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HomeMy WebLinkAboutBLD1977-00013 BUILDING PERMIT APPLICATION - .7/.4 Jefferson County Building Department• County Courthouse •Port Townsend, Wash.98368 • 385-1310 NE I. LOCATION: 'geographic name S W SIDE OF ROAD FEET NE S W FROM INTERSECCTIO,N�OF "`A�p ROAD AND D n ROAD other specific location or landmark:` 1�-g-" J �+�A• 0-4K0 KYLu , /� -+1'� JY LEGAL DESCRIPTION: 10 I-f' Q I v,p-- 1 ....1Z1.44 44____,, Lot Block Subdivision Tax Number %Section Section Township Range II.TYPE AND COST OF BUILDING - TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY ew building .Single Family New County Resident 'ID dition ❑Multi-Family Is this structure to serve the residential Alteration number of units or commercial needs of those employed ❑Hotel,Motel,Dormitory at either the U.S.Navy's Trident or El Re pa it replacement p number of units � o Indian Island Facilities. ❑Wrecking ❑Mobile Home ❑Moving(relocation) ❑Other-Specify ❑YES >KO ❑Foundation only USE OWNERSHIP 12 S›LFull-time Residence �rypivate (individual,corporation, nprofit institution,etc.) ❑Second Home: Recreation Cabin,etc. ❑Public (Federal,State or local gov't.) UBC OCCUPANCY GROUP: ❑Second Home: Future conversion to permanent residence COST (Oiitcents) Nonresidential- Describe in detail proposed use of buildings,e.g.,food • Cost of improvement $ processing plant,machine shop,laundry building at hospital,elementary To be installed but not included ` school,secondary school,college,parochial school,parking garage for in the above cost t 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 T '�'`' ` i 3©O c. Heating,air conditioning 'a '_ q 4 ..• d. Other (elevator,etc.) - • TOTAL COST OF IMPROVEMENT $;KA- 0©e- & d- C..1± III.SELECTED CHARACTERISTICS OF BUILDING - PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL DIMENSIONS Masonry (wall bearing) •Number of Stories ❑ g ❑Public or Private •Total square feet of floor area, ood FramertQi'vidual (septic tank,etc.) all floors,based on exterior 'LI Structural steel ���Vl dimensions TYPE OF WATER SUPPLY f'i•Total land area,sq.ft. 4 .V 1-o ❑Reinforced concrete "'I ? Public or private company ❑Other-Specify NUMBER OF OFF-STREET di idual (well,cistern) PARKING SPACES Enclosed PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE ❑Gas Outdoors ❑Oil RESIDENTIAL BUILDINGS ONLY Q ` -CM (.1/►► Number of.><ectricity ll ❑Coal TYPE OF MECHANICAL Number of Full ❑Other-Specify bathrooms Partial IV. IDENTIFICATION- Name Mailing Address-Number,street,city and State ZIP code Tel.No. 1. I C, - . _ , 7q C Owner -5 b 9- 4 c-r` i ki k Contractor Stave Liceli o se . I 1 3. Architect The owner of this building and the undersigned agree to conform to all applicable laws. Signature of applicant Address Application date ei#421.9416044'ij — /174'" 77 PLANNING AREA F1 i ISTRICT .�u.... SCHOOL DISTRICT 50 WATER DISTRICT APPROVED BY ∎ (V/7/77 OLYMPIC HEALTH DISTRICT: `� �� .' APPROVED BY: PERMIT FEE ISSUE DATE PERMIT NUMBER ii., __./ LQ ,pet.d.,...c- BUILDING OFFICIAL 9,2 '9) ()..<9.0_--)1 1 eot The Printery-Port Townsend 1 jL i" VaYnl 1 f 11! t 4 00) /� i /C ?d pi, ►�C 1/e v1 r Ca 111/:.;:". r a .S'f4tifAil L 4."wt d 7/ 4",f :%'� ��,:i.o!' ,r243...p a 1 t el 74 eY'L ��/ 5 7 /Yli.,rs- G�.,-n� /c.�,��rc ay s � r�-�?8 i"I . f,v't Es/ i.VILl> 41)417.60e.e091:77;J-0". <7—r e-