HomeMy WebLinkAboutBLD1988-00339 - CANCELLED qq �sl ' BUILDING PERMIT APPLICATION .
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VUl �-'� Jefferson County Buildingirtment• County Courthouse • Port TownserSash.98368 • 385-9141
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I. LOCATION: geographic name S W SIDE OF R AD -- FEET
S W FROM INTERSECTION OF ROAD AND l"(�� D
other specific location or landmark:
LEGAL DES CRIPTION:
�.- itc.2 ck Subd' i io
IL� T31L) i (t--)
n'
DO a Number Y S ction Sew on--. P Range
e
C 9
II. TYPE AND COST OF BUILDING-
TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY
❑New building ❑Single Family ❑New County Resident
❑Addition ❑Multi-Family Is this structure to serve the residential
number of units or commercial needs of those employed
❑Alteration P Yed
El Hotel,Motel, Dormitory at either the U.S.Navy's Trident or
❑Repair,replacement number of units
Indian Island Facilities?
❑Wrecking ❑Mobile Home
❑Moving (relocation) /Other—Specify
❑YES ONO
❑Foundation only
L.,
W D a ci...%Tv-e_____
USE
OWNERSHIP
❑Full-time Residence
❑Private (individual,corporation,
nonprofit institution,etc.) •
❑Second Home: Recreation Cabin,etc.
IDPublic (Federal,State or local gov't.) UBC OCCUPANCY GROUP:/ ❑Second Home: Future conversion to
permanent residence
COST (Omit cents)
Nonresidential— Describe in detail 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.
a. Electrical If use of existing building is being changed,enter proposed use.
b. Plumbing
c. Heating,air conditioning
d. Other (elevator,etc.)
• TOTAL COST OF IMPROVEMENT $
III.SELECTED CHARACTERISTICS OF BUILDING -
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL DIMENSIONS
❑Masonry (wall bearing) ❑Public or Private
•Number of Stories
•Total square feet of floor area,
❑Wood Frame ❑Individ,uai'(septic tank,etc.) all floors,based on exterior
0 Structural steel dimensions
TYPE OF WATER SUPPLY
❑Reinforced concrete •Total land area,sq.ft.
❑Other—Specify 0 Public or private company
❑Individual (well,cistern) NUMBER OF OFF-STREET/
PARKING SPACES
' Enclosed...-,.. ,..-
PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE
❑Gas Outdoors
❑Oil ` RESIDENTIAL BUILDINGS ONLY
❑Electricity Number of bedrooms
❑Coal TYPE OF MECHANICAL
❑Other—Specify Number of
Full
bathrooms
-� . Partial
IV. IDENTIFICATION - �/' •
Name Maili g Address—Number,street,city and State ZIP code Tel.No.
f. <x 4 ,� C400 / 4 cQ 3 7�c � 361 —ena0
Owner I f T
2.
Contractor State License No.
3.
Architect
The owner of this building and the undersigned agree to conform to all applicable laws.
. nature applicant thkwe Addres �1 AV ion d)a4
1
PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
APPROVED BY /I//0��_
W JEFFER CO ��` HEALTH DE ARTIJIENT
�yO APPROVE11
:P PERMI EE 1 SUE DATE
RECEIPT NUMBER
3 C./7,3/
`�1 „ 'WI 5) 5 7?(
BUlLDING dfRF qw,
"tANNINr, (-ouNTY
lOb off,T The Printery—Port Townsend
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