HomeMy WebLinkAboutBLD1989-00457 •ILDING 'ERMIT APPLICATION
Jefferson County Building DepartmenteT.02 Box 1220 ?ort Townsend. WA 98368
LOCATION
C\J��� "
SPECIFIC LOCATION SITE ADDRESS
POSTAL DISTRICT /SUBDIVISION
LEGAL DESCRIPTION LOT BLOCK DIVISION TAX NUMBER
PARCEL NUMBER 1 / 4 SECTION
PLANNING AREA SECTION ( 0 TOWNSHIP NORTH RANGE WM
BUILDING INFORMATION
BUILDING TYPE TYPE OF IMPROVEMENT SQUARE FOOTAGE
9
❑ SINGLE FAMILY C NEW BUILDING MAIN FLOOR
,Y 1 ❑ MOE1 I LE HOME l/❑�ADDITION 2ND FLOOR
` i 0 MODU_ : e HOME 0 ALTERATION BASEMENT
{r) ► DETAC. _ I rAFHED a REPAIR CARPORT //S _
REPLACEMENT GARAGE
V . GARAGE❑ WOODSTOVE a(1x y� 0 WRECKING/DEMOLITION I COMMERCIAL
❑ MULTI - FAMILY 0 RELOCATION/MOVING INDUSTRIAL
NUMBER OF UNITS
'�.,, ❑ COMMERCIAL MOBILE HOMES
�,,' SIZE 0 a $35
❑ INDUSTRIAL YEAR
❑ HOTEL/MOTEL/DORMITORY $ is c} / /
NUMBER OF UNITS MAKE /I�-�� "- $8 lG lL�
❑ OTHER SPECIFY ESTIMATED COST OF s 0 Ct� $8
IMPROVEMENTS TOTAL FAIR MARKET VALUE
UBC OCCUPANCY GROUP $ $
t•',,, SELECTED CHARACTERISTICS OF BUILDING
PRINCIPLE 'TYPE OF FRAME PRINCIPLE TYPE OF HEATING FUEL
❑ WOOD FRAME ❑ ELECTRICITY ❑ COLLECTIVE SOLAR '
❑ MANUFACTURED ❑ WOODSTOVE 0 PASSIVE SOLAR
❑ STRUCTURAL STEEL 0 GAS ❑ COAL
+' ❑ REINFORCED CONCRETE ❑ OIL ❑ OTHER - SPECIE
k
❑ MASONRY ( WALL BEARING ) DIMENSIONS
6 0 OTHER
NUMBER OF STORIES TO L LAND AREA
DEPARTMENTAL REVIEW
HEALTH DEPARTMENT TYPE OF SEWAGE DISPOSAL P .+IdiEL? OF PFOFOSED BEDROOMS
❑ PUBLIC OR PRIVATE NUMBER OF EXISTING BEDROOMS
❑ I ND I V I DUAL ( SEPT I C NUR9BFR OF PROPOSED BATHROOM
APPROVED DATE ❑ INDIVIDUAL WELL NUMBER OF EXISTING BATHROOM
PUD ? TYPE OF WATER PPLY
\1) ❑ PUBLIC ( N ' E OF WATER SUPPLY)
APPROVED DATE ❑ PR I VAT ( NAME OF WATER SUPPLY-.. s_ w 4__.. , _ ,,
PLANNING DEPT . WITHI SHORELINE JURISDICTION
O Y- NAME OF ADJACENT WATER BODY
❑ NO
APPROVED DATE BANK HEIGHT SETBACK
PUBLIC WOR DEPT ROAD RIGHT-OF-WAY WIDTH
' 1 NAME OF PUBLIC ROAD
NAME OF PRIVATE ROAD
AP- -OVED DATE ROAD ACCESS PERMIT REQUIRED ❑ YES ❑ NO
IDENTIFICATION
NAME MAILING ADDRESS ZIP TEL NO
OWNER 1,(x../5
'�-0 CONT oi.- IL � _
& , 0/ �1- a3
-Pc& - - ` �I Cf.1 . r _ IVY
ARCH
THE • NER OF THIS BUILDING AND THE UNDERSIGNED AGREE TO CONFORM TO ALL APPLICABLE LAWS;
` - • N. UR;-; • .LIC T AfL CAT ATE RECEIPT NUMB CHECK NUMBER DR CASH
APPROVED BY PERMIT FEES
APPROVED
in ()o BASE FEE INSPECTION
1.
