HomeMy WebLinkAboutBLD1988-00335 BUILDING PE?MIT APPLICATION -
Jefferson County Bt.ig Department• County Courthouse • Port *send, Wash.98368 • 385-1310
4.
I. LOCATION: geographic name SW SIDE OF 611 L 44,114
other specific location or landmark: ( _ R�AD "J- L.t�ui_er, �
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LEGAL DESCRIPTION: Q �"�N
(J OCT 13 1933
Lot Block Subdivision
`a i JEFFERSCN CUUNry
c4 -2 -ocC, P!artr„vr,&Htn'`• --,'T
-•...,, Tax Number %Section Section Township Range
4(7), II. TYPE AND COST OF BUILDING -
TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY
[P-gew 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
j ❑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 ❑YES [ 1c(o
❑Foundation only POC-E= 6U(CPki�
USE____ /
OWNERSHIP E.Pfull-time Residence
[g Private (individual,corporation, ❑Second Home: Recreation Cabin,etc.
nonprofit institution,etc.)
❑Public (Federal,State or local gov't.) UBC OCCUPANCY GROUP: El Second Home: Future conversion to
permanent residence
COST (Omit cents) Nonresidential- Describe in detail proposed use of buildings,e.g.,food
• Cost of improvement $ 17 0'2-1 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.
a. Electrical If use of existing building is being changed,enter proposed use.
b. Plumbing I (0W0/1 — I 3 ! Q
"-- c. Heating,air conditioning �/
j d. Other (elevator,etc.)
Q • TOTAL COST OF IMPROVEMENT $ I--7, DLI
III.SELECTED CHARACTERISTICS OF BUILDING -
ii
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL DIMENSIONS
% •Number of Stories
cq Ell Masonry (wall bearing) ❑Public or Private
b •Total square feet of floor area,
�,�� W-Wood Frame L -Individual (septic tank,etc.) all floors,based on exterior
�..> dimensions 1 a6o it
❑Structural steel
❑Reinforced concrete TYPE OF WATER SUPPLY •Total land area,sq.ft. 2[(6 COX' 4
--- ❑Public or private company
❑Other-Specify NUMBER OF OFF-STREET
❑Individual (well,cistern) PARKING SPACES
Enclosed 4-
PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE
"'�- ❑Gas Outdoors Z-
Cf.3 ❑oil RESIDENTIAL BUILDINGS ONLY
❑Electricity Number of bedrooms
TYPE OF MECHANICAL
❑Coal Full
❑Other-Specify Number of
bathrooms
Partial
IV. IDENTIFICATION - •
Name Mailing Address-Number,street,city and State ZIP code Tel.No.
1. Py Pe c 1-te-80 -- bOx6SZ. , roCZ(CLS, L Eri7-OZ 833I 314 -ZS8
Owner
f t,6( C31C."i SZC H-wy qg, atN,-WooZ>r Lt.948 1A-JarriA.J Teo3"7 -743- (55$.
Contractor State License No.
IC 3tC J2
3.
Architect
The owner of this building and the undersigned agree to conform to all applicable laws.
Signature of applicant Address Application date
,tc.T. Q y 1C,s2.4 --Ht,Jy fit', (ka,0iJc C C?037 c(/a(gS
PLANNING ARE• FIRE DISTRICT _SCHOOL DISTRICT WATER DISTRICT
APPROVED BY ki �b
JEF •-: 0 l • TH DEPARTMENT
APPR • 014! PERMIT FEE ISSUE DATE RECEIPT NUMBER
/5 3,(`'/ 1D /� //
T 14 1988 3,CS� 1 1 V ! 7 �
----
VILDINI�f 1aF�cIuubNTY / 70ivn
PLANNING d,RLDC DfpT
The Printery -Port Townsend
lown OZ1,..iountry_ Suite B • 16521 Highway 99 • Lynnwood, WA 98037-3161
MIIIIIIIIIIMMMINI S T L BUILDINGS Everett Line ) 258-4171
Toll Free 1- 4 9552
_ Administrative eadquarters (206) 743-1555
DIVISION OF •
Quality: Our Future Depends On It'
Site Plan
PLEASE CHECK:
PriProperty dimensions IKSeptic and drainfield NAccess to proposed building
t Existing buildings OSewer lines (Ao. , 0Lot size
®Proposed building f Setbacks of proposed and OElevation of property
OEasements k c existing buildings ❑Bodies of water v
CKMain road with name 1KiFloorplan
Job name: Job Site Address:
Legal Description
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Owner has verified and approved the location of accessories, orientation of the building to th orth, and venfi that a items specified in paragraph
B of the contract arc shown on this drawing and vice versa. Customer signature: ,. it mil _ �.
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