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Home My WebLink AboutBLD1993-00700!r ill 410 JEFFERSON COUNTY BUILDING APPLICATION Jefferson County Permit Center Castle Hill Mall 621 Sheridan St. Port Townsend, WA 98368 206-379-4450 PERMIT # •BLD93-0700 DATE RECEIVED. : 09/24/93 SITE ADDRESS: 1160 SHINE RD :PORT rK W 98 3-9-L(4r6 Q.� , cmm 5 OWNER •JIM & MARY SMERSH PHONE:236-0757 MAILING ADDR: 3400 81ST PL SE • :MERCER ISLAND WA 98040 CONTRACTOR. . : MAILING ADDR: PHONE: • CONTR. LIC #: EXPIRATION DATE: / / ARCHITECT/ . . :TOM HOUHA PHONE: 467-0236 DESIGNER • 614 1ST AVE MAILING ADDR: : SEATTLE WA 98104 PARCEL NO. . . : 721031007 SEPTIC -4) DATE. Z LEGAL DESC. . :STR 03-27-01 EWM, TAX # 8 : LOT 1 , BLOCK WATER :(,S/�. DATE: SHORELINES: DESCRIPTION OF IMPROVEMENT: single family residence BY: DATE: BUILDING TYPE •RES BEDROOMS--- BATHROOMS-- TYPE OF IMPROVEMENT:NEW EXIST. : 0 EXIST. : 0 MAIN FL. . . : 1398 sf ADD'L FL. . : GARAGE/CARPORT •A 9 sf PROP. . : 3 PROP. . : 3 HTED BSMT. : 1085 sf WOODSTOVE TOTAL. : 3 TOTAL. : 3 UNHT BSMT. : 0 sf UBC OCCUPANCY GROUP:R3 SEWAGE DISP. . : SEPTIC CARPORT. . . : 0 sf TYPE OF CONST WATER SUPPLY. :PWELL GARAGE 484 sf UNITS. : 1 STORIES: 2 HEAT TYPES. :HTP/ / DECKS • DIMENSIONS: MOBILE HOME 700 sf FRAME TYPE:WOOD COMMERCIAL: 0 sf MAKE: YR: INDUSTRIAL: 0 sf EST COST. $: 111250 SIZE: PROD GRP. . : 4575 BANK HT. . . :4 ft SH SETBACK: 50 ft Owner/agent FEES Signature: type amount by date recpt -',c PRMT $ 681. 50 AK 09/24/93 83607 Date: PLCK $ 204 . 45 AK 09/24/93 83607 Issued By: B.C. $ 4 . 50 AK 09/24/93 83607 RADO $ 10. 00 AK 09/24/93 83607 Date: $ 900. 45 TOTAL JEFFERSON COUNTY UNIVERSAL PLOT PLAN AND DEVELOPMENT APPLICATION (This is not a permit) Fill in the following information as completely as possible PROPERTY OWNER NAME " 4 � , A `" PHONE " 7 5 7 MAILING ADDRESS ` () W t Else',-< ZIP `' ` ?v CITY/STATE =f.° �` APPLICANT NAME (if different) PHONE or AUTHORIZED REP (circle one) MAILING ADDRESS SEPTIC DESIGNER L- PHONE Z 3 >� ra MAILING ADDRESS ° {' GENERAL CONTRACTORS L.: `; $'k, °�3 CM-At) ,' r e„„ MAILING ADDRESS ` ° C "4` > A PHONE 7 0 :. 40 STATE LICENSE NUMBER tA'li EXPIRATION DATE u.` ARCHITECT SI \r PHONE ' MAILING ADDRESS LOAN LENDER NAME/BOND HOLDER NAME MAILING ADDRESS PHONE SITE ADDRESS: 65 911#/BOND NAME ... � " ; ZIP CODE LEGAL DESCRIPTION: SUBDIVISION NAME LOT BLOCK DIVISION TAX NUMBER 9 DIGIT PARCEL NUMBER --7 ., - O -7 SECTION TOWNSHIP ° NORTH RANGE WM DESCRIPTION OF IMPROVEMENT: �` PLEASE FILL OUT ALL OF APPLICATION **** Dear Property Owner: Please fill this form out as completely as possible. The legal description and 9 digit parcel number may be obtained from your tax statement or from the Assessor's Office in the Jefferson County Courthouse. Please make yourself at least one copy of this form so that you may use it for future development of your property. **** Mailing address: Jefferson County Permit Center, 621 Sheridan, Port Townsend, WA 98368 - , • N\ "#••••(•-•,,,,,.,,,;...,A14..#`,.,..:N.'al 41'4' ,,,11" " , ,,,11:.#7,4#4,0•- ‘' t' t t ' ' ••• Y ' f 1 I ...., if I , 41,t I 1 , I i ' I / I I I / EXISTING PARR tOAc.) 1 I I i / / ...- .....1,..