HomeMy WebLinkAboutBLD1983-00109I
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BUI LDING PERMIT APPLICATION
Jefferson County Building Department. County Courthouse . Port Townsend,Wash.98368 .t3to
BOAD
FEET
t mt+F? \rr,t' 0i- Other soectt,c locatton or
l.FOo' DESCRTPTTON:
ItL|fr4) '10710 r \
NE
L1 N
Tax Number % Section r'Township
/-
BlockLot
3
Section
sroe or <-ll /& E- nono
oF F otr Sl-trt{E- RDF 1{000 d4rv4._ g&FA
landmark:
S W FROM INTERSECTION OF BOAD AND
I . LOCATION i gcographic name
NE
II. TYPE AND COST OF BUILDING
MoBtLtrY
I
pq"* countv Besi{ent -a-AB I Al
ls this structure to sefve the residential
or commercial needs pf those employed
at either the U.S. Na{V's Trident or
lndian lsland Facilitibs?
iEves ^Uro-I\
l
TYPE OF IMPROVEMENT
'fl,nr"* buildins
fl Adaition
! Alteration
D Repair, replacement
! Wreckirrg
I Moving (relocation)
n Foundation only
! Hotel, Motel, Dormitory
number of uni,s
number of units
I Mobite Home
D Otner - Specify
BUILDING TYPE
,Sinsle Famity
E Multi-Family
USE
fl Full-time Resider
F€econd Home: d
Esecond Home: H
permanenf
OWNERSHIP
\qPrivate (individual, corporation,
nonprof it institution, etc.)
E Pubtic (Federal, State or local gov't.)UBC OCCUPANCY GROUP:
-
Nonresidential - Describe in detail proposed use of bui
processing plant, machine shop, laundry building at hos
school, secondary school, college, parochial school, parki
department store, rental office building, office building
(Omit cents)
D
0
lf use of existing building is being changed, enter
e.9., food
industrial plant
I use.
, elementary
garage for
AEsL
-z_TYPE OF SEWAGE DISPOSAL
ffrairiouat (septic tank, etc.)
I Pubtic or Private
/soo il
DIMENSIONS
.Number of Storres .. . . .
. Total square feet of floor
all floors, based on exteri,
d imensions .
.Total land area, sq. ft lt*TfiTYPE OF WATER SUPPLY
D Pubtic or private company
'f,Saiviauat (well, cistern)9,53
Outdoors
NUMBER OF OFF-STREET
PARKING SPACES
Enclosed
LTYPE OF FIREPLACE
LUooo 670{E
TYPE OF MECHANICAL
NONF.-
RESIOENTIAL BUI LDINGS O
Number of bedrooms. . . . .
I
I
F ull.
Partil
Number of
bathrooms
al
Mailing Address - Number, street, city and State ZIP code Tel. No
Btt-r ?Fa.P-saru (Z<'U) FhlnrWN AttE NF l1 rf,Ls5_.- 17_
,R-EruToN ^)NBRI*N, r3EArli-a r)kt* n7 aq td{*L Pc.*yf hnut 4 froir 48s-L-
lLv tQt t* nd(rl,-s
State Ltcense No.tA)Lr4 tcZfL
NdA/E
Address -'*LI (.
Application
frlqt
datelat
I DISTRICT-
PERMIT FEE
t%u)
PE
I
IT BEB
cosT
a Cost of improvement
To be installed but not included
in the above cost
a. Electrical.
b. Plumbinq.
c. Heating,airconditioning ......
d. Other (elevator. etc.). . .
. TOTAL COST OF IMPROVEMENT
III. SELECTED CHARACTERISTICS OF BUILDING
PRINCIPAL TYPE OF FRAME
I Masonry (wall bearing)
fuood Frame
I Structural steel
I Reinforced concrete
fl Ottrer - Specify
PRINCIPAL TYPE OF HEATING FUEL
E Gas
E oit
)EElect.icitv BAS 2:EOA.BD
f] coat
D Other - Specifv
I. IDENTIFICATION.
Name
wner of this building and the undersigned agree to conform to all applicable laws.
're of applicant
1t
ter
$
ect
>J
iING AREA
IVED BY
ISON COUNTY HEALTH DEPT
.ED BY
OFFICIAL
I
rcT SCHOOL DISTRICT- WATE
Ran
Cabin, etc.
res idence
conversion to
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