HomeMy WebLinkAboutBLD1988-00031 . r
BUILDING PERMIT APPLICATION
Jefferson County Building Departm County Courthouse •Port Townsend, Wash i • 385-9141
N E
I. LOCATION: geographic name S W SIDE OF ROAD FEET '.
N E W J�
5 W FROM INTERSECTION OF ROAD AND_c� JCc OAD
other specific location or landmark:
LEGAL D CRIPTION: / 1 ,
Pp-02 Lot �j Block
,,S 1 l c� r �/ Subdivision /
//woo Tax Number %Section Section
. TYPE AND COST OF BUILDING -
TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY
•
(pNevv building 0J Single Family
L l/ � ❑New County Resident
❑Addition ❑Multi-Family
Is this structure to serve the residential
❑Alteration
number of units or commercial needs of those employed
❑Repair,replacement ❑Hotel,Motel, Dormitory at either the U.S.Navy's Trident or
number of units Indian Island Facilities?
❑Wrecking
❑Mobile Home
❑Moving (relocation)
❑Other—Specify ❑YES ONO
❑Foundation only
OWNERSHIP
USE
❑Full-time Residence
❑Private (individual,corporation,
nonprofit institution,etc.) V-----3 ❑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
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 /]/))�� / , ' yt3� (9 C�
c. Heating,air conditioning `/(wt/'\ /� LP Ji
d. Other (elevator,etc.) 1\ 4" � IC{
• TOTAL COST OF IMPROVEMENT $ ' Cn ° .
III.SELECTED CHARACTERISTICS OF BUILDING -
\ f , ' ,
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE ` --o .9 DIMENSIONS
�f;:�� •Number of Stories
Masonry (wall bearing) ❑Public or Private
— , •Total square feet of floor area,
Wood Frame >�jndividu septic tank etc.) all floors,based on exterior
Structural steel /� dimensions
TYPE OF WATER SUPPLY
❑Reinforced concrete •Total land area,sq.ft.
El Other—Specify ❑Public or private company
ndivid al (well cistern) NUMBER OF OFF-STREET
PARKING SPACES
Enclosed
PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE
❑Gas Outdoors
❑Oil RESIDENTIAL BUILDINGS ONLY
'gElectricity — Number of bedrooms C
❑Coal TYPE OF MECHANICAL
` 'D0S cif
Number of Full
�Fl Ate-V ��1�' Partial
IV. IDENTIFICATION-
Name Mailing Address—Number,street,city and Stat ZIP code Tel.No.
S? ti) 31 ac 0 5 (? qgL JR
Owner „rT I-4� _
2. ,
Contractor State License No
3.
Architect e •
The owner of this building and the undersigned agree to conform to all applicable laws.
Xtu o ap licant Address _ Application date
. ^,()LI-12,--44-‘---- -5/ 3 S OA-14 15,4-47 d2.p F('- _-/
PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
APPROVED BY s \ Q�� '
w��.y.�{, \ =a- / t1 6LI�
JEFFA: 11ti: '.i .` likALTH DEPARTMENT
APPROVED BY: I 1 ANL PERMIT FEE ISS E DA/E RECEIPT NUMBER
Ca 381 CA)
AUG 1 'ilVe.,„. 43 i ? 0 o
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3UILDINetAININ✓ IAILDG DEPT 3 S ; cip
3 V rintery—Port Townsend
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Jefferson County P i ann i nn and Ru i i d i nn Department
Courthouse 3rd Floor
PO Box 1220
Port Townsenc3 , WA 98368
2 Ori-•S85-9 1 4 1
PERMIT # • RT D88-003 i TIATF. TSSTTF.TJ_ : 0R/O2 /Rn
STTF. Ai1DRF.SS ' 3135 OAK RAY Ri)
:PORT HAT)T,OCK. WA 983:39
OWNER -GT,ENN RATTSON PHONE : 437-9524
MATT,T NG ADDR - .ii 35 OAK RAY RD
PORT HADLOCK WA 983:39
CONTRACTOR . :NO CONTRACTOR PHONE.
MAILING AT)IJR '
CONTR . LTC #: EXPT RAT T OI'V DATE
PARCEL NO. . . - 921 1 91 -OO2
LEGAL DFSC . . - .STR 1 9-29-0 i EWM. TAX #
LOT BLOCK
T)ESCRTPTTON OF IMPROVEMENT: sinnie family residence
1 Fontina/Sethacks (Shoreline Setha .k) /Mohiie Home Rlnckinc:
F=0 C9-71 4 6 7/;1_ 4"„p
1 Foundation : re„ _ ljG 2-1 01:4" j ._. A vl/
i underground Piumhina/tlnoe nn -
1 Framing/Piumhinn/Chimney
,
i insulation
A‘itiff C)26- 77c--2. A NA
1 Sheetrock :
i Sewage Disposal System Final :
( Final /Occupancy Approval :
r2 / 241 C. 7-
CALL L 385-9 1 4 i 24 HOURS T N ADVANCE TO SCHEDULE INSPECTIONS .
Office Hours 9 a .m . to 5 n.m.
inspector ' s Hours 9 - 10 a .m.
24 Hour Recorder for inspections.
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