HomeMy WebLinkAboutBLD1996-00160 ' 'ILL i I.0 i r.. : Llt.;..: ,.):‘
Jet •
ferson County Building peer cot • County Courthouse •'Port Townsend, I 1. 98368 • 385-1310
I. LOCATION: scw-raphic name SOSIDE OF DWr. ROAD.5 / 5 O FEET
1V E - ' I_
S W �+FROM INTERSECTION OF 1�4/'s ROAD AND 9.CO __C in0 b ROAD
other specific location or landmark: W Q't' 60 IAlek_"0v`4.' : ` V( "ci Oak
LEGAL DESCRIPTION: Q
eqc (1 L L' Lot , Block Subdivision •
rJtCv *T got - 2I2 - ooZ y, 521 >c L Z(8 )[ Rl
Tax Number Y.Section i Section Township Range .
II.TYPE AND COST OF BUILDING -
TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY '
1 Jew building 0 Single Family ❑New County Resident
❑Addition R 1_C . I V E [.) ❑Multi•Family Is this structure to serve the residential
❑Alteration JEFI LUSON C011l l fY number of units or commercial needs of those employed
❑Repair,replacement. -
l ❑Hotel,Motel, Dormitory at either the U.S.Navy's Trident or
f J U I 1 1, I,i I number of units Indian Island Facilities?
❑Wrecking ' (Mobile Home
❑Moving (re19.w1tio11ilrt; pfar1n4 „1:1;.1�•:III ❑Other—Specify ❑YES i*.NO
i�
❑Foundation only
USE
OWNERSHIP
Full-time Residence
Private (individual,corporation,
nonprofit institution,etc.) ❑Second Home: Recreation Cabtn,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 $ 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 iind 't 'tal pl tf r-r
a. Electrical �� ) 000 If use of existing building is being
/changed,enter proposed'use.' 1h" Ili L
b. Plumbing ( �•C) S 000 ` • ._ I Z x CJ
r �-7 t)C120 'c37
c. Heating,air conditioning �i l z
ZOo o �✓ Qcae, J�.t (a;
d. Other (elevator,etc.) (-i`'d!'{
• Q �� `� .� L.LH pc_pr
• TOTAL COST OF IMPROVEMENT $ C�-0OCD
t
•
III.SELECTED CHARACTERISTICS OF BUILDING -
' PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DIS IMENSIONS
Masonry (wall bearin ► •Number of Stories
❑ 9 ❑Public or Private
•Total square feet of floor area,
❑Wood Frame NRI Individual j -tc.) all floors,based on exterior
dimensions 7 Zo
[]Structural steel
TYPE OF WATER SUPPLY
❑Reinforced concrete •Total land area,sq.ft 1 5.7 S,
Other—S ify ❑Public or private company
�/ Individual (well,cistern) NUMBER OF SPACES
/]
LLJJ...1I>l,�4.1L-►Wy �• � PARKING SPACES
Enclosed
PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE
❑Gas Outdoors Z
❑Oil RESIDENTIAL BUILDINGS ONLY
Ip Electricity Nurpber of bedrooms i '
Coal TYPE OF MECHANICAL I
Number of Full
❑Other—Specify bathrooms
r Partial
IV. IDENTIFICATION- ' •
�-�1 Name 1 Mai!ing Addy?as— Number,um street,city and State ZIP codeTel.No
t. 1 (,t (tom-]-- � P`O . &c 9� r, ?e, O� xr✓43-7C
Owner f
J.in Y s•- ( rr r ys
2.
Contractor State License No. '"` ' t
3 9 ? a
Architect : ----•,._
t.
The owner of this building and the undersigned agree to conform to all applicable laws.
Signature f applicant Rrifk
I Address Application date
/). \iit,44..r• `�to cr°_ . S c 5E- Z poi(2)B'
PLANNING AREA ` FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
APPROV/ . 12 el 8
I1-i•� - S'"7 0( II-I('" t• r
JEFFERSON COUNTY HEALTH DEPARTMENT •
APPROVED BY: PERMIT FEE ISSUE DATE RECE I P T NUMBER
75-r CTU. c3
3r5'O- ) .
Azg)--A-i-t—ix,....„50. i --(,a
BUILDING OFFICIAL 1
0t�""'-' 1 /O �Q
3 /T?
r P.m:cry - Purr To.•.:r:rrrd To WO /0//cl?