HomeMy WebLinkAboutBLD1977-00215NE
!. LOCATION: geographic name
-
S w SIDE OF
-
ROAD
ROAD AND
Subdivision
% Section Section Township
I
Lot Block
Range
C^W
Tax Number
LEGAL DESCRIPTION:a^;
, FEET
ROAD
\-,^.-\ e-^-!-a'.
NE
S W FROM INTERSECTION OF
II. TYPE AND COST OF BUILDING.
MOBILITY
D New County Resident
ls this structure to serve the residential
or commercial needs of those employed
at either the U.S. Navy's Trident or
lndian lsland Facilities?
R"n ves
TYPE OF IMPBOVEMENT
81"* buildins
E Aaaition
! Alteration
E Repair, replacement
fl Wrecking
f] Moving (relocation)
! Foundation only
BUILDING TYPE
I Single Family
E Multi-Family
number of units
I Hotel, Motel, Dormitory
number of units
!@tobite Home
E Other - Specify
UBC OCCUPANCY GROUP:-
E
{Furrrime Residence
Li Second Home: Recreation Cabin, etc.
E Second Home: Future conversion to
permanent residence
US
[private (individual, corporation,1. nonprof it institution, etc,)
E Prbtic (Federal, State or local gov't.l
OWNERSHIP
(Omit cents)
$Cost of impro\€ment.,... ....
To be installed but not included
in the above cost
a. Electrical.
b. Plumbing.
c. Heating,airconditioninS ......
d. Other (elevator, etc.). . .
. TOTALCOSTOF IMPROVEMENT
cosT
a
$ lJ /ooo
Nonresidential - Describe in detail proposed use of buildings, e.9., food
processing plant, machine shop, laundry building at hospital, elementary
school, secondary school, college, parochial school, parking garage for
department store, rental office building, office building at industrial plant.
lf use oI existing building is being changed, enter proposed use.
III. SELECTED CHARACTERISTICS OF BU!LDING -
ITYPE OF SEWAGE DISPOSAL
! Pubtic or Private
Hlndividual (septic tank, etc.)tt-l X 7o
DIMENSIONS
. Number of Stories
.Total square feet of floor area,
all floors, based on exterior
dimensions.
.Total land area, sq. ft.lb0XJaa
PRINC]PAL TYPE OF FRAME
l-l MasonrY (wall bearingl
(Wooa rrame
I Structural steel
! Reinforced concrete
E Ottrer - Specify
TYPE OF WATER SUPPLY
n Public or private company
tl lnfli*Nlwell, cistern)NUMBER OF OFF.STREET
PARKING SPACES
Enclosed
TYPE OF TTNCLCE
,*
*TYPE OF MECHANICAL
RESIDENTIAL BUI LDINGS ONLY
Number of bedrooms
Full..
Partial
Number of
bathrooms
PRINCIPAL TYPE OF HEATING FUEL
n G"t
floit
\it.ori"i,vf]co.t
E oth"r - Specify
IV. IDENTIFICATION.
ZIP code Tel. No.Name Mailing Address - Number, street, city and State
7O'ttn, bi (12*a l)1
Owner Q.o.B^, lhL
l*l-s.-\a*-l-t o rc,t-{ -State License No.
2.
Contractor \
3.
Archi tect
The owner of this building and the undersigned agree to conform to all applicable laws.
icant
\
Shna^ture of appl(Lt t /1
r'-rdt,,-n uV ,o
L4'fr.a\)A 9-qt7Application dateAddress
BU! LDING PERMIT APPLICATION
Jefferson County Building Department . County Courthouse . Port Townsend, Wash.98368 . 385-1310
zt Zry
PLANNTNGAREA + = F|REQTSTR|CT I WATER DISTRICT-4?SCHOOL DISTRICT
OLYMPIC HEALTH DISTRICT
APPROVED BY
-ISSt'gDATF:
\rrr1 lq0 \
PERMIT NUMBERAPPROVED BY PERMIT FEE
2s"@LDING OFFICIAL
The Printery - Port Townsend
other specific location or landmark:
Outdoors