HomeMy WebLinkAboutBLD1987-00023 i_'U I L L i i- G I'L;. t i-l„ I'L I C is{ I CJ I'i
Jefferson County Builo apartment• County Courthouse • Port To d, Wash. 93368 • 33543iO
I. LOCATION: geographic name ier'l4 .., SSW-SIDE OF /K7,1/ .0,�-7('?yL-� z�•-, ROAD / (1 `'N'' FEET
SW-FROM INTERSECTION OF/!C}x= -u,y �R.GAD AND I l IC (1 � ROAD
- other specific location or landmark:
LEGAL DESCRIPTION: S- Z ,1 cif /l` '�� /
(i f L Sub vie \> -.
ctr l; 't ! c��y Lot ; Cr �JT
Tax Number 4 Section Sect on Township ange
II. TYPE AND COST OF BUILDING-
TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY
Nt New building ®Single Family ❑New County Resident
❑Addition ❑Multi-Family Is this structure to serve the residential
CI Alteration number of units 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 41:1 NO
❑Foundation only
USE ,
OWNERSHIP ❑ ull-time Residence
❑Private (indiv.idtfa`I,corporation,
nonprofit-institution,etc.) L Second Home: Recreation Cabin,etc.
❑Public (Federal,State or local gov't.) UBC OCCUPANCY GROU : / ❑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 beingchanged,enter proposed use.
b. Plumbing /1 l r'J;:,l +, G CD v 00 c.)
.,....
c. Heating,air conditioning - V g g €__G-kp ' I /
d."Other (elevator,etc.) — = 67.57cR zye_( - 1-/y/(4,
, „
• TOTAL COST OF IMPROVEMENT $ f f
III.SELECTED CHARACTERISTICS OF BUILDING - lf/ O vy r
PRINCIPAL TYPE OF FRAME TYPE O6tSEW GE 1 PO AL r 192 r
DIMENSIONS
❑Masonry (wall bearing) 1"tic •Number of Stories
9 Public or ovate
•Total square feet of floor area,
RI Wood Frame ❑Individual (septic tank,etc.) all floors,based on exterior
❑Structural steel dimensions 7®9g3
TYPE OF WATER SUPPLY -
Total land area,sq.ft J,
❑Reinforced concrete
16 Public or private company `S:C'5 O 77
❑Other-Specify NUMBER OF OFF-STREET
❑Individual (well,cistern) PARKING SPACES - •
r-
Enclosed
PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE ✓
❑Gas y��°^J Outdoors
❑Oil ��r? RESIDENTIAL BUILDINGS ONLY '�
ig Electricity Number of bedrooms ,` )
❑Coal TYPE OF MECHANICAL
Number of
Full
Other-Specify bathrooms partial j
IV. IDENTIFICATION-
Name Mailing Address- Number,street,city and State ZIP code Tel.No.
efri � 4<'1�c� 1�7 —f/sr � �:.� L.c.l r ?E 3 S 7 3 Z L-' )6V
vner Jo
_ („c?
y\t,4 - ' `
tractor State License No.
e 1
act
vner of this building and the undersigned agree to conform to all applicable laws.
e of applicant Address 9/ Appli ion d to s
/�
•
VG AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
=D BYTA t_. r
t COUNTY HEALTH DEPARTMENT •
g { PER T FEE ISSUE DATE. RECENT NUMBER
Yc,y
1. 1' ')' 3 1 9--6y -t----/ a ct(-// c.-
cji / !ibic tcry — Port Tor:nscnd f./7 -�1 f / /1 ( /1 J
••
•
N-W.P r Rc TT i C)t7TsT`i'v
Jefferson County Planning and Building department
Courthouse, 3rd Floor
PO Box 1220
Port Townsend, WA yrs.snrs
206-385-9141
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PRRMTT # -RT,fR7-0023 fATF. T SSURD. ! 09 104 i'R7 •
STTF. ADJDJRF.SS : 650 MONTOOMFRY i,ANF.
!PORT T,1171 ow. WA les.it-n
OWNER -nA V T T) MCT,ROn PHONF. - 732-4064
MA T T,T NC AnnR ! i O7O Fs=,O & I RD •
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C H T MACUM -WA 9R325
CONTRACTOR . . r NO CONTRACTOR PHONE.
MA T I,TNC AI1f1R '
CONTR . LTC #! F.XPTRATTON DATE :
PARCRL NO . . . ! gy0400-255
T,FCAT, fFSC . . r S T-R 04-28-01 RWM . TAX #
LOT 55 , BLOCK 2 PORT mnLoW #1
iir.:si,KTPTTON OF TMPltOVFMRWT [ single family residence
i Font i na/Sethacl (Shoreline SP.that) /Moh i l e Hnme B l ock i nc�r c_
i Frnindatinn !
; tindergrnund P i umh i nn i underground Tnsil i a t i on
i Framing PiumhinajChimney: -
1 insulation :
1 Sheetrock:
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1 Sewage Disposal System Final :
; Final Occupancy Approval :
CALL 385-y i 4 i 24 FOURS TN ADVANCE TO SCHRDULR T NSPFCT T ONS .
Office. Hours q a .m. to 5 p. m.
Tnsnectnr ' s Fours q - i0 a . m.
24 Hour Recorder for Tnspectinns.