- --— / 1 _......E13.. ' I / N1* 39", 501 .,..s E .... /—(1 ...,,,,........,...",.....r.Oillemeibmini Indens....... r......../ i , / // / 1 .,. 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II ! — — ----' I I I , .•,. , , , I I , . 1 41/ JEFFERSON COUNTY BUILDING APPLICATION Jefferson County Permit Center Castle Hill Mall 621 Sheridan St. Port Townsend, WA 98368 206-379-4450 PERMIT # •BLD93-0700 DATE RECEIVED. :09/24/93 SITE ADDRESS:1160 SHINE RD :PORT LUr6 5 OWNER •JIM & MARY SMERSH PHONE:236-0757 MAILING ADDR:3400 81ST PL SE :MERCER ISLAND WA 98040 CONTRACTOR. . : PHONE: MAILING ADDR: rr_VLs\— CONTR. LIC #: EXPIRATION DATE: / / ARCHITECT/. . :TOM HOUHA PHONE:467-0236 DESIGNER •614 1ST AVE MAILING ADDR: :SEATTLE WA 98104 PARCEL NO. . . :721031007 SEPTIC DATE: L 53 LEGAL DESC. . :STR 03-27-01 EWM, TAX # 8 WATER :6 DATE: LOT 1 , BLOCK , SHORELINES: BY: DATE: DESCRIPTION OF IMPROVEMENT: single family residence BUILDING TYPE •RES BEDROOMS--- BATHROOMS-- MAIN FL. . . : 1550 sf TYPE OF IMPROVEMENT:NEW EXIST. : 0 EXIST. : 0 ADD'L FL. . : 398 sf GARAGE/CARPORT •A PROP. . : 3 PROP. . : 3 HTED BSMT. : 1085 sf WOODSTOVE • TOTAL. : 3 TOTAL. : 3 UNHT BSMT. : 0 sf UBC OCCUPANCY GROUP:R3 SEWAGE DISP. . :SEPTIC CARPORT. . . : 0 sf TYPE OF CONST • WATER SUPPLY. :PWELL GARAGE • 484 sf UNITS. : 1 STORIES:2 HEAT TYPES. :HTP/ / DECKS • 700 sf DIMENSIONS: MOBILE HOME COMMERCIAL: 0 sf FRAME TYPE:WOOD MAKE: YR: INDUSTRIAL: 0 sf EST COST.$: 111250 SIZE: BANK HT. . . :4 ft PROJ GRP. . : 4575 SH SETBACK:50 ft Owner/agent FEES Signature: type amount by date recpt Date: 11�� PRMT $ 681.50 AK 09/24/93 83607 PLCK $ 204.45 AK 09/24/93 83607 B.C. $ 4.50 AK 09/24/93 83607 Issued By: j 151� � RADO $ 10.00 AK 09/24/93 83607 fy Date: $ 900.45 TOTAL 01/ • 41 'JEFFERSON COUNTY BUILDING PERMIT APPLICATION BUILDING TYPE IMPROVEMENT TYPE IGf SINGLE FAMILY NEW BUILDING ❑ MOBILE ❑ ADDITION 500+1500- C] MODULAR ❑ ALTERATION ❑ GARAGE ATTACHED/DETACHED ❑ REPAIR ❑ WOODSTOVE ❑ DEMOLITION ❑ MULTI-FAMILY/UNITS ❑ RELOCATION ❑ COMMERCIAL ❑ INDUSTRIAL ❑ HOTEL/MOTEL/DORM/UNITS ❑ OTHER UBC OCCUPANCY GROUP DESCRIPTION OF IMPROVEMENT: C,U1 t.C) N Hrt...1 ,.'k:`i t _ = s=====___ SQUARE FOOTAGE PRINCIPLE TYPE OF HEATING FUEL MAIN FLOOR + 55"a 0 76 ❑ ELECTRICITY ❑ OIL 2ND FLOOR '. 43t co 7)) 7° ❑ WOOD STOVE [W' GAS 3RD FLOOR a HEAT PUMP ❑ OTHER HTD BASEMENT I O S S oi t ID (° UNHTD BASEMENT l CARPORT --- PRINCIPLE TYPE OF FRAME GARAGE A$4 DECKS -7 00 �� LJ WOOD ❑ MASONRY COMMERCIAL 7066 ❑ MANUFACTURED ❑ OTHER INDUSTRIAL ❑ STRUCTURAL STEEL OTHER TOTAL VALUATION /!i J �(. OR ESTIMATED COST IG INSTALLED 19413 TYPE OF SEWAGE DISPOSAL: ❑ SEWER ieLTIC SYSTEM ❑ NOT INSTALLED =========..............===========.-=- ... ==x = ====== =sss=ss========s=ssC== ` TYPE OF WATER SUPPLY: PRIVATE DRILLED WELL OTHER PUBLIC ❑ CITY OTHER: NAME ❑ PUD STATE I.D. a: _=:===a=:=========sax=: = ====== = s===s==s=== NUMBER OF EXISTING BEDROOMS NUMBER OF EXISTING BATHROOMS NUMBER OF PROPOSED BEDROOMS NUMBER OF PROPOSED BATHROOMS TOTAL NUMBER OF BEDROOMS TOTAL NUMBER OF BATHROOMS IF WATERFRONT PROPERTY NAME OF ADJACENT BODY OF WATER 1415(S)12=6 G. e'L. BANK HEIGHT it` SETBACK °S O' sass=a========x=s a=== - =a s css = s= ___ SIGNATURE__� — A Z ` , DATE 4T ' Z. R3 APPLICANT NAME (PLEASE PRINT) I� �� (aresW 1