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HomeMy WebLinkAboutBLD1983-001107 i )J \zbqBUt LDING PERMIT APPLICATION Jefferson ty Building Department . County Courthouse . Port Townsend, Wash.98368 . 385-1310 ! o Iot- oo- I\ o a- o l\ ROAD N S ROAD AN ion Block I. LOCATION or landmark: lol\l ROAD FEET LEGAL DESCRI other specific FROM INTERSECTION NE name - SW SIDE OFI o II. TYPE AND OF BU!LDING MOBILITY D t',,t"* County Resident ls this structure to serve the residential or commercial needs of those employed at either the U.S. Navy's Trident or I ndian lsland Facilities? E ves Eruo TYPE OF IMPROVI p.ttew building E Addition ! Alteration E Repair, replac ! Wrecking ! Moving (reloc ! Foundation o MENT ement rtion ) rly BUILDING TYPE J'1l lSinole Familv,/_' L-l Multi-Familv number of units E Hotet, Motel, Dormitory UBC OCCUPANCY GROUP: number of units fl Mobite Home E Other - Specify OWNERSHIP f-DrfPrivate (indivi/ nonprofit insl EPublic (Feder dual, corporation, itution, etc.) )1, State or local gov't.) USE {rr,'n,." Residenc€ fl Second Home: Recreation Cabin, etc. E Second Home: Future conversion to permanent residence (Omit cents) $ $ Nonresidential - Describe in detail proposed use of buildings, e.9., food processing plant, rnachine 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. building is being changed, enter proposed use qblf use of existinq Cost of impro To be installe in the above c a. Electrical. b. Plunbing. c. Heating, a d. Other (ele . TOTAL COS' cosT a !€ment. I but not included ost rconditioning...... rator, etc- ). .OF IMPROVEMENT III. SELECTED CHA RACTERISTICS OF BUILDING .+1 t t)b a1,LTYPE OF SEWAGE DISPOSAL ! eubtic or Privare '91 lndiviouar (septic tank, etc.) DIMENSIONS .Number of Stories .Total square feet of floor area all floors, based on extenor d i mensi ons . 1,4{ PRINCIPAL TYPE ( D Masonrv (wal \,1plWood Frame E Structural ste ! Reinforced cc n Other - Spec fy rl ncrete IF FRAME beari ng) TYPE OF WATER SUPPLY 2eggEljcsr pri vate companv I lndividual (well, cistern)2 Outdoors TYPE OF FIREPLACE 3 (TYPE OF MECHANICAL RESIDENTIAL BUI LDINGS ONLY Number of bedrooms Full. . Partial Number of bathrooms PRINCIPAL TYPE ( E Gas E oit pGr""r.i"i,v' fl coat E other - Spec IF HEATING FUEL fy IV. IDENTIFICATI(rN ZIP code Tel. No.I\.lam - Number and State V1 2 <w ua<trOwner,hcnn L l.,lA C %2y = (\?2. Contractor ClS ()t-un ef State License No 3. Architect The owner of this bu ilding and the undersigned agree to conform to all applicable laws {*;+'m"x(Address v \-/ PLANNING AREA- APPROVED BY JEFFERSON COUNTY ISTRI HOOL DISTRICT WATER DISTRICT- HEALTH DE5 DBY DING OFFICIAL APP ISSUE DATE A3t-eb )bb t PERMIT NUMBERtu( PERMIT FEE Lb4h ;'44 Y2/ .Total land area, sq. ft. NUMBER OF OFF.STREET PARKING SPACES Enclosed )tt1.{nr.l I M7 s r G r W 0/ U\ 0 00 un 3 n r 2 i� 0 C.� • G© ��a►-c s 3) %!,UST fA• u� o� 3 Scirc4 (: >(.J r`( C 7'L - s7 C cam- (Ls