HomeMy WebLinkAboutBLD1989-00462 - CANCELLED L3UIIIONG 'ERMIT APPLT. CATJONIII PLAII //-
Jefferson County Building Department'P .O . Box 1220'Port Townsend. WA 98368
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LOCATION SPECIFIC LOCATION SITE ADDRESS •SUCCM /-ik e R C/)
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POSTAL DISTRICT /SUBD I V I S IONJ hhpr RftR )/:V
LEGAL DESCRIPTION LOT /' -- BLOCK D 1 V I S I ON TAX NUMBER /�`
PARCEL NUMBER Yca./l 1 (-J D/r 1 / 4 SECTION
PLANNING AREA SECTION /7 TOWNSHIP oR ? NORTH RANGE / E. WM
BUILDING INFORMATION
BUILDING TYPE TYPE OF IMPROVEMENT SQUARE FOOTAGE
y� /-
❑ SINGLE FAMILY )4 NEW BUILDING MAIN FLOOR 0 -IP S
❑ MOBILE HOME 0 ADDITION 2ND FLOOR c2C/O' `7 <7
❑ MODULAR HOME ❑ ALTERATION BASEMENT
❑ DETACHED/ATTACHED ❑ REPAIR CARPORT �
GARAGE 0 REPLACEMENT GARAGE /*0 /[
2 -2 - 7 ���
❑ WOODSTOVE ❑ WRECKING/DEMOLITION COMMERCIAL
MULTI - FAMILY ,/ 0 RELOCATION/MOVING INDUSTRIAL
NUMBER OF UNITS L�-
❑ COMMERCIAL MOBILE HOMES 6 �.77 .�
SIZE 3vass• @. $35 (05,I2Z7. 15
❑ INDUSTRIAL
YEAR o�_l� y7 @ $ 1 6 ' 7/3&
❑ HOTEL/MOTEL/DORMITORY ,J
MAKE 0 @ $g
NUMBER OF UNITS
❑ OTHER - SPECIFY ESTIMATED COST OF /y?a-Q @ $8 // 77/6
IMPROVEMENTSfl TOTAL � i R�MgR VALUE
UBC OCCUPANCY GROUP OOOG 'S"
SELECTED CHARACTERISTICS OF BUILDING
PRINCIPLE TYPE OF FRAME PRINCIPLE TYPE OF HEATING FUEL
) WOOD FRAME A- ELECTRICITY 0 COLLECTIVE SOLAR
❑ MANUFACTURED 0 WOODSTOVE ❑ PASSIVE SOLAR
❑ STRUCTURAL STEEL 0 GAS 0 COAL ZP,V-�O- CI I� N' .Q_,e
' ❑ REINFORCED CONCRETE ❑ OIL y OTHER - SPECIFY ! +A, '&d-
( ❑ MASONRY ( WALL BEARING ) DIMENSIONS
CI OTHER NUMBER OF STORIES TOTAL LAND AREA
DEPARTMENTAL REVIEW
.I HEALTH DEPARTMENT TYPE OF SEWAGE DISPOSAL NUMBER OF PROPOSED BEDROOMS Si
g PUBLIC OR PRIVATE NUMBER OF EXISTING BEDROOMS
0 I ND I V I DUAL ( SEPTIC ) NUMBER OF PROPOSED BATHROOM
APPROVED DATE ❑ INDIVIDUAL WELL NUMBER OF EXISTING BATHROOM4a
\+' PUD TYPE OF WATER SUPPLY LuDt_oc,� , -^ �
X PUBLIC '( NAME OF WATER SUPPLY)
APPROVED DATE 0 PRIVATE ( NAME OF WATER SUPPLY
PLANNING DEPT . WITHIN SHORELINE JURISDICTION
0 YES NAME OF ADJACENT WATER BODY
N NO
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APPROVED DATE BANK HEIGHT SETBACK
PUBLIC WORKS DEPT ROAD RIGHT-OF -WAY WIDTH
NAME OF PUBLIC ROAD
NAME OF PRIVATE ROAD
APPROVED DATE ROAD ACCESS PERMIT REQUIRED ❑ YES ❑ NO
IDENTIFICATION
NAME /;M��A/I�-L�I(NAG ADDRESS�(�T �\^'�' /'�/ ZIP TEL �]N�O
OWNER T^ i ResourceS to�l/,"��� Paff.c�..il/�Jlr,)1ci ! 11. `�.J l�41 /� 37wfc✓
•TO -Y. LAD L o w 111 &IQ ;
Cora S M e l
1csA ttI F1a 5 Dq:
ARCH 1
THE OWNER OF THIS BUILDING AND THE UNDERSIGNED AGREE TO CONFORM TO ALL APPLICABLE LAWS.
1
SIGN OF A APPL CAT ON DATE RECEIPT NUMBER CHECK NUMBER O CA^N
. � -� /Ci I �7, , Li ` ( O�z )
PP O 0 BY PE MIT FEES /
BASE FEE INSPECTION
A P Vcs,.... --4BLDG SURCHARGE PLAN CHECK
Ut 1 9 /V ��/�./"ENERGY SURCHARGE $� 1 a J ,
l v TOTAL
JEFFERSON COUNTY (-9 - i t j\)9 I I NUMBER REFUND DATE DAT ISSUED
SUPUQtO'MP 18Frifn AL 7 f w.,...... 1 1