HomeMy WebLinkAboutBLD1988-00326 BUILDING PERMIT APPLICATION
Jefferson County Buildinlipartment• County Cpurthouse •Port Town. Wash.98368 • 385-9141
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I. LOCATION: geographic name S W SIDE OF ROAD FEET
NE
S W FROM INTERSECTION OF ROAD AND • , Oeda ( ROAD
other specific location or landmark: P
LEGAL DESCRIPTION: 1C-L I I Block Past i,�e _" F,c,��'��S 4-
v .rc&`- -ti-('`J r Subdi Sion
C! C ''J"`t io + CO Tax Number /.Section ,Q 8 t
Section Township Range
II.TYPE AND COST OF BUILDING -
TYPE 9F IMPROVEMENT BUILDING TYPE MOBILITY
a ew building ❑Single Family ❑New County Resident
❑Addition ❑Multi-Family
Is this structure to serve the residential
❑Alteration number of units or commercial needs of those employed
❑Repair,replacement ❑Hotel,Motel, Dormitory at either the U.S.Navy's Trident or
number of units Indian Island Facilities?
❑Wrecking
Mobile Home
❑Moving (relocation)
❑Other—Specify El YES ❑NO
❑Foundation only
sand Cri, u (1E,
OWNERSHIP USE
❑Private (individual,corporation,
❑Full-time Residence
'+' „r nonprofit institution,etc.) ❑Second Home: Recreation Cabin,etc.
❑Public (Federal,State or local gov't.) UBC OCCUPANCY GROUP: ),' ❑Second Home: Future conversion to
COST permanent residence
(Omit cents)tsl
Nonresidential— Describe inmdetail proposed use of buildings,e.g.,food
• Cost of improvement $ processing plant,machine shop,laundry building at hospital,elementary
To be installed but not included school,secondary school,college,parochial school,parking garage for
in the above cost department store,rental office building,office building at industrial plant.
e a. Electrical If use of existing building is being changed,enter proposed use.
b. Plumbing _
c. Heating,air conditioning
-"-,.`1 d. Other (elevator,etc.) .
'ems •
•\1 TOTAL COST OF IMPROVEMENT $
III.SELECTED CHARACTERISTICS OF BUILDING -
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL DIMENSIONS
❑Masonry (wall bearing) ❑ •Number of Stories
Public •or Private
Wood Frame 1I9�('(� � e •Total square feet of floor area,
l �) Individual eptic tank,etc.) all floors,based on exterior
❑Structural steel — � dimensions
4 ❑Reinforced concrete TYPE OF WATER SUPPLY •Total land area,sq.ft.
Public or private company
/
NUMBER OF OFF-STREET
\1(l(11 -'O ( I l I F {1 ❑Individual (well,cistern) PARKING SPACES
PRINCIPAL TYPE OF HEATING FUEL Enclosed
TYPE OF FIREPLACE ,,
El Gas Outdoors
❑Oil
RESIDENTIAL BUILDINGS ONLY
Electricity Number of bedrooms
Coal TYPE OF MECHANICAL
Other—Specify Number of
Full
Z) c,1--Ue bathrooms
C�� 1 Partial
IV. IDENTIFICATION-
�yf Name t (^t` �rMailingtA�lddress—/Number,street,city and State ZIP code Tel.No.
1. _aJ I'<1)ncl tX )f?.l U1 j,'�C(� -P) I,4A1 ( \U e cl -�--� t r
Owner U �_� l< t F . `�C 1� i
2.
Contractor State License No.
3.
Architect ..
v
Th owner of this building and the undersigned agree to conform to all applicable laws.
ig ; aPPlicaF
of Adseta W
Application date
)41--
(7)(0 /07/8 8
PLANNING AREA ,FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
APPROVED BYv(c 10 ��ce,��
r
6�e\ opt
JE FAj a HEALTH DEPARTEv1EwT
APPTFIOV I I
PERMIT FEE /sUEE R,EGEPT NUMBER
C,C /,,c.,,?
BUILDItlf16 FE1 DIKDOIN-Y '
3..2 -0 6 17
PLANNING &BLDG DEf T
I l9q(50 The Printery—Port Townsend f () lJ I 7
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