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Home My WebLink AboutBLD1989-00043 LDING 'ERMIT.APPL ICATION glik Jefferson County BuiLaing Department®P .O . Box 122O1F,rt Townsend. WA 98368 LOCATION SPECIFIC LOCATION SITE ADDRESS ' lC nil} �" ' ilw..'� POSTAL DISTRICT , /SUBDIVISION LEGAL DESCRIPTION LOT / BLOCK DIVISION TAX NUMBER /PARCEL NUMBER 0042 0/47/ 00/ 1 / 4 SECTION PLANNING AREA SECTION TOWNSHIP NORTH RANGE )-,IA) WM BUILDING INFORMATION BUILDING TYPE TYPE OF IMPROVEMENT SQUARE FOOTAGE ❑ SINGLE FAMILY NEW BUILDING MAIN FLOOR �ry-d_ SQ'_' ❑ MOP. I LE HOME 0 ADDITION 2ND FLOOR `7 U -_ ❑ MODULAR HOME 0 ALTERATION BASEMENT K DETACHED/*, e_ 0 REPAIR CARPORT GARAGE 0 REPLACEMENT GARAGE n ❑ WOODSTOVE 0 WRECKING/DEMOLITION ( COMMERCIAL O MULTI - FAMILY 0 RELOCATION/MOVING INDUSTRIAL NUMBER OF UNITS d MOBILE HOMES ❑ COMMERCIAL SIZE -----0 CU $35 ❑ INDUSTRIAL YEAR 0 @ $ 16 O HOTEL/MOTEL/DORMITORY MAKE ) Vi @ $8 'IM NUMBER OF UNITS / O OTHER - SPECIFY@ $8 ...;_ lin...;_ linr ESTIMA D COST OF 1 IMP 1EMENTS TTO�AI�FIR MARKET VALUE UBC OCCUPANCY GROUP/�J (44 SELECTED CHARACTERISTICS OF BUILDING PRINCIPLE TYPE OF FRAME PRINCIPLE TYPE OF HEATING FUEL ` WOOD FRAME ❑ ELECTRICITY ❑ cO-LCECTIVE SOLAR O MANUFACTURED 0 WOODSTOVE _---It-PASSIVE SOLAR O STRUCTURAL STEEL ❑ GAS ,. - ❑ COAL O REINFORCED CONCRETE 0 OIL ❑ OTHER - SPECIFY ❑ MASONRY ( WALL BEARING ) DIMENSIONS O OTHER - NUMBER OF STORIES a TOTAL LAND AREA (SO '0' DEPARTMENTAL REVIEW HEALTH DEPARTMENT TYPE OF S WAGE DISPOSAL NUMBER OF PROPOSED BEOOHS ,� 4- 0 PJJBL I C OR PR I VATE NUMBER OF EXISTTING '$EDDROOMS / VI ND I V I DUAL ( SEPT i C } NUMBER OF- ,FRO. ED BATHROOM APPROVED DATE ❑ I ND I V I DUAL WELL NUMB `OF EXISTING BATHROOM PUD TYPE OF WATER SUPPLY ❑ PUBLIC ( NAME OF WATER SUPPLY) APPROVED DATE 0 PRIVATE ( NAME OF WATER SUPPLY PLANNING DEPT . WI HIN SHORELINE JURISDICTION L( YES NAME OF ADJACENT WATER BODY ❑ NO APPROVED DATE B.*tNK HEIGHT 150 ` SETBACK 2-I3©1 PUBLIC WORKS DEPT ROAD RIGHT-OF -WAY WIDTH W 0 t NAME OF PUBLIC ROAD M ATINN ,4 • NAME OF PRIVATE ROAD APPROVED DATE ROAD ACCESS PERMIT REQUIRED 0 YES ❑ NO IDENTIFICATION NAME _ ... MAILING ADDRESS _ ... _. ZIP TEL... NO OWNER 3....pthkL4e e oZI- 3Z i . Serrowrryf 9 6/9? ZO-oa?? CONT S�6.________-----' 'STATE Lrc,.Nsk. NO 1 ARCH r-, THEWNER OF THIS - DING AND THE UNDERSIGNED AGREE TO CONFORM TO ALL APPLICABLE LAWS, SIGNA URE OF P • , -NT AP LiCATION (DATE RECEIPT NyJ�-SER CHECK NUMBER OR Si8t/��j 'co/ WO 1; •-', VED, BY PERMIT J ES t4$- �'• ‘ Q V BASE FEE INSPECTION JEFFERSIA °s BLDG SURCHARGE PLAN CHECK PEANMN6 8 :.i. ERT 56 ENERGY SURCHARGE 4 , / TOTAL 522 .1' /� 9 1 1 NUMBER REQ ue�D DATE AT ISSUED BUILDING OFFICIAL f - 12 t., /SU Top ( u I _ n . ' ' N \--xiN.....,,, _ . n 20 N N -cell 3? 40 r c AA psi ti N r \mac .% --- 0 • ,Io ' 0 10 r 1 7.:\ 1)e-Prilj te/4"3 _3T:T'F°F'.RSC"3iiT C7C")YTTT9PV RTTT T.T)T ITC; iPP:RMT 'V Jefferson County Planning and Building Department Courthouse, 3rd Floor PO Box 1220 Port Townsend, WA 9R36R 2O6-3R5-9141 PERMTT # -RT,fR9-0043 DATE TSSURT). -OFi/05/A9 SITE AT)fRESS - Al O MCMTNN RT) PORT TOWNSF.ND, WA 95368 OWNER •.TOE WALDEN PHONE! 2R3-0299 MATT,TNC AT)T)R- 2621 32 W. SEATTT,F. WA 9f3199 CONTRACTOR. . -N0 CONTRACTOR PHONE- MATLTNC AT)T)R - CONTR . LTC #: EXPTRATTON DATE! PARCET, NO. . . -002014001 LEGAL T)ESC. . -STR 12-30-02 WWM. TAX # LOT 1 , BLOCK , DESCRTPTTON OF TMPROVRMF.NT- •J -1ekAQ c ( ) Fnotina/Sethacks (Shoreline Sethack) /Mnhile Home Rlockina- l i Foundatinnr ( ) Underground Plumbing/Underground Tnsu i at i nn - f 1 Framing/Plumbing/Chimney! ( ) Tnsulatinn - ( ) Sheetrock- ( ) Sewage Disposal System Final - ( 1 i n_ , .cunancy `. 'r*✓ z 7 CALL 3R5-9141 24 HOURS TN ADVANCE TO SCHRT)ULF. TNSPECTTONS . Office Hours q a .m. to 5 p.m. inspector ' s Hours q - 10 a .m. 24 Hour Recorder for inspections.