HomeMy WebLinkAboutBLD1987-00012 II
Jefferson County Building' 3,tment• County Cour:house • Port I < ;Wash.9S3GS • 3S5-1 10
N E ti
I. LOCATION: geographic name S W SIDE OF A , FEET
NE
S W FROM INTERSECTION OF ROAD AND ROAD
other specific location or landmark:
9LEGAL SCRIPTION:
Lot . Block Subdivision --
Q l � ,-5 ax Number 'h Section Section Township Range
II.(( TYPE AND✓✓✓ COST OF BUILDING -
TYPE OF IMPROVEMENT L ,% BUILD NG TYPE MOBILITY
lNew building �2 �e Single Family ❑New County Resident
dition ❑Multi-Family Is this structure to serve the residential
number of units or commercial needs of those employed
{ ❑Alteration ,l at either the US.Navy's Trident or
ek ❑Hotel,Motel, Dormitory
❑Repair,replacement number of units Indian Island Facilities?
❑Wrecking ❑Mobile Home
❑Moving (relocation) ❑Other—Specify ❑YES ❑NO
❑Foundation only
USE
OWNERSHIP ❑Full-time Residence
❑Private (individual,corporation, ❑Second Home: Recreation Cabin,etc.
nonprofit institution,etc.) n`'?J
❑Public (Federal,State or local gov't.) UBC OCCUPANCY GROUP: /— ❑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
r 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 of existing building is being changed,enter proposed use.
30 C-5—��
b. Plumbing "M�[ ' �
c. Heating,air conditioning CU / f Y l 1 1 C v
7-7
d. Other (elevator,etc.) f3a2v,3/ )/6/ ! 5-67 t
• TOTAL COST OF IMPROVEMENT $ � ��. /
III.SELECTED CHARACTERISTICS OF BUILDING - 7'47 r c 7 �(//
1 DIMENSIONS
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPO I( •Number of Stories
c6
s
❑Masonry (wall bearing) ❑Public or Private '` •Total square feet of floor area,
i all floors,based on exterior
{ ood Frame divid •
al (septic tank,a c.)
dimensions
ructural steel
TYPE OF WATER SUPPLY •Total land area,sq.ft.
❑Reinforced concrete
❑Public or p company
❑Other—Specify (w ������tttJJl NUMBER OF OFF-STREET
Indivi al cistern) PARKING SPACES
Enclosed
1 PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE
Outdoors
❑Gas
1RESIDENTIAL BUILDINGS ONLY
❑Oil r02.d J
/7 CeJ� Number of bedrooms
(Electricity
TYPE OF MECHANICAL
❑Coat Number of. {Full
Other—S cif • bathrooms }
Partial
IV. IDENTIFICATION •
-
f
Name Mailing Address— Number,street,city and State ZIP code Tel.No.
i. ''hrt•(-4 (AC .
...-4.1.it..._.9-
Owner ) c..,..,396-
11°6 00AO- GC//5
2.
Contractor mate License No.
3.
Architect
The owner of this building and the undersigned agree to conform to all applicable laws.
Signature of applicant Address w., ils
licat date
Gil 7Jf7 _V
•
PLANNING AREA FIRE DISTclICT SCHOOL DISTRICT WATER DISTRICT
APPROV D t.�b
�` '
JEFFER r
TH DEPARTI ` `Z k s`
APPROV D BY • ERM/T FEE ISSUE DATE RECE I PT NUMBER
' 7c/
1, SO 5"....1 ...__V .75~c
OFFICIAL BUILDING O CIAL (/
S ,
3qq ,Yh ,t:, ownse "TD _7
4"S .7. i
.7 r. r+ r'-. F.1? C7 i\T C`,; i 1 t 7 TT-i-'yT .1R t aT T �i T.i 3 T T\T C� K i vT
Jefferson County Planning and Building Department
Courthouse, 3rd ' 1nor
PO Box 1220
Port Townsend , WA 98368
206-3R5-9 1 4 1
PERMIT # • RLT)fi7-OO1 2 DATF. TSSUFSD. :05/i 5/87
STTF. AI)1)RF.SS : 5O 1 SHINF. RT)
PORT T.UDLOW; WA g8365
OWNER -MARRY STvI'I TH PHONE' 43 7-29 1 3
MATT.TNC A DR : 601 SHTNF. RT)
:PORT T.Ui3T.OW WA gH365
CONTRACTOR . . :NO CONTRACTOR PHONE :
MATT.TNC ADDR :
CONTR . T.I C #' F.XP T RATTON IDATF.
PARCEL NO. . 821 334On5
T.EGAT. fRSC. . -STR 33-2R-01 F.WM. TAX #
T.OT RT.00K
DESCRIPTION OF IMPROVEMENT : single family residence
; Fnntinc7/Sethacks (Shoreline Sethack) /Mohiie Hnme Riockinn:
) Foundation :
i Underground Plumhincg/Underaround Insulation :
) Framing/Plumhino/chimney.
i Insulation -
i Sheetrock •
i Sewage Disposal System Final :
i Final /Occupancy Annro alp
CALL 385-9 1 4 1 24 HOURS TN ADVANCE TO SCHEDULE INSPECTIONS.
Office Hours q a .m. to 5 p. m .
Inspector ' s Hours q - 10 a . m.
24 Hour Recorder for Inspections.
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