HomeMy WebLinkAboutBLD1984-00017 .T P.T—r. R 5S C-Yr C7 C-)T Y T'T lr=T :=s t T T T.i)T N C= F- r=1.rc FV1 T m
Jefferson Cnunty Pianninn and Ruiidincr Denartmer...t
Cnurthnuse , 3rd F1nnr
PO Fox 1 220
• Pnrt Townsend; WA yn.znrs
206-355-9141
PFRM T # •RLfR4-0017 T)ATF. TSSi1Rf . : 10/30/84
STTF. AI1DRF.SS : 59 i% F.YROIY Rig
PORT LUDLOW, WA 95365
OWNER - TREK WILLIAMS PHONF : 732-4924
MA T LTNG AT)T)R : 1 70 EMROflY Ri)
PORT LunLoW WA 95855
CONTRACTOR . _ :NO CONTRACTOR PHONE :
MATTING AI/17R ,
CONTR . T.TC #: EXPIRATION DATE :
PARCEL NO_ . . : 801112-014
r,ErAr, DFSC . _ :STR 12-2R-01 WWM . TAX #
TOT RT,00h
7F.SCRTPTTON OF IMPROVEMENT : single family residence
) Fnntinr/Sethanks (Shoreline Sethack) /Mnhiie Home Rlnckinri:
—— -- - --
( ) Foundation : --- -
{ } ilndergrrnm[i PlumhingiTlndergrrnund Tnsniatinnc
i r^ramingiPlumhinnJChimney
-._._.._
) Insulation :
) Sheetroc-k
- .
SewaC7e Disposal System Final :
i F, ^.� ti;:r-�;r: ncv Approval .
/,Uwe - la /30 l�� �2L /
CAL.T. 385-9141 24 HOTIRS TN ADVANCE. TO SCRF.DTILF. INSPECTIONS .
Office Hours 9 a . m . to 5 n. m.
Inspector ' s Hnurs 9 - 10 a . m.
24 Hnur Rer.nrder fnr Tnsnectinns.
t
BUILDING P.RMIT,APPLICATIOC
Jefferson County Burg Department • County Courthouse • Port Townsend, (Rash.98368 • 385 7370
NE
I. LOCATION: geographic name 5 W SIDE OF ROAD FEET
NE
5 W FROM INTERSECTION OF ROAD AND/2? `I���- - ROAD
, other specific location or landmark: /574
LEGAL DESCRIPTION:
p CO Subdivision q ,. )
Lot .W SCO Block p E _ i 2 O Iv 1 Ir`-'
Q eV/2A l/./ Tax Number R Section Section Township Range
II. TYPE AND COST OF BUILDING
•
TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY
New building Ingle Family ❑New County Resident
❑Addition ❑Multi-Family Is this structure to serve the residential
number of units or commercial needs of those employed
❑Alteration
❑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 ❑YES ONO
❑Foundation only
•
USE
_
OWNERSHIP ❑Full-time Residence
Private (individual,corporation, ❑Second Home: Recreation Cabin,etc.
nonprofit institution,etc.) f
❑Public IFederal,State or local govt.) UBC OCCUPANCY GROUP: y 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. py
` b. Plumbing AA A-tn - Coot?- 24..430 I Its (13 �3))�L.(
c. Heating,air conditioning Z s.c o F-1.00 W--. 2`(x z q 52‘ ref ✓ ( ?/
p �)� "7�j
d. Other (elevator,etc.) $Aysµex..�s 2'(.`/3$ �1 12_ ld 8' f "
• TOTAL COST OF IMPROVEMENT $
•
III.SELECTED CHARACTERISTICS OF BUILDING - �/ "C.� .2-, _
DIMENSIONS 3
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL •Number of Stories ;/
Masonry •
(wall bearing) ❑Public or Private
❑ •Total square feet of floor area,
od Frame E3,4tflividual (septic tank,etc.) all floors,based on exterior - di
Lii O
rmensions
❑Structural steel SfMeNT '9.3-6
TYPE OF WATER SUPPLY ���111 oral land area,sq.tt.
❑Reinforced concrete IQ--I !'M'
❑Public or private company
❑Other—Specify NUMBER OF OFF-STREET
• fJ1lndividual (well,astern) PARKING SPACES
Enclosed
PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE
Outdoors
❑Gas
DOH Nion) RESIDENTIAL BUILDINGS ONLY
Number of bedrooms 2.
❑Electricity
TYPE OF MECHANICAL I
ID Coal W I/� _ {Full
G-1 Number of
Other—Specify 00 bathrooms
Partial.-1-. I
`
IV. IDENTIFICATION- •
Name Mailing Address—Number,street,city and State ZIP code TeL No.
mss-;-1 C., a let 1710 e-w,_b occc 2eAck 13..
Owner SRC.M / I.. S ?ovr 1 (110,o 3 WA Qg 36 r 49 a4
2. Se l� 1
Contractor State License No.
3. Se
Architect
The owner of this building and the undersigned agree to conform to all applicable laws.
Signature o�rf applicant / Address A3 o/ n date fl
R,,:i ,,,A. i WYteitAnd- Atik i- A/20,/€ 1 Z PLANNING AREA ( FIR • - 'ICT �� HOOL DISTRICT WATER DISTRICT
o APPROVED BY 6t_ set-,•.i 6. - �
I- ll f'- — (,,_ \ ``p JE/pERSOr COUNTY HEJ.LT,- OLPT w, - \•:`- � vr�`
ISSUE DATE PERMIT NUMBER
I APP'�E Y: PERMIT FEE •it.: \.,. - , •&.A It'll?)5° • 210'5 . .BUILDING OFFICIAL / S
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