AUG 14 1 (`)i 7 So BLDG SURCHARGE PLAN CHECK
JFFFERSON COUNTY ENERGY SURCHARGE $/ J1 J// TOTAL
911 NUMBER REUNO DATE DATE ISSUED
BUILDING OFFICI ' _. M-
n
` Ae qe-e4 qV s'.3-s 0
' , 1 t
JEFFERSON COUNTY BUILDING APPLICATION , ,
Jefferson County Permit Center . ei A, ta
itle-,0 i i
cr , , ,
Castle Hill Mall
621 Sheridan St . rt �
Port Townsend, WA 98368
360-379-4450
PERMIT # •BLD98-0452 DATE RECEIVED. : 07/14/98
SITE ADDRESS :251 CENTER CEMETARY RD
:CHIMACUM, WA 98325
APPLICANT. . . :ROBIN HELM PHONE: (360) 732-4676
JAILING ADDR:251 CENTER CEMETARY RD
:CHIMACUM WA 98325
CONTRACTOR. . :OWNER PHONE :
JAILING ADDR:
CONTR. LIC # : EXPIRATION DATE : / /
1.RCHITECT/ . . :FRANK KNOX PHONE : 692-6663
DESIGNER •BENTLY DRIVE
^TAILING ADDR:
:BREMERTON WA
PARCEL NO. : 801035006 landslide — plat cond wetland _ flooding
LEGAL DESC:STR 03-28-01 W WM seismic streams / 3 erosion f & w
SOT , BLOCK , TAX # aquifer recharge
DESCRIPTION OF IMPROVEMENT: addition (residential) ( S
BUILDING TYPE •RES BEDROOMS--- BATHROOMS-- MAIN FL. . . : 620 sf
TYPE OF IMPROVEMENT:ADD EXIST. : 2 EXIST. : 2 ADD' L FL. . : 0 sf
GARAGE/CARPORT • PROP. . : 2 PROP. . : 1 HTED BSMT. : 0 sf
WOODSTOVE • TOTAL. : 4 TOTAL. : 3 UNHT BSMT. : 0 sf
JBC OCCUPANCY GROUP: SEWAGE DISP. . :CON OTHER 0 sf
TYPE OF CONST WATER SUPPLY. :PWELL CRPT/GAR. . : 0 sf
JNITS . : 0 STORIES : O HEAT TYPES . :EEE/ / DECKS 0 sf
DIMENSIONS : COMMERCIAL: 0 sf
FRAME TYPE:WOOD INDUSTRIAL: 0 sf
EST COST. $ : 33337 BANK HT. . . : 0 ft
PROJ GRP. . : 10542 SH SETBACK: 0 ft
Jwner/agent FEES
Signature : type amount by date recpt
PRMT $ 482 . 15 MM 07/14/98 2738
Date : PLCK $ 144 .65 MM 07/14/98 2738
B.C. $ 4 .50 MM 07/14/98 2738
Issued By:
Date :
'bld_appl .txt 4/98)
` � $ 631 .30 TOTAL
I 7 o1D_gg
/e•-•/ ,....., ./.........
s......., f . , •. (
, •
i
r I
t 1
I , 1.---.. ... 1 f•f\ , t
I 1
1/4.--..4 • /...'
..r---. ,......
••••. t 1
---------- i__-.. •
,-........,...____..w......
2„...s.,
-‘:‘,,........ ,:______12..:.___________... -"..) •<) -5 r' /
-r-., ,:ki•s-_ ---__________,'1-:-
. .. . .
--,--
-. ,It .....i
1
--I ill I
I i '
i
I t .).- --•
n;
rs—
r-c) ,.(,,...
/& ;
\ ,..G-:
/
Tri
....3 a.....
1
CZ
(..)3
6--;
1
-r- - 1 c-• I • ..a K. rr....7)
(---.
....0'i 0
-4- i ,• lo .......
•,-) , '.... I„
= i.. .
.......,.. , . .
..._—____. ....
\ i
I f
...e,
...--\- ,.-
----•..r.....
---,
--:,.--
....,...
- - -,.‘-''e.-
6 -'-
r'f'•
• •
I
I
' I ..---
1 !
'-—-.-----.--.
1
. i ' •.::,
I
1 U
, a-- ,......
,-. -
I
,
I
1 ,
: .
1 ,
I I1 ... ,;