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HomeMy WebLinkAboutBLD1990-00283 411, c r' 0 :-.T7F7.T.PTPFr.TRF;C)TNT C7CDTJT47r7.7 F3 T T T T.T3 T 1\T f. A T>1 T. .i. C-7 .A T'T. C71\r Jefferson County Planning an Building Department Courthouse . 3rd Floor PO Box 1220 Port Townsend: WA 98368 , 206-385-9141 )F.RMTT # •RT,D90-0283 T)ATF RFCF.TVF.T). :05 /01 /90 5TTF. ADDRESS : FT.AGT,F.R RD :NORDLAND, WA 98358 OWNER •CART. .TOHNSON PHONE. MAII TNG ADDR ' tic ', In3' es-i 8 :NORDLAND WA 98358 CONTRACTOR . . :PRARCF. r'3'cJ T T,DF.RS PHONE : MAILING ADDR: CONTR . T,T C #: PFSRCP61 41 P8 FXP i.RATTON T)A"T F. : 0 i/01 /90 ARCHTTFCT/ . . : PHONE : T)FSTGNRR MAILING ADDR : PARCEL. NO . : 02 1 332032 HEALTH: T,F.GAT., DF.SC. • : STR 33-30-01 F.WM, TAX # BY: DATE,: LOT , BLOCK SHORFT,TNFS : BY: T)ATF: DESCRIPTION OF IMPROVEMENT: storage hu i i d i ng /p p;;,,_,_ i_JS.s LY BUILDING TYPE •RFS BEDROOMS--- BATHROOMS-- MAIN FT... • . : 0 sf TYPE OF TMPROVFMFNT:NFW F.XTST . : 0 F.XTST . : 0 2ND FT, • 0 sf GARAGE/CARPORT • PROP. . _• 0 PROP. _• 0 3RD FT., • 0 sf WOODSTOVF TOTAL. : 0 TOTAL. : 0 BASF.MRNT. . _ 0 sf NBC OCCUPANCY GROUP:M1 SFWAGR DTSP. . _ CARPORT. . . : 0 sf TYPE OF CONST WAT"F.R. SUPPLY'. _• GARAGE. • 1 448 sf UNITS . : 0 STORTF.S : HFAT TYPES . : FCKS 0 sf DTMRNS T OiNS : 30 X 48 MOBTLR HOMF COMMFRC T AT.: 0 sf FRAME. TYPE: STET, MAKE.: YR : INDUSTRIAL : 0 sf FST COST $ : 14480 STZR: BANK HT. . . _ ft PROJ GRP. . : 456 SH SETBACK: ft Owner/agent FF.RS Signature: type amount by date recpt /9.61 PRMT16t' .60 MA 05/01 /90 45362 Date: `j/// $PT.CK S 24.;?J MA 05I01 i90 45362 R.C. $ 4 . 50 MA 05/01 /90 45362 T ssued By: ADDR $ 10 . 00 MA 05/01 /90 45362 Date : 5/3/q V 200. 80 TOTAL ,2.67) UUiLDINU . ri<iArl MHNL1LAI1UN Jefferson County BuildiSDepartment•P .O . BQx 1220 rt Townsend. WA 98368 • LOCATION - SPECIFIC LOCATION SITE ADDRESS POSTAL DISTRICT /SUBDIVISION LEGAL DESCRIPTION LOT BLOCK DIVISION TAX NUMBER PARCEL NUMBER Y0 / %04«- -L' 1 / 4 SECTION PLANNING AREA SECTION TOWNSHIP 70-0 NORTH RANGE WM BUILDING INFORMATION BUILDING TYPE TYPE OF IMPROVEMENT SQUARE FOOTAGE .iiii0 ❑ SINGLE FAMILY ❑ NEW BUILDING MAIN FLOOR 'SvA1/4--i6 --_ill 