HomeMy WebLinkAboutBLD1982-00080I
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BUI LDING PERMIT APPLICATION
Jefferson'ty Building Department . County Courthouse . Port Townsend, Wash. 98368 .385-t 3t 0
ROAD
Tax Number l/n Section Section
K-
Block n
p
l. LOCATION I geographic name
other specific location or landmark:
LEGAL DESCRIPTION
NE
SW SIDE OF-, FEET
ROAD
NE
S W FROM INTERSECTION OF-- ROAD AND
II. TYPE AND COST OF BUILDING
BUILDING TYPE MOBILITY
E New County
number of units
E ves nruox
USE
use
ls this structure serve the residential
at either the U.S Navy's Trident or
ident
Other - Specify
UBC OCCUPANCY GROUP: . .
(Omit cenrc)
tf
n
D
or commercial of those employed
ies?lndian lsland
residence
at industrial plant.
e.9., food
tal, elementary
garage for
department store, rental office building, office build
lf use of existing building is being changed, enter
E Single Family
E Multi-Family
I Hotel, Motel, Dormitory
number of units
[-l Mobile Home
cosr
a
OWNERSHIP
{Rr, r"r" {individual, corporation,
/ -nonprofit institution, etc.)
D Prbti" (Federal, State or local gov't.)
Costof improrement..... .. . .
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
TYPE OF IMPROVEMENT
J
Xruew building
E Addition
! Alteration
f] Repair, replacement
I Wrecking
! Moving (relocation)
E Foundation only
Full-tinre
Recreation Cabin, etc.
Future conversion to
Nonresidential - Describe in detail proposed use of
processing plant, machine shop, laundry building at
school, secondary school. college, parochial school,
ec+rea
12$ f
III. SELECTED CHARACTERISTICS OF BUILDING .
ual (septic tank, etc.)
TYPE OF MECHANICAL
IEt
Ir ual (welL, cistern)
.Total land area, sq. ft
Outdoors
D Other - Specify
TYPE OF SEWAGE DI
E Public or
TYPE OF WATER SUPPLY
TYPE OF FIREPLACE
I Pubtic company
PRINCIPAL TYPE OF HEATING FUEL
Full
Part
Number of
bathrooms
NUMBER OF OFF.STREET
P.ARKING SPACES
Enclosed
RESIDENTIAL BUILDINGS
Number of bedrooms. . .
PRINCIPAL TYPE OF FRAME
fl MasonrY (wall bearing)
flwood rrame
! Structural steel
! Reinforced concrete
DG"s
D oit
D Etu"tri"ity
E coal
DIMENSIONS
.lJumber of Storres . . . . .
. Total square feet of floor
all floors, based on e
dimensions.......
IV. IDENTIFICATION.
Name ,.Mailiny Address -- Numbglstreet, city and State-,.-a I llP code Tel. No/tjlct {cv\l ffi
t)Owner Hr1^DA[],1Aba.a{nta.ds2
Con tractor 6l t)f)? t
State Licerrse No.
J.
Architect
The owner of this building and the undersigned agree to conform to all applicable laws.
Signature of
RI STRICT-
JEFFERSON COUN.I-/ HEALTH DEPT
Address
DISTRICT WATERPLANNING AREA
APPROVED B
DING OFFICIAL
APPROVED BY PERMIT FEE
2r8c@
ISSUE DATE
q3-6L
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