HomeMy WebLinkAboutBLD1981-00120),!aBUILDING PERMIT APPLICATlON
Jefferson County Building Department . County Courthouse . Port Townsend, Wash.98368 .*fl3KE
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other specific location or landmark
LEGAL
ROAD
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S W SIDE OFl. LOCATIONi gcographic name
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II. TYPE AND COST OF BUILDING
MOBILITY
E N"* 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?
E ves &'o
TYPE OF IMPROVEMENT
p frr"* buildrns
n Addltion
I Alteration
E Bepair, replacement
I Wrecking
! Moving (relocation)
! Foundation only
BUILDING TYPE'\--lt
X.Single FamilY
E Multi-Family
number of units
-
[] Hotel, Motel, Dormitory
number of units
{l Mobile Home
E Other - Specify
GROUP:
USE .'[rutrt;nre
Residenc€
D Second Home: Recreation Cabin, etc.
D Second Home: Future conversion to
permanent residenceUBC OCCUP
RSHIP
Private (individual, corporation
nonprof it institution, etc.)
f] Prbtic (Federal, State or local gov't.)
OWNEx
(Omit cents)
)
Cost of improvement.. .. . .. . .
To be installed but not included
in the above cost
a. Electrical.
b. Plumbing-
c. Heating,airconditioning ......
d. Other (elevator, etc.). . .
TOTAL COST OF IMPROVEMENT
COST
a
a
TYPE OF SEWAGE DISPOSAL
E Puotic or Private
VJlndividuat (septic tank, etc.)/\-
toA
DIMENSIONS
.lJumber of Stories
. Total square feet of floor area
all floors, based on exterior
dimensions.
.Total land area,sq. ft. ... .. .
PRINCIPAL TYPE OF FRAME
E $asotrY (wall bearing)
{ood F'ame
E Structural steel
I Reinforced concrete
III. SELECTED CHARACTERISTICS OF BUILDING
E Other - Specify NUMBER OF OFF"STREET
PARKING SPACES
Enclosed
Outdoors
TYPE OF WATER SUPPLY
E Public or private company
ndividual (well, cistern)
TYPE OF FI
flr
32TYPE OF MECHANICAL
RESIDENTIAL BUI LDINGS ONLY
Number of bedrooms
t
I
Full..
Part ia I
PRINCIPAL TYPE OF HEATING FUEL
E G"t
E oit
DCoatE1
J
FLElectricitv
IV. IDENTIFICATION -
ZIP code Tel. No/1 _ Marr?s Address - Numfer, street, citv and StateName
I 7 (o\
3S7 r.,,UNU1
Owner
fdWna , CL)
State License No
2.
Contractor )n8rr
3.
Architect
The owner of this building and the undersigned agree to conform to all applicable laws
Application dale3lo 5AddressSignature gt. appl icant-tY;d*c.4,u<,Lr)
STRIFtRE D|STR|CT d3.PLANNING AREA SCHOOL DIST
-rafl XW4AgiLYun vT)Prt bED BY
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PERMIT NUMBERPERMIT FEE
1.1(oe
ISSUE DATE
.1J.,El
86/z,ztG*
'PJ1LDtNG OFFIcIAL
APPROVED BY
4rs)
S
affi
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.
Number of
bathrooms
I 'f Ir1.
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