HomeMy WebLinkAboutBLD1987-00006 . l l'.. :y 1J+ 1'.,.. l., . ,., , . ...,. • 1 . . • .. 1,. • .. . IJ..
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I. LOCATION: prographicname S W SIDE OF ROAD
FEET
S W FROM INTERSECTION OF ROAri9NDa° O-12.S-O/v (le ROAD
4
)
other specific location or landmark:LEGSCRtPT10N: ( j/2 Sj-P Block SubVispn
'• I 055 1 Tax Number Y.Section ction Township 1
Range
II.TYPE AND COST OF BUILDING-
TYPE F IMPROVEMENT BUILDING TYPE MOBILITY •
ICJ New building Single Family 0 New County Resident
❑Addition ❑Multi-Family Is this structure to serve the residential
number of units or commercial needs of those employed
❑Alteration
❑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 C
USE
OWNERSHIP
0 Full-time Residence r
❑Private(individual,corporation, IP
nonprofit institution,etc.) a_ 0 Second Home:Recreation Cabin,etc.
❑Public(Federal,State or local goVt.) UBC OCCUPANCY G8OUP: 1 0 Second Home:Future conversion to E:
permanent residence i•
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 f
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 IfAuse of existing building is being changed,enter proposed use.
b. Plumbing )/rA
u 2 / 3 5-Pt e __- / L 3 3
a Heating,air conditioning I 0 /6 `._._ (0 J ?( :
(5q,(7� — e g Z C(0 .'
d. Other(elevator,etc.) i' ( �"
• TOTAL COST OF IMPROVEMENT $ 5 C-/j 8' P72
'
III.SELECTED CHARACTERISTICS OF BUILDING - �k � N( F• .
r4,
•
PRINCIPAL TYPE OF FRAME E OF SEWAGE DISPOSAL DIMENSIONS + `:<
Masonry(wall bearing) •Number of Stories
Public or Private r�:-
•Total square feet of floor area, i..-,
❑Wood Frame Individual (septic tank,etc.) all floors,based on exterior (;:-
0 Structural steel dimensions r`-
❑Reinforced concrete TYPE OF WATER SUPPLY •Total land area,sq.ft. / !
0 Public or private company
❑Other—Specify —./ NUMBER OF OFF-STREET r
?6ndividual (well,cistern) PARKING SPACES r. ,
Enclosed
PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE
O Gas Outdoors
o it RESIDENTIAL BUILDINGS ONLY .-
Electriciry Number of bedrooms /
Coal TYPE OF MECHANICAL
�( Number of Full
L]-Uther—Specfy
( - bathrooms
L - OC!,�� ',4Q - Partial
IV- IDENTIFICATION- • , 92
v LA tk- �
Name Mailin Address—Number,street,city and State _ ZIP code Tel.N
1. . 0&);---iLACL( - 51 qa-1 .9 ,5().S---(.77—
Owner
\M '.. /
g' ?
2. rZzQ , .
ContractorState License No. tl i'
3- -
Architect
The owner of this building and the undersigned agree to conform to all applicable laws.
J of applicant Address
y Application date
fir✓/G �✓l? >'ZS� 1 /� ' '?�% � _ (/ — `'� /
PLANNING AREA FIRE DI RICT SCHOOL DISTRICT WATER DISTRICT
APPROVED BY �� •
/ JLt.?
JEFFERSON COUNTY HEALTH DEP NT �''4'c--' -
APPROVED B : PERMIT FEE G
ISSUE DATE REEIFT NUMBER_
/ 0 , c7-0 c_i _IV
,.
BUILDING OFFICIALD \_- / �j
iBl't>:..:.,. v ,:rt e.Pd'g: ur r / TheeR cc.) 3-/y , _
oar Tosnscnd C O -// l -q `i/ S
I
M TNT C )77iV'r'V' TTTT.T'i T. 1\7 PF. F rv7T
Jefferson County P iann inr-r and R1] i ?ri ing department
Courthouse, srd F'innr
PCi Rnx 12 C)
Port Townsend ; WA Cti36F-3
206-.SR5-q 1 4 1
PERMIT # - RT,D67-OC1C1n DATE, I SSTJF.D. - 04 30 F R 7
SITE Afl 1R-.SS - 1 (420 SWAf'VSONV TT,T,F. Rd
: PORT .ITDl,(1W; WA at5.165
OWNER • Ar`.AiV AIVDFRSO T P-TOT\TE : 4.17-2175
MA T T,T NG ADDR : 5 1 .TOHNSCIN ROAD (4
: PORT T,TJDT,OW WA -=16.7165 ~ �:J 1 ,. „'ice
CONTRACTOR . • -O CONTRACTOR
PHONE :
MA T T,TWG AlfR
•
CONTR. LTC #: F,XP T RAT T O1iv DATE :
PARCEL 7VO. . . : R21115.SOoq
LEGAL DESC . . " S'TK
WM, TALC'
,il"T PiLo :iC'
fFSCRTPTTO'N OIr TMPROVF.MFNT"
single family
residence
ant i ng%Sethacks (Shoreline Sethack t 1 Moh i I P Home R Inc i nr7-
Foundation :
1 Underground P umh i nr7%'I1'nderground Insulation !
1 Framing Pinmhina Chimney-
i Tnsuiation •
Sheetrnck-
1 Sewarge Disposal System Final !
j Final/Occupancy Approval :
ow, 66
CALL 355-q. 141. 24 FCiiRS TN ADVANCE. To SCrEDUUTF. T FvSPFCTTO`vS .
Office n!17-c G a m T l m
I
fw
A� erso n des A er��
RECEIVED
JEFFERSON COUNTY
APR 10 1987
PLA,NNiNe UEPAAiMENt
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