HomeMy WebLinkAboutBLD1977-002207
BUI LDI NG PERMIT APPLICATION
Jeffersn Counry Building Department . County Courthouse c Port Townsend, Wash.98368 . 385-1310
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Tax Number 7o Section
ROAD
Lot
I?Bot)f
Block
Section Township
Ere
Range
l. LOCATION: geographic name
3{ -/?
LEGAL DESCRIPTION:
FEET
other specific location or landmark:
NE
S W SIDE OF
ROAD AND ROAD
NE
SW FROM INTERSECTION OF
II. TYPE AND COST OF BUILDING.
EKe* Countv 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?
MOBILITY
E ves tu6
TYPE OF IMPROVEMENT
d*"*building
n Addition
l-l Alteration
I Repair, replacement
I Wrecking
I Moving (relocation]
E Foundation only
E Hotel, Motel, Dormitory
numher of units
! Mobile Home
E Otner - Specify
number of units
BUlLDING TYPE
6nde Famitv
n Multi-Family
UBC OCCUPANCY GROUP:-
USE
f] Full-time Residence
fl Second Home: Recreation Cabin, etc.
Ed""ona Home: Future conversion to
permanent residence
owNERlHrP
dPriu"t" (individual, corporation,
nonprof it institution, etc.)
E prutic (Federal, State or local gov't.)
. Cost of improvement,. .,... ..
To be installed but not included
in the above cost
a. Electrical.
b. Plumbing.
c. Heating,airconditioninS ......
d. Other (elevator,etc.)...
TOTAL COST OF IMPROVEMENT
cosT
a
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 of existing building is being changed, enter proposed use.
(Omit cents)
I!I. SELECTED CHARACTERISTICS OF BUILDING -
,
2/+TYPE OF SEWAGE DISPOSAL
E Pubtic or Private
ffiaiuiar.l (septic tank, etc.)
I
t-7 gL
DTMENSIONS
. Number of Stories
. Total square feet of floor area,
all floors, based on exterior
d i mensi ons .
.Total land area,sq. ft. .,. . ..
PBINCIPAL TYPE OF FRAME
l-l Structural steel
! Reinforced concrete
ry (wall bearing)l--l Mason"W6"o
Frame
E otnet - SPecifv
TYPE OF WATER SUPPLY
n Pubtic or private company
ffiiviauat (well, cistern )
NUMBER OF OFF.STREET
PARKING SPACES
Enclosed
Outdoors
TYPE OF FIREPLACE
MASON' RtI +
Me,Th t-I
PRINCIPAL TYPE OF HEATING FUEL
D cus
E oit
dr,".r,,.,r,
ncoat
l!/bther - Specify LLI6Ct D
TYPE OF MECHANICAL
RESIDENTIAL BUI LDINGS ONLY
Number of bedrooms
Futt...l....
Partid..%
Number of
bathrooms
IV. IDENTIFICATION.
ZIP code Tel. NoNameMailing Address - Number, street, city and State
-t.8. Sidclein Ll t AJ. L, . t o-r!!l -st'1
Owner a seA-rTle WA. dBt77 q Pt77 s92 -rs
-\ E q, iil C LRIa sAME2.
Contractor
I -st-^tc-Lc * 33 t PzB, Jit *e. girucleit3.
Architect
The owner of this building and the undersigned agree to conform to all applicable laws.
''nu i-T"""), '^.1 nip Llt Al,W . ltS9 st.
Application date
u/ez /tzAddress
pMrrrrurruc AREA 7 FIRE DISTRICT - SCHOOL DISTRICT 4F9 WATER DISTRI
APPROVED BY
OLYMPIC HEALTH DISTRICT
7
PERMIT FEE
l4 z. oo
ISSUE DATE
+lal tl,t
PERMIT NUMBER
114t
APPROVED BY
ILDING OFFICIAL
The Printery - Port Townsend
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