING PERMIT APPLICATION IMPORTANT - Complete ALL items. Mark bones where applicable. Number and street V� , S ubdiv'sion ���, I Lot I Blo Census tract ! IATION OF N S ��// ��// —N S� BUILDING E W side of 417/31Cle-G? feet E W from intersection of(Other local geographic, political, or legal subdivision identification) wc3•=2 7, d Al /C//� II. TYPE AND COST OF BUILDING - All applicants complete Parts A - D J A. TYPE OF IMPROVEMENT D. PROPOSED USE - For "Wrecking" most recent use 1 j Flew building /4/Q,9441 ,4/' Residential Nonresidential 21 I Addition(If residential, enter number 12 Li One family 18 Amusement, recreational of new housing units added, if any, in Part D, 13) 13 Lj(] Two or more family —Enter 19 Church, other religious number of units—---—-► 31 I Alteration (See 2 above) 20 Industrial 14 L_i Transient hotel, motel, 41 Repair, replacement or dormitory — Enter number 21 Parking garage 5 I I Wrecking(If multifamily residential, of units- -► 22 Service station, repair garage enter number of units in building in 18 El Garage 23 Hospital, institutional Part D, 13) 16 L] Carport 24 Office, bank, professional 6 1 I Moving (relocation) 17 I 1 Other — Specify 25 Public utility 7 I Foundation only 26 School, library, other educational B. OWN ERSHIP 27 Stores, mercantile 8IIt•r''Private (individual, corporation, 28 Tanks, towers nonprofit institution, etc.) 29 Other —Specify 9I_] Public (Federal, State, or Qlocal government) C. COST (Omit cents) Nonresidential — Describe in detail proposed use of buildings, e.g., food processing plant, machine shop, laundry building at hospital, elementary 10. Cost of improvement $ school, secondary school, college, parochial school, parking garage for To be installed but not included department store, rental office..building, office building at industrial plant. in the above cost If use of existing building is being changed, enter proposed use. a. Electrical Lb. Plumbing -.S c. Heating, air conditioning d. Other (elevator, etc.) ii. TOTAL COST OF IMPROVEMENT $Z� L� M. SELECTED CHARACTERISTICS OF BUILDING - For new buildings and additions, complete Parts E - L; for wrecking, complete only Part J, for all others skip to IV. E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS 30 L]Masonry (wall bearing) 40 Li Public or private company 48. Number of stories 31 ood frame 41 Individual (septic tank, etc.) 49. Total squarefeet floor area, all floors, based onn exterior /�/1om( '� 321 I Structural steel dimensions T 331 I Reinforced concrete H. TYPE OF WATER SUPPLY 34 L-j Other —Specify 42 I{/rPublic or private company 50. Total land area, sq. ft 411,..5-G7<7 431 I Individual (well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed �7 351 I Gas Will there be central air 52. Outdoors /`"'•• 361 Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY 371 lectricity 441 i Yes 45 LI No 53. Number of bedrooms n 381 I Coal 391 1 Other —Specify Will there be an elevator? ` Full 54. Number of J1( 461 I Yes 47 I I No bathrooms Partial IV. IDENTIFICATION - To be completed by all applicants Name /�e Mailing address —.Number, street, city, and State ZIP code Tel. No. Owner1. /5A/YC. #/�T /7 /7ai .3 47)'C .23k 527, 5. • /f0, c'v e 'v/rs l© K.y3c-,c/.e.." 39/3 2. Ere/Q aee e,e, 52 '5- r<i•Qk�sox:, 44.1 i, to%a.�> ,�-ez- Contractor State License No. /�/de174%% A' f�d.4Yep A 2 3-'/-r Y-AA"•- _ `1'8 V- 9' .3e;v3 3. ,S.40e G/y .