HomeMy WebLinkAboutBLD1976-00302 BUILDING PERMIT APPLICATION
Jefferson County Building Department• County Courthouse • Port Townsend, Wash.98368 • 385-13 / i
N E
I. LOCATION: geographic name pS W SIDE
�I DCElOF D / ipF�E'ET
N E Ay
S W FROM INTERSECTION • OAD AND C/.JGt�Gc ROAD
other specific location or landmark: /�.�ia�/f"y-7 rL.,:l...e__„--. __ ,-
LEGAL DESCRIPTION:
Lot Block ) Subdivision —
S3 IJ 8'4- '5. ( V
I ot.)rn nl
Tax Number /a Section Section Township Range
,S4, II.TYPE AND COST OF BUILDING -
Nic `' TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY
Vew building Ingle Family El County Resident
El Addition ulti-Family Is this structure to serve the residential
number of units or commercial needs of those employed
❑Alteration p Y
❑Hotel,Motel, Dormitory at either the U.S.Navy's Trident or
❑Repair,replacement number of units
Indian Island Facilities?
❑Wrecking ❑Mobile Home
❑Moving (relocation)
❑Other-Specify El YES ❑NO
❑Foundation only
USE
OWNERSHIP ull-time Residence
Privaprofte (individitualinstitution,corpora
etc.)tion, Second Home: Recreation Cabin,etc.
,
❑Public (Federal,State or local gov't.) UBC OCCUPANCY GROUP: ❑Second Home: Future conversion to
permanent residence
COST (Omit cents) Nonresidential- Describe in detail proposed use of buildings,e.g.,food
• Cost of improvement $ processing plant,machine shop,laundry building at hospital,elementary
c To be installed but not included school,secondary school,college,parochial school,parking garage for
in the above cost department store,rental office building,office building at industrial plant.
a. Electrical If use of existing building is being changed,enter proposed use.
b. Plumbing _ ,0/ L, ! A 14 1�c. Heating,air conditioning O
_ma
�__��• d. Other (elevator,etc.) 2,0 S O c
0 2 ( ri 6
• TOTAL COST OF IMPROVEMENT $
c
III.SELECTED CHARACTERISTICS OF BUILDING -
w PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL DIMENSI -
r Masonry (wall bearing) •Number of Stories
❑ ❑Public or Private
ood Frame •Total square feet of floor area,
ddual (sep ' t k,etc.) all floors,based on exterior
❑Structural steel dimensions
1. ElReinforced concrete TYPE OF WATER SUPPL •Total land area,sq.ft.
(7.} ❑Other-Specify El Public or private company e2o 7 XaO/
NUMBER OF OFF-STREET
dividual,(we cistern) PARKING SPACES
- �'az Enclosed
PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE
❑Gas Outdoors
❑Oil RESIDENTIAL BUILDINGS ONLY 2
lectricity �' Number of bedrooms V
❑Coal TYPE OF MECHANICAL
El Other-Specify
Number of Full ��
bathrooms
Partial
IV. IDENTIFICATION-
Name Mailing Address- Number,street,city and State ZIP code Tel.No.
1.
lir, i
Owner ��,,//��� ,{I , Y A 1 W - 2
2. j�rX/7)Z `Yam^
: tt0r
onrac to License o. ���r�-9 • j (X/ 3
. ri�Z- 9ra /o2ip S D-O Z
Architect
IA a `re le_ x( (g:so ►f.-
T - owner of this building and the undersigned agree to conform to all applicable laws.
Sig•a ure of applicant Address pplication date
ram e� 4 �— -- 7i,
PLANNING AREA (ELE7RICT _SCHOOL DISTRICT `7 J WATER DISTRICT
APPROVED BY
OLYMPIC HEALTH DISTRICT: \ \ �7.)
APPROVED BY: .� PERMIT FEE ISSUE DATE PERMIT NUMBER
• .‘ ‘ — -7--7
/-47/7/‘
BUILDING OFFICIAL / J 5.00
&lie Printery-Port Townsend •
• Robert Burpea
Chimacum, Wash.
732-4414
Septic Systnm
Scale 1"=40'
•
That portion of tho 510 foot of that portion of the south 3/4 of tho
NZ / r Soc. 35, Township 29 Ny I, Wf' ; Port LudlowHighway; ,.
1 4 0, SRange S-i�.�hwa/a o;<co;��
therefrom the right of way condp rnod for drainage canal of Highway District ;;i
State of Waahingtonp described ao follows; Beginning at tho point of intersection
of tho W Lino of said county road parallel with the south lino of acid N 510 foot
along the south lino 207 foot; thence no uh parallel to tho aaid woot lino of road
207 foot thence oaot parallel to said south lino 207 foot to said road thence
south along cad woof lino to point of beginning.
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STA1<ES
BU1PEE LEGAL
That portion of the 510 feet of that portion of the south 3/4 of the
NE 1/4 of Sec. 36, Township 29 N, Range I, WMM, Port Ludlow Highway, except
therefrom the right of way condemned for drainage canal of Highway District ;71
State of Washington, described as follows, Beginning at the point of intersection
of the W Line of said county road parallel with the south line of said N 510 feet
along the south line 207 feet, thence north parallel to the said west line of
road 207 feet thence east parallel to said south line 207 feet to said road
thenco south along said west line to point of beginning.