HomeMy WebLinkAboutBLD1996-00773 JEFFERSQN COUNTY PERMIT CENTER, 621 SHERIDAN ST, PORT TOWNSEND WA 98368
BUILDING PERMIT APPLICATION
PROJECT DESCRIPTION: -.�a c,r,` t`\. f FrzR ►Gi r. l) b
BUILDING TYPE: PROJECT TYPE: FRAME TYPE:
KSINGLE FAMILY ,X NEW .WOOD
❑ GARAGE ATTACHED/DETACHED 0 ADDITION 0 STEEL
❑ MODULAR 0 ALTERATION/REMODEL 0 CONCRETE
❑ COMMERCIAL 0 REPAIR 0 MASONRY
❑ MULTI FAMILY/# OF UNITS 0 DEMOLITION ❑ OTHER
❑ INDUSTRIAL
❑ OTHER
BEDROOMS: BATHROOMS: TYPE OF SEWAGE DISPOSAL:
EXISTING EXISTING ❑ SEWER COMMUNITY SYSTEM
PROPOSED 2 PROPOSED JJJJ2 0 INDIVIDUAL SYSTEM ❑Conventional
TOTAL `' • TOTAL 2.-- PERMIT # SEP ❑Alternative
WATER SUPPLY: TYPE OF HEAT:
❑ PRIVATE WELL 0 ELECTRICITY 0 OIL
❑ PUBLIC Name of water system: 0 WOODSTOVE 0 PROPANE
HEAT PUMP 0 OTHER:
SQUARE FOOTAGE: " FOR OFFICE USE ONLY
MAIN FLOOR Of0e7Co
UBC OCCUPANCY GROUP.
2ND FLOOR _
3RD FLOOR — i` BASE FEE .s
HTD BASEMENT _ PLAN CHECK :
J
UNHTD BASEMENT STATE SURCHARGE 4 50
CARPORT — SUBTOTAL / 7 ..93
GARAGE ' r
DECKS 'LU 7a (.n Imo`;: , 1..
1
COMMERCIAL
H
GRAND TOTAL /37
INDUSTRIAL — (l
OTHER RECEIPT # �
TOTAL VALUATION /J O/ cn cAst�r! � ��
or INITIALS' f
ESTIMATED COST DA
IF WATERFRONT PROPERTY,
DISTANCE TO BANK OR HIGH WATER LINE IJ c ft BANK HEIGHT ft
SIGNATURE �I. / UP1 ,.tr--,1._ DATE I el 9 16
NAME (PLEASE PRINT) Plr1) NIS �, N( El-Pc -Ve V H:Viome\PIncntr\Forms\Bldspp.DOC 4/96