-if f"3C7 Architect The owner of this building and the undersigned agree to conform to all applicable laws of (name of permit jurisdiction). Signature of applicant Address C,'9- �9-- Application date _ /' ` 9 /"�- j ' !. ,4 $$ci, / C,ev, 5- /9-7 7 l rt DO NOT WRITE IN THIS SPACE - FOR OFFICE USE • Approv.e9y Permit fee Date permit issued Permit number v-r k $ 7a ,00 =O- 77 / 777 6/Iar77 • • Phone (206) 385-3913 BANCROFT NONENCUMBERED PROPERTY - DISCOVERY BAY Route 3 , Box 238 , Port Townsend, Washington 98368 Beginning at the intersection of the north boundary of the "Four Corners - Chevy Chase" county road and the west boundary of the southeast quarter of the northwest quarter of Section 32 , Township 30 north, Range 1 West, W. M. , thence north along the west boundary of the southeast quarter of the northwest quarter of Section 32 , Township 30 north, Range 1 west, W. M. a distance of 300 feet; thence east along a line parallel to the north boundary of the southeast quarter of the northwest quarter, a distance of 550 feet, thence south along a line parallel to the west boundary of the southeast quarter of the northwest quarter to its intersection with the north boundary of the "Four Corners - Chevy Chase" county road; thence northwesterly along said north boundary of "Four Corners - Chevy Chase" county road to the Point of Beginning. • • 7--)3 y 03 E. Caroline OLYMPIC HEALTH DISTRICT Receipt No. v9 ' [-' Pert Angeles, Wa. SEWAGE DISPOSAL PERMIT _ . v 457-8583 Submit in Duplicate Builder t, . d 802 Sheridan DATE /1/1 ---- vi, Port Townsend, Wa. 335-0722 Installez , -.../. ^ H O';ATNER ADDRESS PHONE DIRECTIONS, IONS FOR Lc \TINE SI`T'EJ�;�)y f- 7 l he:/�Li (',1d•r,, c_7o/� v=, iPCC. - -e i INSTALL NEW i SYS• �i�^y ) ],REPLACE SYST1 PARTIAL REPAIR F-` TANK/DRAINFIELD H TYPE OF NO. OF SITES` '= z BUILDING i 'iJr� ax REDRO^ 3 -- --- BASEMENTr' sIz r r r 4L_ i „...i ,a 1 Aft- q H DRA.INFIE LD . 1OTH / 7l0 WIDTH -D -7. 1'),-#-IaINES c? T t� SIZE /,'.�Jr' GAL. fj _- % COMPARTMENT CIPARTMENT . 1?1 DRAW DETAILED PL.)? PLAN BELOW. STUB PLUMBING ,7)UT ABOVE FOUNDATION FOOTING LI H e SOIL LOG: L \.t\-� \--..t ,'- f��i1 � ,� . IM a Q� • 1�T� 7 , • A _ 1 ii ��i11 jiJ 'l , )L w \?�sc'�• 4-i/C-P : A \ • �-� NSA_ r ANY CHANGE IN BUILDING OR SEWAGE DISPOSAL PLANS, OR LOCATION INVALIDATES THIS PERMIT UNLESS PRIOR APPROVAL IS OBTAINED FROM THE HEALTH DEPARTMENT. • APPROVED: DATE INSPECTED PARTIAL/FINAL DATE SANITARIAN'S COMMENTS: el SEE REVERSE SIDE FOR AS BUILT Oa-tO 2-7 7 1•5'4 IR • 0 Purchaser agrees to be solely responsible for and hereby warrants the following: a. That he has good and legal title to the subject property, free and clear of all encumbrances. b. That the boundary lines of the subject property are as represented by Purchaser to Contractor for the purpose of the project contracted for. c. That all requirements of the applicable zoning codes including set-back requirements are met by the location of the house on the subject property as requested by Purchaser. d. That suitable road access to the subject property is and will be available to the Contractor during the construction period. e. That the geological and all other sub-surface conditions of the subject property are suitable for the construction and use of the home contracted for. f. The establishment of appropriate structural site elevations related to fixed reference. PLOT PLAN THE HOUSE IS TO FACE DIRECTION INDICATED BY FRONT DOOR ON DRAWING BELOW. 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