The URL can be used to link to this page

Home My WebLink AboutBLD1987-00347 ODJefferson County Build srtment • Cou:'ty C,i,'rt!'ouse • Port Towns Wash.98368 • 335-1310 N E I. LOCATION: geographic name S W SIDE pF ' R D_ FEET NE S W FROM INTERSECTION OF ROAD AND )9IROAD p �other specific location or landmark: `I LEGAL ES�RIPTION: a'I a Areo--�- Lot . Block ivi 7 Tiol;r0. Tax Number '/.Section Section Township Range II. TYPE AND COST OF BUILDING - TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY • w building >ifLgingle 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 ❑Repair,replacement ❑Hotel,Motel, Dormitory at either the U.S.Navy's Trident or number of units Indian Island Facilities? El Wrecking ❑Mobile Home ❑Moving(relocation) ❑Other—Specify -,,, ❑YES ❑NO ` ❑Foundation only USE OWNERSHIP a;: ❑Full-time Residence ❑Private (individual,corporation, ❑Second Home Recreation Cabin,etc. nonprofit institution,etc.) CI Public (Federal,State or local gov't.) UBC OCCUPANCY GROUP:12;27 ❑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 tom, 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 fi r/1,,,, — c3 / 7 / c. Heating,air conditioning 4(AM/��J d. Other (elevator,etc) / Ut CI • TOTAL COST OF IMPROVEMENT $ J `. III.SELECTED CHARACTERISTICS OF BUILDING - PRINCIPAL TYPE OF FRAME 10 TYPE •F ;A4sposAL DIMENSIONS •Number of Stories ❑Masonry (wall bearing) ►; •ublic ,r Private •Total square feet of floor area, Wood Frame I .rvidu-jrep tic t y etc.) all floors,based on exterior Li Structural steel dimensions ❑Reinforced concrete TYPE •F WATER SUPPLY •Total land area,sq.ft. ❑Other—Specify ►.Public or private company ❑I dividual (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 Number of Full W©her—S ify bathrooms W-Q� Partial IV. IDENTIFICATION- - • Name Mailing Address—Number,street,city and State ZIP code Tel.No. ,. 6o r-d -7OCe A., O/ Owner (A) 2- an7t es A P. 0 , (506 V 9 ? `3 ractoryy�ar `rU cols+ .. Jc iS11'tatA ns o ( 3 is h{a&0 ci �y 3. J 1i�1 ll Mr Architect he owner of this building and the undersigned agree to conform to all applicable laws. natur of applicant Add ss A�yg,{plli ttioo/rydda^ttee / Sig 0/ de ANNING AREA N FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT APPROVED BYcli,\t.- (1 . ,a": rily .45 JEFF COUNTY HEALTH DEPARTMENT' • APPROVE B DEPARTMENT'- PERMIT E D E RECEIPT NUMBER .\\ 41 ( ,I 77/ 3O33 BUILDING OFFICIAL /J'^ t Dc Port To..1O nd \ \ ) 1.CA.S f' 7 k---'t -i - 0....._..„ ), ,, ,) 0„......„ ( I , I Cb544-Nr6 /64-1/41,1,-T- Ok,D.Vv.-. -.- ,,6-4\04acstrAll I r I -3? tr...3 c.. ......., _ 1:,,„ ‘,...,0,... av_ .04.....-- - Lc" ----- '1— L.:3,_ no w I ) f LSE R £el 0;1 p Q E j`F Eli �c VE n , II R C f i E`• 6 f� �- '