HomeMy WebLinkAboutBLD1987-00017 N L
I. LOCATION: geographic name S W SIDE__OF_________ .—)11 ...___ i--- _----ROAD FEET
RECEIVED SN
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1EF FERSiJN COUNTY -vi FROM INTEAZECi#ON-0F ROADS X 7tZ�-/1' , 'y-� E- it ROAD otharspe _11 c location or landmark; / � C7
LEGAL DESCRIPTION: Subdivision
l_ Lot Block
PL�,i : ih Ai' . ar rs� IC
X 99 ac> t 2 , 4'
By.y •'°°° .....' ... ,.......- ..arTax Number Y.Sem son Section Township Range
II.TYPE AND COST OF BUILDING - •
TYPE OF IMPROVEMENT BUILDING TYPE PUBLIC WORKS APPROVAL
if$New building Single Family
❑Addition ❑Multi-Family
number of units Road Access Permit No.
❑Alteration
0 Hotel,Motel, Dormitory Utility Permit No.
Repair,replacement number of units '
D Wrecking 0 Mobile Home Emergency Services NO.
0 Moving jreiosation) O Other-Specify Street Width A:
0 Foundation only
B:
. Additional Permits Required:
OWNERSHIP
❑Private (individual,corporation,
nonprofit institution,etc.) 3
❑Public(Federal,State or local gov'L) UBC OCCUPANCY GROUP:
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.
a. Electrical If use of existing building is being changed,enter proposed use,
b. Plumbing ISTFCs /l. ISOU�
c. Heating,air conditioning Z."� -- -yZ
d. Other(elevator,etc) -37'ABS1Axx� ' I Ii 0«
• TOTAL COST OF IMPROVEMENT S
III.SELECTED CHARACTERISTICS OF BUILDING
DIMENSIONS .-.
PRINCIPAL TYPE OF FRAME TYPE OF SE'sVAGE DISPOSAL • •yu, of Stories L-
D Masonry (wall bearing) 0 Public or Private •Total square feet of floor area,
0 Wood Frame 0 Individual (septic tank,etc.) s all floors,based on eal
r
dimensions ..34...
0 Structural steel �L17L1
TYPE OF WATER SUPPLY •Total land area,sq.fL iE _t-
Reinforced concrete
\ 0 Public or private company
Individual (wellOther-Specify NUMBER OF OFF-STREET c
,cistern) PARKING SPACES
Enclosed '
PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE tetra ?':.";e y �i'_
❑Gas
❑Oil RESIDENTIAL BUILDINGSON4Y '�
Number of bedrooms a- ^
pI Electricity
TYPE OF MECHANICAL
❑Coal ' Number of Full_..r ..
D Other-Specify bathrooms Partial E
h
IV. IDENTIFICATION
Name Mailing Address-Number,street,city and State ZIP code TN-No.
(.4� .� gFA..,_,..in-,S't-) , _93f 4 �'F I ,
Owner
Ii,--- i -
2. ` > a
ontraaor^
C ,wteLicense o. i
i
Architect Pel 4/6 ✓'1 :',r ,
The owner of this building and the undersigned agree to conform to all applicable laws.
11 i
Signature of applicant 1
--/-
'''' //277' //— ti -; '4 o6-'-71 38 116, 5 •-•- c/cT, '7 ;_.,
PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT ,...1
/
APPR ED Y APPROVED 3",,,S- S '6'1' '"" `k• APPROVED BY
o E JEF HEALTH DE sHO�'EL I NE DEPT g 6.3°ri PLANNING D_. T.
APPROV D B PERMIT FEE ISSUE DATE RECEIPT NUMBER
(0 ---%). --- ---7 7 Ly 7 5._._ ..-
30D / S •(r°
BUILDING OFFICIAL o
1 . / , ,.n7.rr — /'a»( To, ,send � L /
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.TFr.WWF.RF C)TQ" C,C)T71iTm y T, 17T T.T)T TTC; iPFRMT7'
Jefferson County Planning and Building Department
Courthouse, 3rd Floor
PO Box 1220
Port Townsend , WA 98368
206-385-9141
PFRMTT # •RT,DR7-0017 DATE ISSUED. :O6/08/87
SITE ADDRESS: 100 TALA SHORE DR
:PORT T,UDT,OW. WA 98365
OWNER •ROYA T. .TOURNEY PHONE:
MATT,TNC ADDR : 100 TAT,A SHORE DR
:PORT T,UDT,OW WA 98365
CONTRACTOR . . :NO CONTRACTOR PHONE :
MATT.TN(, ADDR :
CONTR. LTC #: EXPIRATION DATE:
PARCET, NO. . . : 998200123
LEGAT, DF.SC. . :STR 22-21 -01 FWM. TAX #
LOT 26 . RT,OCY
DESCRIPTION OF TMPROVEMENT : single family residence
( ) Fontinn/Sethacks (Shoreline SPthack) /Mnhilp ROMP Blocking:
( ) Foundation
( ) Underground P1umhing/Underground Insulation :
( ) Framing/Plumbing/Chimney:
( ) Insulation : Zj /cl,TZj 0i _�/
( ) ShPPtrock: zo.eitn -r0 I y ( j 7 ?j D 4 71-7----
( ) .rj�_wage Disposal System Final :
( )) Final/Occupancy
i na 1 /Occupancy Approval • k(r f q . �� R .s _
CAT,T, 385-9141 24 HOURS TN ADVANCE TO SCHEDULE TNSPFCTTONS.
Office Hours 9 a .m. to 5 n.m.
Tnsnpctor ' s Hours 9 - 1 (1 a .m.
24 Hour Recorder for inspections.
' • •- . REla... ✓ . D
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t! L' I 26 T411 5goj i S • P1ANNINn DEPARTMENT
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45.Cli 77Z, , ; 'X �
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_ 1 F46 it-a f' £
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