HomeMy WebLinkAboutBLD1998-00072 FFER ON COUNTY PERMIT CENTER, 621 SHERIDAN ST, PORT TOWNSEN�WA 98368 ii�
JE S ,
BUILDING PERMIT APPLICATION
PROJECT DESCRIPTION: YC_l OSe_ /- o - -
BUILDING TYPE: PROJECT TYPE: FRAME TYPE:
❑ SINGLE FAMILY ❑ NEW 'WOOD
❑ GARAGE ATTACHED/DETACHED 0 ADDITION 0 STEEL
❑ MODULAR CI ALTERATION/REMODEL ❑ CONCRETE
❑ COMMERCIAL 0 REPAIR 0 MASONRY
❑ MULTI FAMILY//{ OF UNITS 0 DEMOLITION 0 OTHER
❑ INDUSTRIAL
61.1 OTHER C_a...r y O ri-
(a&c.;- e_A)
BEDROOMS: BATHROOMS: TYPE OF SEWAGE DISPOSAL:
EXISTING EXISTING 0 SEWER 0 COMMUNITY SYSTEM
PROPOSED PROPOSED 0 INDIVIDUAL SY ,TI I� _ ❑Conventional
TOTAL TOTAL ' "
PERMIT II SEP � ❑Alternative
WATER SUPPLY: TYPE OF HEAT:
❑ PRIVATE WELL 0 TWO PARTY WELL 0 ELECTRICITY 0 OIL
Et tiRLtC Name of water system: &z—.— 0 WOODSTOVE 0 PROPANE
0 HEAT PUMP ❑ OTHER: g01ae----
SQUARE FOOTAGE:
FOR Or1 ICE USE ONLY
MAIN FLOOR
UBC OCCUPANCY GROUP
2ND FLOOR Q 17
BASE FEE U 2, `6
3RD FLOOR
HTD BASEMENT PLAN CHECK ,
UNHTD BASEMENT STATE SURCHARGE 450
CARPORT SUBTOTAL. b ( /F 491
GARAGE /g21t-/2$=32 rrfI POTABLE WATER
DECKS
911/ROAD APPROACH
COMMERCIAL )
INDUSTRIAL GRAND TOTAL I/ L 7,(9.
OTHER RECEIPT # /) 41/p eq
TOTAL VALUATION CASH/ ,407
Or INITIALS121,
ESTIMATED COST o9 DATE C ./ t
,i7s,,)
IF WATERFRONT PROPERTY,
DISTANCE TO BANK_OR HIGH WATER LINE ft BANK HEIGHT ft
SIGNATURE � 02_,N4Sef2._ t ..) ... ?"--7ren..„...„,,, DATE 6 Fe g
NAME (PLEASE PRINT) ---Roy,„ ,S_ L , W PTA'V H:\Home\PIncntr\Forms\8ldapp.DOC 6/97