HomeMy WebLinkAboutBLD1987-00004 •
BUILDING PERMIT APPLICATION
Jefferson County Buiidit partment• County Courthouse •Port`Town�, Wash.98368 • 385-9141
N E
I. LOCATION: N E raphic name S W SIDE OF ROAD
/ , FEET
S W FROM INTERSECTION OF ROAD AND J^jC,''
ProTrri.---ElivED ROAD
other specific location or landmark: c l
LEGAL DESCRIPTION: uta; 3 D 1987
I �� �� Lot Block
JEEFERSON COUNTY
W I 1 /2 * 1 NE Slit)
} 3� Subdivision/�P�A�I�„^,U Mr;�ErPT, l
vv Tax Number '\! '/'.�ISvecctiioon VlJ Section l J i nge
II. TYPE AND COST OF BUILDING - Township Range
TYPE OF IMPROVEMENT
BUILDING TYPE MOBILITY
•
ANew
building Single Family •
❑Addition ❑New County Resident
Multi-Family
❑Alteration number of units Is this structure to serve the residential
or commercial needs of those employed
❑Repair,replacement, LI Hotel,Motel, Dormitory at either the U.S.Navy's Trident or
number of units
❑Wrecking Indian Island Facilities?
❑Mobile Home
❑Moving
(relocation)
❑Other—Specify
❑Foundation only ❑YES ❑NO
OWNERSHIP �)ie ibrK l �1,'- 5..�,.
USE
V COD<7-
❑Private (individual,corporation, J ❑Full-time Residence
nonprofit institution,etc.) 6 lc- >___,
❑Second Home: Recreation Cabin,etc.
El Public (Federal,State or local gov't.)
UBC OCCUPANCY GROUP: R.`—3 ❑Second Home: Future conversion to
COST (Omit cents) Permanent residence
• Cost of improvement Nonresidential— Describe in detail proposed use of buildings,e.g.,food
Tot inimpr d me not included $ processing plant,machine shop,laundry building at hospital,elementary
in the above cost school,secondary school,college,parochial school,parking garage for
department store,rental office building,office building at industrial plant.
a. Electrical If use of existing rent building
g is being changed,enter proposed use. •
b. Plumbing
r)r)rnom' 021,1 X I.p o2.W0 i L 8 = I , 9.Z0
c. Heating,air conditioning
d. Other (elevator,eta) r�
• TOTAL COST OF IMPROVEMENT $ (it2
III.SELECTED CHARACTERISTICS OF BUILDING - �� (�9.2'
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL DIMENSIONS
ElMasonry (wall bearing) •Number of Stories
❑Public or Private
Wood Frame
Xan •Total square feet of floor area,
J? Individua (septic—tank, :tc.) all floors,based on exterior
Structural steel f •
dimensions
ID
❑Reinforced concrete TYPE OF WATER SUPPLY
•Total land area,sq.ft.
❑Public or private company
ED Other—Specify
)41ndivid al (well cistern) NUMBERPARKING OF OFF-STREET
SPACES
PRINCIPAL TYPE OF HEATING FUEL Enclosed
>4Gas TYPE OF FIREPLACE
Outdoors
❑Oil
❑Electricity RESIDENTIAL BUILDINGS ONLY
Number of bedrooms
❑Coal TYPE OF MECHANICAL i..
❑Other—Specify Number of Full 1
•
bathrooms 1
Partial
IV. IDENTIFICATION- .
•
Name Mailing Address—Number,street,city and State
ZIP code Tel.No.
1. NI
i
Owner rl, . E 1+�� 0 I .& 14 6 I balitil I
Inal2.
Contractor State License 'To.
3.
Architect
The owner of this building and the undersigned agree to conform to all applicable laws.
f a•plicant Address
pp
�`'/ Application date
1a3c8�
PLANNING AREA FIRE DISTRICT
SCHOOL DISTRICT WATER DISTRICT
APPROVED BY OLG
JEFFER • /TM 8e
APPRfAVW,ri „ , NTY HEAL DEP TPvIEEVT
',r� D PERMIT FEE ISSUE DATE
`� ''t� CO RECEIPT NUMBER
ppllit
Ilk
3 50. 37C�
BUILDIN�EEFE I :CbUNTY 39' B - 50
The• Print
ery—Port Townsend .��
11, a a r { S
r;.- r+-i~:r iiT C1CiT3\rm'T F tTT T.i3Ti\7t; Ar` -T. T ( ,WI'T ()TAT
Jefferson County Planning and Building Department
Courthouse, 3rd Floor
PO Box 1220
Port Townsend , WA yts3t7ts
206-38 S-`f i 41
PF.RivTiT
RTJ)87-0004 TIATR RRCFTVRD. . 12/30/37
S T'I F. A DRF.SS : 542 PROSPECT AVF.
