HomeMy WebLinkAboutBLD1985-00046r • ---
BUILDING PERMIT APPLICATION
Jefferson County Building Department • County Courthouse/ Port Townsend, Wash 96368 • 385-1310
N E
I. LOCATION: geographic name S W SIDE OF ROAD FEET
NE
S W FROM INTERSECTION OF ROAD AND ROAD
other specific location or landmark
��/7 ZZZ,AL/ Pe07-
,c')/-)
•
LEGAL DESCRIPTION: Subdivision
P - 0(S `° / s/ 6t,t /6' 26 /1� •
(gel I(l•/ Tax Number /P Sec Section Township / Range
II.TYPE AND COST OF BUILDING
TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY
•
0 New building \yiSingle Family ❑New County Resident
• D Addition D Multi-Family is this structure to serve the residential
0 number of units_ or commercial needs of those employed
Alteration
❑Hotel,Motel,Dormitory at either the US.Navy's Tndent or
D Repair,replacement number of units Indian Island Facilities?
D Wrecking D Mobile Home
o Moving(relocation) D Other —Specify ❑YES' ONO
0 Foundation only
-- USE
OWNERSHIP ❑Full-time Residence
D Private (individual,corporation, _ ❑Second Home: Recreation Cabin,etc.
public(Federal,decal,State etc.) _. �
❑Public(Federal,State or local gov't.) UBC OCCUPANCY GROUP:, 0 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 "1 ,ol..1 n cn3/C J L 0 3'7 `/y/, r T�V
C. Heating,air conditioning O�i,L6 1, — C(" ( t / -4 / ` e-//T"
I / ,'
d. Other lelevator,etc 1 ^L1/ /- b
(fir,, .. ' f [[[
• TOTAL COST OF IMPROVEMENT $ '121 13 / 6. e)0 p
III.SELECTED CHARACTERISTICS OF BUILDING - 04.2i&,34/x/
DIMENSIONS
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL •Number of Stories ,
. •
D Masonry (wall bearing) D Public or Private •Total square feet of floor area,
XWood Frame -,-kndividuaV(septic tapk,etc.) all floors,based on exterior
`- dimensions
D Structural steel
TYPE OF WATER SUPPLY •Total land area,sq.ft.
❑Reinforced concrete
D Public or private company
D Other—Specify ''``�� NUMBER OF OFF-STREET
/Individu (we)1l cistern) PARKING SPACES
Enclosed
• PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE -
D Gas G G°�X._J��G`-� Outdoors
RESIDENTIAL BUILDINGS ONLY
Doi, r CV c �-� °
_C_. Number of bedrooms
D Electricity
• /TYPE OF MECHANICAL
D Other Full
Number of
0 Other—Specify bathrooms Partial
•
IV. IDENTIFICATION-
Name Mailing Address Number.street,city and State ZIP code Tel.No.
1. {/) j '
7 ()&. C 3K5-
df�UpG /&2C17A
. 2_1/(P /()7
Owner .f / ///4
2. 2y - f / / - '
L L 6'Y// -17/19
Vremeelemar � State License ) G,v ` O Sz'
3. 5+.4-(.hns�-rlaAr (t)-n, q -eA Nror+taurM S ) a \2 Architect l 2
The owner of this building and the undersigned agree to con m to a I applicable laws.
Sign tore of appl, 't Address Application date
13 o
E PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
APPROVED BY
....
p JEFF N COVn'rY t-,EAL71 DEPT
61 APPROVED B Vc,, ��� 1-29 DATE PERMIT NUMBER
H° L OFFICIAL t�� -"---- ^ - ii--/&-EY -
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oJL 1•r Sr..1T;;_1; RE�!)1 ; tlS.
jet,rode 9 rap.y
/�fJ• kl LH.,I a U R
r'FkAddress____ /-3 2 At/C _.&11:::-.._ —
Applicant ' c :inc.
(work)
Phone (home) _
Z6
Building Location (legal description) sir V T T C 1 :N R R / L✓
'Parcel Number_
Adjacent Water Body /-/0 012 c/9-___
Based set
Eased on the information, the most waterwadmside of the proposed structure must
back at least -feet from the high water
b. feet from the edge of the bluff or bank
not to be determined without additional information
Additional comments: -
- A/1 .�f ��6 S'
�' ,
Signature, Jefferson County Shorelines
Administrator Building Dept.
Jefferson County planning $
County Courthouse
Port Townsend, WA 98368
38S-1427 _---------
---____--------------------- I,,.7�.Ry�C'eiy%�131uff stability -
q_sluff or Bank height 1
Adjacent kesidential Structures within 300 feet? yes no 1 >^/�
If yes, existing setback of adjacent homes:
Home g2:
Home �l:
foot setba k from bank
foot setback from bank applicant's
Prope
• foot distance from app
_ not distance from applicant s proper_�-
r information
Much of the above information is supplied by the applicant- Should any be"
inaccurate, this setback requirement may be changed.
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