HomeMy WebLinkAboutBLD1976-00115+34L
JEFFE N GuNrY.coMMrssroNERs
Port Townsend, Washington
BUILDING PERMIT APPLICATION
1-Health Dept,
,tllPORfANf - Complete ALL irems. Mork 6ores where opplicoble.
Subd ivi sion I
I
I/2Lot7 BI
I ockr Census tractNumber and street CAFE e61Off<LE
7 E) tuN\l'/La{i: kl @ol otcLtt.
LOCATION
OF
BUILDING
(Other local geographic, political, or legal subdiuision identification)
N
E fuir* lr"*'*"t^l NS
;
-feet
E W from intersection of
ll. TYPE AND COST OF BUI LDING - All oppliconts complete Ports A - D
A. TYPE OF IMPROVEMENT
New building
Addition (II residential, enter numbet
of new housinp units added, iI any,
in Part D, 13)
Alteration (See 2 above)
Repair, replacement
Wreckin g 1lf mul ti tamity re si denti al,
enter number of unils in buildinp in
Part D, 13)
MovinS (relocation)
Foundation only
xtl
efl
6
7
aI
sI
I
2
D. PROPOSED USE - For "Wrecking" most recent usc
Residentiol Nonresidentiol
tzffi One family tB [] Amusement, recreational
numher of untls + _ 20
2t ! Parking garage
l5
l6
t7
Garage
Carpo rt
Other -.. Specify
tq fl Transient hotel, motel,
or dormi tory - Enter number
of unils +
-
22
23
24
25
Service station, repair garage
Hospital, institutional
Off ice, bank, professional
Public utility
27
2A
29
Stores, mercantile
Tanks, towers
Other - Speci{y
-
Church, other rel i Sious
lndustrial
26 E School, library, other educational
B. OWNERSHIP
I & Pilvate (rndivrdual, corporation,
\ nonprofit Insti tulron, etc.)
9 I I Public (Federal, State, or
local government)
(Omit cants)
$
b. Plumbing
c. Heatrng, air condrtioning..,..
d. Other (elevator, etc.)
II. TOTAL COST OF IMPROVEI'4ENT
lO. Cost of improvement
To be installed bul not included
in the above cosl
a. Electrical
c. cosT
$
Nonresidentiol - Describe in detail proposed use of buildings, e.t., food
processinS plant, machine shop, laundry building at hospital, elementary
school, secondary school, college, parochial school, parking, garag,e for
department store, rental office building, office building at industrial plant.
lf use of existinS building is being chanted, enter proposed use.
loo8 I oo B
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III.SELECTED CHARACTERISTICS OF BUILDING - For new builainlsTnU odditions, complete Ports E - L;
for wrecking, comp,ete only Port J, for ollothers skip to ,V
IG. TYPE OF SEWAGE DISPOSAL
ag [-l Public or private company
4t T-l lndividual (septic tank, etc.;7A/L
48. Number of stories .. .. .. .:::
49. Total square feet of floor area,
all floors, based on exterior
d imens ion s
50. Total land area, sq. ft.
15"-.ru^*J. DIMENSIONS
'&
E. PRINCIPAL TYPE OF FRAME
30 fl Masonry lwall bearing)
Wo od f rame
Structural steel
Reinforced concrete
Other - Specity
-
Efl
31
32
33
34
H. TYPE OF WATER SUPPLY
42El Public or private company
43 I-l lndividual (well, cistern)K. NUMBER OF OFF.STREET
PARKING SPACES
5.l. Enclosed
52, Outdoors
I
/
TYPE OF MECHANICAL
Will there be central air
conditioninST
44 Tl Yes 4s K No
will there be an elevator?
qs l--l Yes 47 Tl No
L. RESIDENTIAL BUILDINGS ONLY
53. Number of bedrooms
Full
Partia I
54. Number of
bathrooms /lr-
F. PRINCIPAL TYPE OF HEATING FUEL
35 f_] Gas
oil
Electricity
Coa I
Other - specity
-[S-9-9,-E-
E
36
37
38
39
lY. IDENTIFICATION - To be completed by oll opplicants
Mailing address - Number, street, city, and State ZIP code Tel. No.N ame
aV02rt.i/-/fl lJ ndrLL /4/b tAl.f trtq P < ott A Vltt
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l.
Owner
B) tl ar ^t F.l L
2,
Conlroclor State License Np
3.
A rch itect
The owner of this building and the undersigned atree to conform to all applicable laws ol (name of permit jurisdictiod.
Signature of applicant Addres s
DO NOT WR'TE IH'S SPAC OFFICE USE
o
-FO
Application date
L
ermit fee
$/b
Perm it numberOate 3/
ved by
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