0 ❑ MOf:11 LE HOME (U ADDITION 2ND FLOOR ❑ MODULAR HOME ❑ ALTERATION BASEMENT DETACHED/ATTACHED 0 REPAIR CARPORT GARAGE /C I�W-C ❑ REPLACEMENT GARAGE ❑ WOODSTOVE ❑ WRECKING/DEMOLITION COMMERCIAL ❑ MULTI - FAMILY 0 RELOCATION/MOVING INDUSTRIAL NUMBER OF UNITS MOBILE HOMES❑ COMMERCIAL SIZE _____�{,� @ $40 ❑ INDUSTRIAL YEAR VI @ $20 ❑ HOTEL/MOTEL/DORMITORY MAKE t/IIr VI @ $10 / 7r7I.. NUMBER OF UNITS ❑ OTHER - SPECIFY ' ESTIMATED COST OF 0 i� $10 IMPROVEMENTS TOTAL FAIR MARKET VALUE UBC OCCUPANCY GROUP $ $ /1/- SELECTED CHARACTERISTICS OF BUILDING PRINCIPLE TYPE OF FRAME PRINCIPLE TYPE OF HEATING FUEL ❑ WOOD FRAME ❑ ELECTRICITY ❑ COLLECTIVOCAR ❑ MANUFACTURED ❑ WOODSTOVE ❑ PASSIVE SOLAR ❑ STRUCTURAL STEEL 0 GAS COAL ❑ REINFORCED CONCRETE ❑ OIL 0 OTHER - SPECIFY ❑ MASONRY ( WALL BEARING ) DIMENSIONS ❑ OTHER - MA111BER OF STORIES TOTAL LAND AREA DEPARTMENTAL REVIEW �...t HEALTH DEPARTMENT TYPE OF SEWAGE DISPOSAL NUMBER OF PROPOSED BEDROOMS ❑ PUBLIC OR PRIVATE. NUMBER OF EXISTING BEDROOMS ❑ I ND I VLDUAL ( SEPTIC ) NUMBER OF PROPOSED BATHROOM APPROVED DATE .,-®--1 ND I V I DUAL WELL NUMBER OF EXISTING BATHROOM_ _ PUD TYPE OF WATER SUPPLY ❑ PUBLIC ( NAME OF WATER SUPPLY) APPROVED DATE ❑ PRIVATE ( NAME OF WATER SUPPLY �— PLANNING DEPT . WITHIN SHORELINE JURISDICTION ❑ YES NAME OF ADJACENT WATER BODY ❑ NO APPROVED DATE BANK HEIGHT SETBACK PUBLIC WORKS DEPT ROAD RIGHT-OF -WAY WIDTH _ NAME OF PUBLIC ROAD NAME OF PRIVATE ROAD APPROVED DATE ROAD ACCESS PERMIT REQUIRED ❑ YES ❑ NO IDENTIFICATION NAME MAILING ADDRESS ZIP TEL N O . OWNER CONT 41tOrrtt TE 1 CENSE r`IO '�iv�.c c :� ; ST c C,AL�. / f ly --1143 . ARCH THE OWNER OF THIS BUILDING AND THE UNDERSIGNED AGREE TO CONFORM TO ALL APPLICABLE LAWS. SIGNATURE OF 4PPLICANT APPLIC TI N DATE RECEIPT NUMBER CHECK N MBER OR CASH ai ,:iii9y D PE IT FEES /(}2 L BASE FEE I NSPECT I ON )1AY ` I5) BLDG SURCHARGE 41 PLAN CHECK ENERGY SURCHARGE $ --2� c TOTAL Jefferson County Planning \ "— s 1 1 NUMBER r REUNDP DATE DATE ISSUED & BuiinOqFFICI L BUILDING OFFICIAL U. N S �"�r" i-^ - a .;fir;r;,v*4' ...r,P,. ,g� .,f:, - ' '. '<- .<�"<, �` ;;r, °'*' ,`rs' •S.�.V '-"-, P. 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