HomeMy WebLinkAboutBLD1987-00013 1. LOCATION: propraphicname S W SIDE OF ROAD FEET
N E ROAD
S W FROM INTERSECTION OF ROAD AND
. . Ilik
other specific location or landmark:
7i� 4/fig l�'°�
LEGAL DESCRIPTION: - /
Lot Block Subdivision
00/ 5Z/ da G%'` 2- _ 63Z.3 4/E (3 ) 3o >✓ /4J
Tax Number Y.Section Section Township Range
II.TYPE AND COST OF BUILDING • S uriWW,
TYPE OF IMPROVEMENT BUILDING TYPE PUBLIC WORKS APPROVAL
-%.
New building 0 Single Family _
Addition ❑Multi•Fsmily number of units Road Access Permit No.
Alteration 0 Hotel,Motel, Dormitory
Utility Permit No.
Repair,replacement number of units •
0 Wrecking ❑Mobile Home Emergency Services No.
(�.
❑Moving(relocation) //)ther-Specify Street Width A:
❑Foundation only •
TTT
P be ha l'p,.
ci}EV p a An-)5 kit) B:
—� �% . Additional Permits Required:
IAC�t\oGN - StNK-- AL.S-1.
OWNERSHIP 1,..Yv.T LLosa..l
0 Private(individual,corporation,
nonprofit institution,etc.) n A�l
0 Public(Federal,State or local goVt.) UBC OCCUPANCY GROUP: r[�r
COST (Omit cents) Nonresidential- Describe in detail proposed use of buildings,e.g.,food
• Cost of improvement S
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.
If use of existing building is being changed,enter proposed use.
a. Electrical �_( ..0
b. Plumbing c7j�1 x g ^ ' 3/ 82y
1
c. Heating,air conditioning y
d. Daher(elevator,etc.)
• TOTAL COST OF IMPROVEMENT S
III.SELECTED CHARACTERISTICS OF BUILDING �X/ ,..,y /no)- -ttpi i5sS
DIMENSIONS ( -i
PRINCIPAL TYPE OF FRAME TYPE OF S AGE DISPOSAL •tyumber of Stories
0 Masonry (wall bearing) 0 Pu is or Private •Total square feet of floor area,
Frarrte .Individual (septic tank,etc.) all floors,based on exterior •
/� r,
dimensions ! 2-
Structural steel
TYPE OF WATER SUPPLY •Total land area,sq.ft &,7
❑Reinforced concrete
Public or private company
❑Other-Specify NUMBER OF OFF-STREET •
0 Individual (well,cistern) PARKING SPACES
Enclosed •
PRINCIPAL TYPE OF HEATING FUEL a •E OF FIREPLACE •
tars
CI Gas �
D Oil RESIDENTIAL BUILDINGS ONLY l' Inn
Number of bedrooms eX/S%,. j
❑Electrici TYPE OF CHANICAL //'°.tlS'M�
Number of {FI
•
•Other-Specify bathrooms Partial E
IV.IDENTIFICATION
Name /lIFiecie. /- PO/Mailing Address-Number.street,city and State e�ZIIP code Tel.No.
6 8/i/ P? /O3l�g
I. , y.A1 /V .32g�-
I..
Owner g.you
tt.
2. Gw .4 tom.-
Contractor- State License No. I i
a
Architect 1
The owner of this building and the undersigned agree to conform to all applicable laws.
Signature of appivn r Address /1 1 (�2
PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
APPROVED BY APPROVED 3Y APPROVED BY
SS $ a HEAL DE t E I NE CEPT . PLANNING DEFT. k
JEF ISSUE DATE RECEIPT NUMBER
APPROVE B PERMIT FEE
7t4Ni%/J 3 0(1
BUILDING OFFICIAL 1 / Y.-r O �/
TLr P..nlrri• — Pot( To.s:Jsend _
1
0L Mtn —
r
FPW F+.R C)1V' C .7C )\.!'iT'S'Y iit)'i I.i l i WC--; t+.R1 s1 �E
Jefferson County Planning and Building Department
Cnurtho1]p. . 3rd] Fl nor
PC) Rox 1 22n
Port Townsend . WA gR36A
206-355-a 1 41
PERM T T # - RT,ilR7-O0 i 3 T)ATF T SST1'F1l. : 115%%Cl%8 7
STTF ATiilrrr.» : i CUR RT)
PORT TOWNSFNTI. WA yn.inrs
(JWNF.R •HA N T r•, CKRR PFONF :
MATL N) A nR : PO BOX RA1
: PORT T(OWNSFNT) WA 9R368
CONTRACTOR . . :NO CONTRACTOR PHONE.:
MATT,TNC AT DR :
•
CONTR . LTC #: RXPTKATTON TlATR :
PARCFT, NO. . . : OO i 3 i O0
T,FCAT, T)F.SC . . : STR WM. TAX #
LOT RT,OCK
FSCRTPT T O)N OF TMPRO/VFMF.NT ` ,.
i FnntingriSethacks (Shoreline Sethac:k i nviohi ie Home Rinnkingr:
i Foundation :
i TTnderaround P1umhincriTTndernround Tnsulatinn :
i Framing/P lumhingr/Chimney:
i Tnsulation :
i Sheetrock:
i Sewage Ti i snnsa l System Final :
I /Occunan Annrova l
-27 •
CALL 385-91 4 1 24 HOURS T N ADVAIVCH TO SCHFIITTT,F T N:1t- I'T ONS .
Office Hours a a . m . to 5 p.m.
inspector ' s Hours 9 - 10 a .m.
24 Hour Recorder for inspections.