-PORT TOWNSRNT); WA 9,836S
OWNER
PWT T,T P SAXTON PHOJF - 385-7327
MATT.T NG AT)T)R -PO BOX 602
•PO}RT TOWNSRNT) WA gR368
CONTRACTOR . . :NO CONTRACTOR
Pi-ii�iJ F.c
MA T T.TNC A DP:
•
CONTR . T T C #: F.XP T RATTON T)ATF.
ARCWTTF.CT/ . . . PHONE.:
FSTSNF.R
MA T LTNO ADI R
PARCFT. NO. . . : OO1343002 RF.AT,TH:
T,RCAi. TIF.SC. - STR 34-30-01 WwM, TAX
RV: T)A T F.-
SHOR F.LTNF.S
LOTRT,ni K T�ATF.
BY:
DF.SCRTPTTON OF IMPROVEMENT- single family residence
MAIN FT.. . . . 37800 sf
RTTTT.i)TiJc, T`r'PF. •RFS RF.T}ROOMS--- RATHROt'iMS-- 2NT� FT. • r,a i 2 sf
i drr. Or.,
ii�PRt)VF.i�fF.NT-TJF.w F.XTST . : 0 FXTST . - 0 SRC FT, 0 sf
C;ARAGF/i ARPORT PROP. .• 2 PROP" . • 1
WOODSTOVF TOTAL. ! 2 TOTAL. : 1 RASF.Tv1F.NT. . . 0 sf
USC OCCUPANCY GROUP:R3 SFWA( F UTSP. . : SFPT T C
CARPORT. . . : 0 sf
TYPE OF CONST
wATF.R SUPPLY. :PR T VATF OARACF. 0 sf
FCKS O sf
UNITS . - 1 STORTFS : 2 HFAT TYE D
P S . :CAS/ / FCMFRCTAT,. 0 sf
DTMFNSTONS - MORTT,F. HOME
MAKE • YR . TNT�TTSTRTA: 0 sf
-BANE. TY PF-wOOn BANK HT. . � O ft
F.ST COST. $ - 46632 S T 7.F ft
SF SFTRAC K: O
PRO.T rRP_ i Oh=3
r^F.F.S
Owner/anent
S i gnature: type amount try date recant
01 f 20/88 31761
lute - PICK 3 . 50 01 /2O/isis 31761
issued Sy: R.C . $ 4 . 50
T)atP-
3 -/ v+ c o
HT,
r r.
1 {
•
7•.r ;=•- s*.3'c =, i 3 - i:i )i 1 TN i`T 1 T;► T T.i)T TNT C� >�. F 1v
Jefferson County Punning and B13 ilaing flenartmPnt
CnurtnnusP; srn Fri nor •
PC Box 1 2 2 it
Port Townsend , WA 98368
206-385-9141
MATE TSSiiRii. - Ci i2ilj�Srs
PF.Ri�i T''" # •RT,7n7-ililt)4
S'I TF. ADT)RFSS : .5a42 PROSPECT AVE
:PORT Ti1WNSRNfI; WA :7rs.inrs
PHi)TvF.� .Srsra-7�27
OW iV N.K •P11'i i I.T P SAXTO'IV
MATT, NO AT)fR :PC) R0X 602 ,J
•PORT TOwlisF.iVi) WA 9R368
PHi1NR
COINT'RACTOR . . [Nil CONTRACTOR
TV1A'( L't NO A nR •
•
CONTR . LTC C #• RXP i RATTON f1ATR'
PARCr.I. NO . . . 001 343iO3
LEGAL f1RSC . . : STR 34-30-01 WWM; TAX #
LOT RLOCK
nESCRTPT T ON OF T MPRCVRMFNT- single family res i denrP
( i Footing/Setbacks (Shoreline Setback) /Mobile Home R 1 nk i ng
i Foundation :
i iindergrnund Plumbing/Underground Tnsu 1 at i on
i Framing/Plumbing/Chimney: /4?2 �.LG, 44/73/9
1`•>/.a4w / 1 3 / • o ��
) T n s a l 1 at i on
,�•/ J04
i Sheet rock -
i Sewage T)isnosal System Final :
) Final /Oc:c:upanc:y Approval : �i 10-5"191
CALL R -9i1 4 1 24 FOURS TN AT)VANC F TO SCHRiiiil.R TNSPF
Office Fours y a .m. to 5 n.m .
TnspPctor ' s Hours - 10 a .m.
24 Hour RPrnrdPr fnr' Tnsnec:t i ons .
A N
b bw-
4 mil 7;p4.
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3
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4 SL 3 !
syc,•
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v r`
�SU
fr e- /.Z --rs
Slope- '/y.
Trench DriaA (,144r+14.4... -Ora mA,1
rat dv«...81
t . . f r lo.....% 5n.'4.1,..xf;4•
R1YIN.....
. rtpfN<(E4!<I..VJ t • • y v[ -1 o
It0 i ; 0M `.W4ycL rock. .1
i �f •
•I e i
nrf {06+rr ,' t "i/T•et•- f
•
♦z f 0"••-'
• j
34"
RECEIVED
DEC 28'87
JEFF. COUNTY
HEALTH DEPT
i
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