HomeMy WebLinkAboutBLD1984-00132,
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BUlLDING PERMIT APPLICATION
Euitding Department . County Courthouse . Port Townsend, Wash.98368 385-t 3t 0
a
Jefferson CountY
ROAD
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Block
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other specilic lNation or landmark
LEGAL DESCRIPTION Loi-
NE
S W SIDE OF FEET
ROADS W FROM INTERSECTION OF-._-- ROAD AND
l. LOCATIONi geogtaphic name
NE
II. TYPE AND COST OF BUILDING
DruoD ves
ies?
Besident
ls this
lndian lsland
to serve the residential
of those employed
Naw's Trident or
MOBILITY
D rue*
or commercial
at either the u
TYPE OF IMPROVEMENT
{*"* buildine
tllaatrion
f] Alteration
f] Repair, replacement
! Wrecking
! Moving (relocation)
D Foundation only
BUILDING TYPE
E Single Family
D Multi-Family
number of units
-
D Hotel, Motel. Dormitory
number o{ units
I Mobile Home
{o,n". - specifv
UBC OCCUPANCY GROUP:
ELPrjvate (individual, corPoration,
noitirof it insritution. etc.)
E Prutic (Federal, State or local gov't.l
OWNERSHIP
(Omit cenrc)Nonresidential - Describe in detail proposed use o{
processing planr, rnachine shop, laundry building at
school, secondary school, college, parochial school,
department store, rental office building, office bui
lf use of existing building is being changed, enter
USE
w1
use
:16
*
{rrtt+ime
ng at industrial plant
garage for
D Second Ho
E Second
idenc€
residenc?
ings, e.9., food
tal, elementary
Recreation Cabin, etc.
Future conversion to
Cost o{ 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 IMPROVEMENTa
COST
a
I1I. SELECTED CHARACTERISTICS OF BUILDING -
F SEWAGE DISPOSAL
lndividual (septic
E puu
DIMENSIONS
o Number of Stories . .
. Total square feer of f
.Total land area. sq- ft
area,
all floors. based on
dimensions......
TYPE OF WATER SUPPLY
D lndividual (well,
company
PRINCIPAL TYPE OF FRAME
! MasonrY (wall bearing)
Xwooa r'a-e
!Structural steel
fl Reinlorced concrete
fl otner - Specify NUMBER OF OFF.STR
PARKING SPACES
Enclosed
OutdoorsTYPE OF FIREPLACE
*",oh*AL BUILDINR
Nu
Number of
bathrooms
TYPE OF MECHANICAL
PRINCIPAL TYPE OF HEATING FUEL
fIG"s
E lect ricity
Dcoat
D Otn", - Specifv
E
D
IV. IDENTIFICATION.
ZIP code Tel. No.Mailing Address - Number, street, city and StateName
Orruner
2.
Cont
3.
Architect
The owner of this building and the undersigned agree to conform to all applicable laws.
Address
5t E 5,r a t+
Application dateappl,
R DISTRIL DISTRICT- WANING AREA
APPROVED BY
HaLfHJ
ISSUE DATE
r'/?fl
RMIT NUMBER
00/
APP
?.1BUlLDlrtG OFFICIAL *\'
PERMIT FEE
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County
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