HomeMy WebLinkAboutBLD1980-00179Jefferson County Building Department . County Courthouse . Port Townsend, Wash.98368 . 385-1310
PE RIVlIT FEE
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BUI LDING PEBMlT APPLICATION
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ROADS W FROM INTEBSECTION OF- ROAD ANO
l. LOCATION; seographic name
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II. TYPE AND COST OF BUILDING
E Ne* County Resident
ls this structure to serve the residential
or commercial needs of those employed
at either the U.S. Navv's Trident or
lndian lsland Facilities?
MOBILITY
n ves Eruo
TYPE OF IMPROVEMENT
E N"* building
Haoditron
! Alteration
! Repair, replacement
I Wrecking
I Moving (relocation]
D Foundation only
BUILDING TYPE
number of units
lll Mobite Home
E Ottrer - Specify
f-l Frll -tinr" Residence
E Second Home: Recreation Cabin, etc.
!,$econd Home: Future conversion to' permanent residence
USE
UBC OCCUPANCY GROUP:
$-P.lr"t" (individual, corporation,
nonprof it institution, etc.)
f] Prbtic (Federal, State or local gov't.)
OWNERSHIP
(Omit cents)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.
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. Cost of impro\r'ement
To be installed but not included
in the above cost
a. Electrical.
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AGE DrsPosAL
I Public or Private
frtndividuat (septic tank, etc.)t at Je,{$6-,4z/{
I oo't la(
DIMENSIONS
.lJumber of Stofles
. Total square feet of floor area,
all floors, based on exterior
dimensions.
.Total land area, sq. ftTYPE OF WATER SUPPLY.r--.r'_ CoSq^
Ell-Public or private company
D lndividual (well, cistern)
III. SELECTED CHARACTERISTICS OF BUILDING .
PRINCIPAL TYPE OF FRATI'IE
n Otner - Specify
! Masonry (wall bearing)
FA/ood Frame
E Structural steel
I Reinforced concrete
NUMBER OF OFF-STREET
PARKING SPACES
Enclosed
Outdoors
TYPE OF FIREPLACE
, A\\.
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RESIDENTTAL BUI LDINGS ONLY
Number ot bedrooms
I
I
Full..
Part ia I
Number of
bathrooms
PRINCIPAL TYPE OF HEATING FUEL
D Gat
fl ott
E Electricity
Ecoal
potner - sp"cn1@gg$>--
TYPE OF MECHANICAL
IV. IDENTIFICATION.
Tel. No.ZIP codeMailing Address - Number, street, city and StateName
n t'Tk..- L,R+ " I 3^r- uq RD qga6f 432*z?o rt L.^ \\^.^)
1
Owner k r tT-.>-
Ll372.
Contractor l-:ovva-//7s%r 2Ll?n/ c,A ffiturqfuI
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The owner of this building and the undersigne!"agree to conform to all applicable laws.
,fSo-8CApplication dateAddressSignature
SCHOOL DISTRICT WATER DISTRICT-NNING AREA RIFE
OVED BY
JEFFERSON COUNTY HEALTH DEPT
ISSUE DATE
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PERMIT NUMBEH
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APPROVED BY
NG OFFICIAL
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Ttlumber 7. Sectio" -- $ctio. ----%wnship --ELs!-
, -fEcnu QfslflPTtofrl:,14tt / zrlttr$-
G3<,-,t()t3
p€ingle Famity
E Mulri-Family
number of units , -
n Hotel, Motel, Dormitory
b
b. Plumbing.
c. Heating,airconditioning ......
d. Other (elevator, etc.). . .
. TOTAL COST OF IMPROVEMENT
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