HomeMy WebLinkAboutBLD1981-00131wq71
rerrerson county Buitdinsr"?Y,1h'",f I.G"5,T#J :::'J:|:,lT*,n,0, wash. eB368 . 3Bs-1310
The owner of this building and the undersigned agree to conform to all applicable laws
Signature of
'LANNING AREA
PPROVED BY
=FFERSoN CoUNry HEALTH DET
NUM BE R
NE
l. LOCATION: seographic name
-
S W SIDE OF
NE
ROAD
e
Tax Number 7o Section
Lot Block
It
Range
+
Subdivrsion
_ '4 -18\
Section Township
FEET
S W FROM INTERSECTION OF ROAD AND
other specific location or landmark
LEGAL DESCRIPTION: S,
II. TYPE AND COST OF BUILDING
f] N"* Countv Resident
ls this structure to serve the residential
or commercial ne{ds of those employed
at either the U.S. Navy's Trident or
lndian lsland Facilities?
MOBILITY
E yes Etrro
USE
residence
ion Cabin, etc.Recreat
Esecond Home Future conversion to
TYPE OF IMPROVEMENT
8Q"," buildins
E Addition
! Alteration
D Bepair, replacement
fl Wrecking
! Moving (relocation)
fl Foundation only
E Hotel, Motel, Dormitory
UBC OCCUPANCY GROUP:
number of units
number of units
BUILDING TYPE
Xsinsle Family
E Multi-Famity
[_l Mobite Home
E Other - Specify
QPrir"r" lindividual, corporatron,z \onprof it institutron, etc.)
n PrUti" (Federal, State or local gov't.)
OWNERSHIP
(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
$ 115 tooo
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, par(ing garage for
department store, rental office building, office building at industrial plant.
lf use of existing building is being changed, enter proposed use.
,
-7J'Ll q63
III. SELECTED CHARACTERISTICS OF BUILDING
'2_
lndividual (septic tank, etc.)
TY
Plr\
or Private
DISPOSAL
3 st I
.Total land area, sq. ft
? s,,( 3q 8
PRINCIPAL TYPE OF FRAI\,IE
I Masonry (wall bearing)
i$A/ood Frame
E Structural steel
E Reinforced concrete
E Other - Specify
WATER SUPPLY
or pflvate company
(well, cistern)7
NUMBER OF OFF.STREET
PARKING SPACES
Enclosed
Outdoors -iBTYPE OF FIREPLACE
'YVlrsot'ry,
-5
3
PRINCIPAL TYPE OF HEATING FUEL
D Gus
E oit
D Electricity
E Coat lerllru/EQrn", - Specify
TYPE OF MECHANICAL
RESIDENTIAL BUILDINGS
Number of bedrooms. . . .
I
I
Full
Partial
Number of
bathrooms
IV. IDENTIFICATION.
N ame Mailing Address - Number, street, city and State ZIP code Tel. No/h/,-, {,.,
Owner 7 fzrl ,lttrzlar.l . )/2-/,(vf,36-t/;7-;t sU;{z En2.
Contractor t,-//filr"f ea/u^-3.
Archi tect /
Address Application date
RICT DISTRICT WATER STRICT-
PERIVIIT FEEflg,ft ISSUE DATE
Q-rcar
PROVED BY
ICIAL
PERMI
sg
DIMENSIONS
.lJumber of Storres
o Total square feet of floor area,
all floors, based on exterior
dimensions.
Pa 11