HomeMy WebLinkAboutBLD1988-00353 BUILDING PERMIT APPLICAT N
Jefferson County ling Department• County Courthouse •Porte send, Wash.98368 • 385-9141
•
N E
I. LOCATION: geographic name S W SIDE OF ROAD FEET
NE
S W FROM INTERSECTION F ROAD AND OAD
other specific location or landmark:
LEGAL DE CRIPTION: 6
p Lot Block 3 (4.
Su ,yoni I
Tax Number Y.Section Section Township Range
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
❑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 ❑YES ONO
❑Foundation only ,
�^�, m w , �-
OWNERSHIP O" i y- �Q USE
r' �I (� kr ❑Full-time Residence
////''''''���� ❑Private (individual,corporation,
nonprofit institution,etc.) 22 ❑Second Home: Recreation Cabin,etc.
ElPublic (Federal,State or local gov't.) UBC OCCUPANCY GROUP: /2!J ❑Second Home: Future conversion to
permanent residence
‘ COST (Omit cents)
06) Nonresidential- Describe in detail proposed use of buildings,e.g.,food
• Cost of improvement $ processing plant,machine shop,laundry building at hospital,elementary
C'-` To be installed but not included school,secondary school,college,parochial school,parking garage for
w in the above cost department store,rental office building,office building at industrial plant.
•
a. Electrical If of ex'sting building is being changed,enter proposed use. ` >
b. Plumbing a f- r- �Cl 'mil Q qO xf f 0 '_L/6��t/1C' 6
'�" c. Heating,air conditioning v(/ !! uV/h�� t �(� (4\,
-C,
d. Other (elevator,etc.) cScv 7�>`
• TOTAL COST OF IMPROVEMENT $ �� (� — Z�
III.SELECTED CHARACTERISTICS OF BUILDING - C(v9 FM lj,f ) G, C a 0
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL DIMENSIONS l (�V
❑Masonry (wall bearing) •Number of Stories
❑ •Public or Private
•Total square feet of floor area,
Wood Frame ❑Individual (septic tank,etc.) all floors,based on exterior
❑Structural steel dimensions
TYPE OF WATER 0-LY
❑Reinforced concrete •Total land area,sq. .
❑Other-Specify ❑Pub' r private company
Individual (well,cistern) NUMBER OF O- -STREET
PARKING S:-CES
Encl. •d
PRINCIPAL TYPE OF HEATING FUE TYPE OF FIREPLACE
El Gas Outdoors
❑Oil RESIDENTIAL BUILDINGS ONLY
❑Electricity Number of bedrooms
❑Coal TYPE OF MECHANICA
El -Specify Number of Full
bathrooms
Partial
IV. IDENTIFICATION- •
Name Mailing Address-Number,
mber,steet,city and State ZIP code Tel.NoM .
1.
i
I l eir 6� bake- ?q,,c79' „2.7`/
Owner V / ( In 0'�
/'v/
2-
Contractor State License No.
3.
Architect
The owner of this building and the undersigned agree to conform to all applicable laws.
i ture of applicant i Address Ap icat• n dal
-e...-k.."-ei.2}-1.-. .tf..."-C.....).-e4L- g(
PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
APPROVED BY
JEFFER''.r COUNTY HEALTH DEPARTMENT
APPA•;. Ali i v PERMIT FEE ISSUE DATE RECEIPT NUMBER
BUILDINGG R MR 3, SC) �� ��
OpFFICIAL
JE FERSON COUNTY , �� S
PLANNING&BLDG DEPT
The Printery-Port Townsend 3
„&„,,,t, .
a4__:---) 4 A.-5Y ' - - '7th4-1.41-1 ei-LA-4-4-1
1,,i hi. .,..,__
,... a t ,, 1
.... __--77-.) ,
, -
-4 -4, ,
,-7.\
7,26.,:6,7 M.) "7& lif
`i - - f o
z
1k
3
i.1
f,
w
1 � ✓/
/�� r