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HomeMy WebLinkAboutBLD1989-00008 • ' laBUILDING PERMIT APPLICATION 72 l.---- Jeffe.son County Building artment• County Courthouse •Port Townse , wash.98368 • 385-1310 N!I7 � I. LOCATION: geographic name S W SIDE OF I Lu6-1t� Jo l ROAD FEET N E -r1- C 1 R,D- S W FROM INTERSECTION OF _ A��D 6 411/ - a,4T!k T �^r n►1O✓t ROAD other specific location or landmark: m:!)'Qv-is S rcm„_r •114 s.At-01 AL1 %o g /Mrvl,.R 6$4wee 6% InC,Vcwa$1 C1er4 ' v`k 61I:r•ro.c ( �:.-1 1-w.45. eta 5i i..-� no 1"G LEGAL DESCRIPTION: 4, G©JI/'LOtl.Tre-- Thai e0y---Ti.sr\ in.hci No It I of 11 t P.-apes AA se-wA2. k Lot Block Ctn 1 4,e.e .1 hell0 S b vision pi goo,0.5 Si- �Q 6l7- x as I as- AL . Ram 4pr[/g' -Tent Number 'A Section Section Township Range II.TYPE AND COST OF BUILDING - TYPE OF IMPROVEMENT BUILDINGIYPE MOBILITY ›itiNew building XSingte Family ❑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 ❑NO ❑Foundation only USE OWNERSHIP ❑Full-time Residence Private (individual,corporation, nonprofit institution,etc.) X 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 $ a OoO 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 a L>V rJ If use of existing building is being changed,enter proposed use. b. Plumbing O 0 o l 2,0 c. Heating,air conditioning ,5 O U Loc r 371 Q- q d. Other (elevator,etc.) :aS�' 5 I I '4- • TOTAL COST OF IMPROVEMENT $ y 6-001� / III.SELECTED CHARACTERISTICS OF BUILDING - DIMENSIONS PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL y •Number of Stories 7 ❑Masonry (wall bearing) ❑Public or Private �� �"` •Total square feet of floor area, X Wood Frame ®Individual (septic t nk,etc..) all floors,based on exterior ❑Structural steel Ad"� b.c. � II t1, ,— dimensions i lsti TYPE OF WATER SUPPLY ❑Reinforced concrete •Total land area,sq.ft. 5 0 ❑Public or private company I-err c..5+:- 5-t?.000+ /to ❑Other-Specify NUMBER OF OFF-STREET RI Individual (well,cistern) PARKING SPACES Enclosed PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE ❑Gas Outdoors C4-...4. L1 ❑Oil +-ee. S � RESIDENTIAL BUILDINGS ONLY I' �{ tg Electricity �1 Number of bedrooms ❑Coal TYPE OF MECHANICAL Other-Specify Vllcr•,A Number of Full bathrooms I Partial IV. IDENTIFICATION - Name Mailing Address-Number,street,city and State ZIP code Tel.No. . /Ytt,-I k.n IY1.:I It st • -6 3i civil Owner %If/.111D' -- 2. I I (( 174arriffil . ,. s`�. am r Contractor State License No. 41_,., s 3. 7- 0 7t(--4- �� TIC di 9314 5 S- t.- Architect The owner of this building and the undersigned agree to conform to all applicable laws. _ —/ci _7 y Signature of applicant n Address Application date �' - ��6' - 5 011 C • I D-3 v-& S`F' . Tiz-c -,,... ) .-a_. S ys- PLANNING AREA / I FIRE DISTRICT Si SCHOOL DISTRICT /8 WATER DISTRICT APPROVED BY OK e P , OLYMPIC HEALTH DISTRICT:., .S-\. 3 . APPROVED BY: PERMIT FEE ISSUE DAT PERMIT NUMBER .1a7."?‘2./;'-'4' '4'-‘‘:". •4c; BUILDING OFFICIAL /�O ���.4hi i/ g'S--- The Printery-Port Townsend