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HomeMy WebLinkAboutBLD1987-00022, Jeffersnn County Buildr_r '�arrrnent• County Courthouse • Port Town j Wash.98368 • 385-1310 N E l I. LOCATION: geographic name S W SIDE OF ROAD FEET NE n /� p , S W FROM INTERSECTION OF ROAD AND O�l�/n I� O ROAD other specific location or landmark: 1(�(7�'�Vtn11 Y �5C/t.w, -- nal) , LEGAL SCRIPTION: Lot Block f SubdivisionaC /(� qa 1 0�z-I 0.;. , Tax Number Section Section Township Range II.TYPE AND COST OF BUILDING- TYPE j /OF IMPROVEMENT BUILDING� f TYPE MOBILITY ' PE 1 N\ew building 1 MJ Single Family El New County Resident "❑Addition �/❑\Multi-Family Is this structure to serve the residential number of units❑Alteration or commercial needs of those employed ❑Hotel,Motel,Dormitory at either the US. Navy's Trident or ❑Repair,replacement number of units Indian Island Facilities? ❑Wrecking ❑Mobile Home ❑Moving (relocation) ❑Other—Specify ❑YES El NO ❑Foundation only _ USE OWNERSHIP ❑Full-time Residence El Private (individual,corporation, ❑Second Home: Recreation Cabin,etc. nonprofit institution,etc.) ❑Public (Federal,State or local gov't.) UBC OCCUPANCY GROUP: 3 El 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 of existing building is being changed,enter proposed( use. ap • b. Plumbing rnaU�, +a/ O / 0 00 4, c. Heating,air conditioning gac.t4M12.41vitt_cAq . 7 /n€ ? � 7.�d. Other(elevator,etc.) Q�O X ( 7 W,/G` II I,Sc 0 • TOTAL COST OF IMPROVEMENT $ III.SELECTED CHARACTERISTICS OF BUILDING - WI 7Q 2 3q,P, f7/1( 6C PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DIMS DIMENSIONS •Number of Stories ❑Masonry (wall bearing) ❑Public or Private •Total square feet of floor area, good Frame \ndividu (septic tank, tc.) all floors,based on exterior dimensions -U Structural steel ✓✓\\ ❑Reinforced concrete TYPE OF WATER SUPPLY •Total land area,sq.ft. ❑Public or private company ❑Other—Specify NUMBER OF OFF-STREET IndividuP istern) PARKING SPACES Enclosed PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE El Gas Outdoors ❑Oil RESIDENTIAL BUILDINGS ONLY Electricity Number of bedroomsta El Coal TYPE OF MECHANICAL Full ca. Number of t'30©S cif bathrooms VIIJl Partial IV. IDENTIFICATION- • Name Mailing Address— Number,street,city and State ZIP code Tel.No. ,. Owner li t -7C"n� l PO 1 . . 7 k) 2. �` Contractor State License No. 3. Architect The owner of this building and the undersigned agree to conform to all applicable laws. S�gnat,i,re of Z Applt on ate PLANNING AREA sr FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT APPROVED BY 0\C- L` Pam`-7k ( y q�ma 'q , � JEFFERSON HLTH DEPARTMENT APPRO lyl' RMIT FEE ISSUE DATE RECEIPT NUMBER �__-__.._�._i ,U—o 7 � - a i/V - 3O3� � BUILDING OFFICIAL '�0 IS 0 Ti e Printery - Fa't Too.^s `i 'no /...../(0 c4//57' 7? sie --r • , 4,-, , .Tr%.FFF:Fi TxT (()TTPI97—v' RijnT.ii i i•3C; P T T Fv7Tm Jef fersnn County Planning and Building department Cnurthnuse; Rrd F-lnor 1 PO Rnx 1220 Pnrt Townsend; WA 98368 206-385-9 I4 1 PRRMTT # -RT.d8 7-0022 DA'I R T SS IRD. :CJ9/2 1 /R7 STTR AI111RFSS - 32n RORRTNS Rd -NORIIT,ANf . WA 98358 OWNER • DAT,F SHRTVF.R PHONE : 385-721 0 MATT,TNO A DR 7 320 RORRTNS RD :NORl1T,ANn WA `-Irs.inm CONTRACTOR. . [ NO CONTRACTOR PHONE MA T i.T NG ADDR [ • CONTR. T,T C, #! RXPTRAT T ON DATE! PARC;RT. NO. . . [ 92i 084-032 T.RCAT, TY SC. . - STR 08-29-01 RWM, TAX LOT , RT,OCK DRSCRTPTTON OF TMPROVRMFNT - single family residence i i Rooting/Setbacks i(Shoreline i nP SPthac:ir; iMnni lP Home Rinririnc7- ( ) nnundatinn - ( ) tinderarnund Plumbing/Underground Tnsu l at i nn Fram i nn/P i umh i na/C.h i mney_ nS11 iatinn - . {�.. Cftra, , 1/4 1 -- 6\(. tom- -_ , , i i - - ..vw612,..0 4 o.r 7 c O . %.-\2-q Q.�-o�c��.J uA.c� _ CK6:c: \CSnrC1-`au•1/4-, , .-c f i SPwag€ Disposal System Final i i na i i Occupancy Annrnva Fo[As L Ok_ 3- 7..q 4pic....? CAT,T, 3R5-91 4 i 24 HOtTRS TN ADVANC;F. TO SCHFdtJT,R T N-,rr.cn Ti ONS . Office Hours 9 a .m. to 5 p. m. Tnsnectnr ' s Hours 9 - 10 a .m. 24 Hour Recorder for inspections. 1 Li_ � �� w .,o LI —r3 vtrt `s.� c S 105--,4:.: A, - .it...lel- 1 o �t h h. a \\\\ -.,..„_______--, - --- 0a � aT',43 d AO —____ -- t(4o4 o7-4VI -- -- ---- -- ----- Z --- 9'--�_ - _ I T � -- I Nat 7 ' -- _ Id Il • — } II- (,, It -,— .� _ z � a a I 1-ter �"a : 4..vcrq c3 t� — I I -..-- __• �,, 58 LI D RAIL 3- -- ___.,.. _...,,L _ J Ell Ili6- - , .`� h Ail- `` ----- _ - - _._ __ a If II 1., J � - I:mac.- I 1 . R --_—..J 1d L, 3 z —._, O ' -- — O�. • f — u l( I. I -� ...a-y - Q' t j3 £ pat 1 !.4 I a' \ 1 - ---........ g . ,k 4 ...„ 4 `-') ) 57 33 A, 07' 7s i 9 oe bQ' O - � f / 7 0 wF:: NiAD - - ------------ oviM ceow7y DiTcH 30' CLP&vlo r Ro 6btNs Road ( (o. Rd1%) 7 tn 0 Q 0 cc "R D ON NO. tOOpl LlFJ111 NIIM