HomeMy WebLinkAboutBLD1987-00009 BUILDING PERMIT APPLICATIO •
Jefferson County Build,,.epartment• County Courthouse •Port TodffilWri, Wash.98368 • 385-1310
N E
I. LOCATION: geographic name S W SIDE OF ROAD QFEET
NE
S W FROM INTERSECTION OF ROAD AND 0c 1 -kD`_` _--����� --
other specific location or landmark: t
L GAL E CRIPTION: f``1 Mee 2. _ bL-
Lot Block Subdivision
977/0 04i/// C� ' t- ....age
Tax Number '/.Section Secti n Township Range
II.TYPE AND COST OF BUILDING -
TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY
7'516ew building 0 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
0 obile Home
❑Moving (relocation)
Other—Specify ❑YES LINO
❑Foundation only
OWNERSHIP USE
❑Full-time Residence
❑Private (individual,corporation,
nonprofit institution,etc.) ❑Second Home: Recreation Cabin,etc.
❑Public (Federal,State or local gov't.) UBC OCCUPANCY GROUP:'- I 0 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 oof ` 1 e \
of existingbuilding is being anged,enterlppropos use. /
b. Plumbing ( 4 ' 71 7 / 3 7 C0b
c. Heating,air conditioning /(0 Y. �� e C-/c/OZ 3 c< 't CD
d. Other (elevator,etc.) 4 D�/ (�p
• TOTAL COST OF IMPROVEMENT $ f`- '� ��
III.SELECTED CHARACTERISTICS OF BUILDING -
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL DIMENSIONS ��
�❑Masonry (wall bearing) ❑Public or Private •Number of Stories r. ....
ivood Frame •Total square feet of floor area,
❑Individual (septic tank,etc.) all floors,based on exterior
❑Structural steel dimensions
TYPE OF WATER SUPPLY Total land area,sq.ft.
❑Reinforced concrete •
ID Other—Specify ❑Public or private company
NUMBER OF OFF-STREET
❑Individual Avvell,cistern) PARKING SPACES
PRINCIPAL TYPE OF HEATING FUEL Enclosed
TYPE OF FIREPLACE
❑Gas Outdoors
❑Oil
' RESIDENTIAL BUILDINGS ONLY
0 Electricity 1Number of bedrooms
oal
TYPE OF MECHANICAL
05./other) Scif Number_of-- Full
gll�JJtM!JJVV
`A bathrdoms
' Partial
IV. IDENTIFICATION- •
Name Mailing Address—Number,street, ' y and State ZIP cod Tel.No.��
1.
Owner \} ��� 1
nJ � 1
2. �` di
Contractor -''.N' State License No.
. 3
Architect
The owner of this building and the undersigned agree to conform to all applicable laws.
' 1 - " 111 0.Q.L__..,
ture plic t Ad9ess r_
Ap lira on d
°- ,..).,0.11,9,_ 1/9.-- 6, _
. „..,
PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
APPROVED, Y
0yc1L il , cT° , —1®'LA la-
JEFFERSON COUNTY HEALTH DEPARTMENT
APPROVED B PERM! ISSUE DATE RECEIPT NUMBER
r.t,
Ca
BUILDING OFFICIAL ea? t� 30 ?C�.
0.-ct - IC i:4 ,/ -'
The Printery—Port Townsend i
1 • 1 S
W S '
.i r--e• '� r'? f)T`T ( C7tJT3 'V' F tTT T.TT)T 1Ttr R F.Rr e •T'
JeffPrsnn County Piannincr and Building ilPnartment
Courthouse,- 3rd 'Floor
P7 Box 1220
Port Townsend, WA. yrsnnrs
206-385-9 1 41
PERMIT .# • RT 87-f 009
STTF, Afl RF.SS 31 COMBS PT, iJATr. I SSUF.i). _ 1 it i 30 j 87
:PORT TOWNSFNTI, WA 98368
0WNF.R •R T CHARD NELSON
MAILING A DR : 3 1 COMBS PTA PHt71VF'
PORT TOWNSiFNIJ WA 98388
CONTRACTOR. . t NO CONTRACTOR
MAILING AffR : PRONE!
•
CONTR. T.T C #: F.XPTRATION T)AT.
PARCF., NO. . . : OO22441JO3
T.F(GAT. T)FSC. . : S T R 24-30-02 WWM. TAX #
LOT
DESCRIPTION OF TMPROVF.MFNT: craraccre and storage
i Fnntinn/Setharks (Shoreline Sethac-k) iMnhi le Home Rinc kincr:
) Foundation ! --
) ilndercrrrnund P l nmh i na lilndercircnjnd Insulation :
) Framina/Plumhinolc^himnev:
i ) Insulation .
) Sheet-rock !
1 Sewage Disposal System Final !
l/i r+i na 1 /Oc cupanry Annrnva i : (n «
•
CALL 38 -9 1 41 24 FOURS IN ADVANCE TO SCHF.I1ULF. TNSPFCTII ONS.
Office Hours a a . m. to 5 p.m.
Inspector ' s Hours y - 10 a . m.
24 Hour Recorder for inspections.
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