HomeMy WebLinkAboutBLD1984-00126UI LDING Pf fft'llT APPLICATION
n,(,nt . Cou,ir.v Courthortset. Porl Town
a
Jellerson CountY Euilding D?t)art send. I'iash.98368 . 385'r310
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Subd rvrsionB<Foi'6"qa 06\ ot-l % Secrronax
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t. LOCATIONi grogaPh,c name
LEGAL DESCBIPTION
othet tpecilrc lealton or landmar*
NE
S W SIDE OF FEET
ROADNE
S W F ROM INTE RSECTION OF
-
ROAD AND
II. TYPE AND COST OF BUILDING
D N"* CoJntv Flesident
ls lhis srruclPre lo sarve thc resrdential
or cornmercifil needs ol lhose employed
at either rhe U.S. Naw'l Trident or
lndian lslanJ Facilities?
E ves Dtuo
MOBILITYTYPE OF IMPROVEMENT
P*"* building
E Add'rion
! Atteration
f) Repair. replacement
[-l Wrecking
I Moving (relocation]
n Foundation onlY
! Horel, Motel. DormrtorY
number ol units
BUI LDING TYPE
Horne
Rsrngle FamilY
D Mulli-Family
number ol units
Residenc,
ome: Recreation Cabin, etc.
ome: Future conversion lo
ent residence
D Second
E Second
usE
D Frtt
UBC OCCUPANCY GROUP:
OWNERSHIP
ffi Prirate (individual, corPoration,
- nonprolit institution, erc.l
E Prbti. lFederal, Stale or local gov'r.l
lOmit centsl
x
e foodofusebuildings.s.,Descr be prdetai I oposedtialnresidenNo
al elementaryIalunduildhospibn9ruchineshop,plantingproc?ss lor9ara9epark ingschoolparochdaseconschoolegeschool
i nd ust rialat plant.tdofrentalbuificeld n9ntmStorengdepart use,beisexisrirdibu changed,n9olngnguse
SUr
'icc bu
enter I
Yr
. Cost ol improEment
To b installed but not included
in the above cost
a. Electrical.
b. Plunbing.
c. Heating,airconditioning . - -' -.
d. Other (elevator, etc.l. . .
. TOTALCOSTOF IMPROVEMENT
cosT
tII. SELECTED CHARACTERISTICS OF BUI LDING -
TYPE OF SEWAGE DISPOSAL--
I euutlc or Private
fl lndividual (sepric tank. etc.l
. Total square feet of floor area,
all lloors.based on exterior
dirrensions.
o Total land area, sq
. Numbe. of Srories
DIME
TYPE OF WATER SUPPLY ./
! euutic or Private company
l-_l lndividual (well, cistern)
PRINCIPAL TYPE OF FRAME
I MasonrY (wall bearingl
flWood Frarrr
E Strudural sreel
[--l Beintorced concrele
D Ott er - Specilv NUMBER OF OFF-STR
PARKING SPACES
E nclosed
T
OutdoorsTYPE OF FIREPLACE
BESIDENTIAL BUI LOINGS ONL
Number o{ bedrooms. .
Full
N
Partial
TYPE OF MECHANICAL
PRTNCIPAL TYPE OF HEATING FjIEL
EG"s
Eoir ..t'
DEtealic;,tY'-/
Ac;P/'-
- SPecifY
IV. IDENTIFICATION.
ZIP code Tel. NoSrateandNumberstreet.cityMailAddressrn9N ame
Orryner
r3t30tateo
2
3.
Archirect
icabl aws.toform alcon appltoUNdithedersignedagreendrhiofbuiownerngThe
ApplrBlion datcIAddrestSrgnature o, aPPli@nt
OL DISTRICT
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WATER DISTBICT--RICTPLANNING AREA 1 F SCHO
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APPROVED BY O
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RMIT NUMEEB
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ISSUE DATE
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