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HomeMy WebLinkAboutBLD1987-00024 Ab BUILDING PERMIT APPLICAN ' Jefferson County Building Department• County courthouse •Port 1ownsend, Wash.98368 • 385-1310 N E I. LOCATION: geographic name S W SIDE OF ROAD FEET NE S W FROM INTERSECTION OF ROAD AND 1(( cy-r— I- 0nr6)-r- ROAD other specific location or landmark:1 J LEGAL DESCRIPTION: 'Parce,I # Lot Block Subdivision -7 oz . -[y od ICI -7 C�J Tax Number Y+Section Section Township Range II.TYPE AND COST OF BUILDING - TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY ❑New building )igngle Family ❑New County Resident ❑Addition ❑Multi-Family Is this structure to serve the residential Iteration t number of units or commercial needs of those employed �(nIS�11n�( P Y ❑Repair,replacement �J ❑Hotel,Motel,Dormitory at either the U.S.Navy's Trident or number of units Indian Island Facilities? ❑Wrecking ❑Mobile Home • ❑Moving (relocation) ❑Other—Specify ❑YES ❑NO ❑Foundation only gyeiiP Ce Oc.- cAS 9"./41'.— , USE OWNERSHIP eTi__ `r __ ❑Full-time Residence ❑Private (individual,corporation, u.,pS_LOPED /nonprofit institution,etc.) ❑Second Home: Recreation Cabin,etc. yµp S"` T � ❑Public (Federal,State or local gov't.) UBCIp OC1CUPANCY GROUP:Z Y"^3 ❑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 useus of existing building is being c(((`JJJhaanged,enter proposed use. /^� b. Plumbing L50 ma 111 "( `�� = 33 2 ? 'i� J c. Heating,air conditioning /„O�') (� hc) IC I L - Q 3 (0 O� d. Other (elevator,etc) lLh�`' 4/O1 / R SO • TOTAL COST OF IMPROVEMENT $ 4 III.SELECTED CHARACTERISTICS OF BUILDING - PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL DIMENSIONS •Number of Stories ❑]Masonry (wall bearing) ID Public or Private el� •Total square feet of floor area, `6Z1 Wood Frame Indivi al (septic tank, tc.) all floors,based on exterior 0Structural steel / dimensions ❑Reinforced concrete TYPE OF WATER SUPPLY •Total land area,sq.ft. ❑Public or pri e company ❑Other—Specify NUMBER OF OFF-STREET Individ I (well, istern) PARKING SPACES //�\ Enclosed PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE ❑Gas Outdoors ❑Oil RESIDENTIAL BUILDINGS ONLY lectricity L Number of bedrooms ❑Coal TYPE OF MECHANICAL Number of Full ,ther—Specify t bathrooms ti,-) St e)\r Partial IV. IDENTIFICATION- • Name Mailing Address—Number,street,city and State ZIP code Tel.No. . ,,01,I te,f, . c o ren ce 1 y 813 NSF �i r wood e (vol c(f5o5 8 R55 Owner N, 3 c h ('r� Ice. Rc nto r f� (5O 2. al-P Contractor State License No. / 3 Architect The own of this building and the undersigned agree to conform to all applicable laws. ign of applicant AddressrliAA '"1 Application date CSAVALIA.464._j/l S Al.mac I Ill S E ii I l g k(. Wilt 161051 (-1 PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT APPROVED BY/to/aim 0 ( /l/� JEFFER$ONUNTY HEALTH DEPARTMENT APPROVED Y: ',(A.; PERMIT FEE ISSUE DATE RECEIPT NUMBER g:00 50 � 0�� ABUILDING OFFICIAL 0 I (� 1 'OQ` � 3 ?n50 The Printery—Port Townsend • • r s l w � c C)T J 1'3 T''T t=s 1"7 T i.T)T 1\1 C R TF.R T - -�'iT T Jefferson County Planning and Fsui ding Department Cnurthnilse . 3rc3 Floor PO rRnx 1220 Port Townsend WA 95365 206-385-91 4 1 PN.RMTT # •K DR7-OO24 1JATF. T SSUFD. : 1 0%1 2 / % S T TF AT111RFSS : R(11 T.TNOF.R ONOF.R F ) :(QUTT,CF.NF; WA :1 - .iIh Pd. 1)ox 6// OWNFR • T,AWRFNCF. SCH I NT F. PHONF : 255-5 1 5O MAT T,T NG AT111R : 1 4Fs 1 3 SF FA i RWOOfl t'3'LVD [R F.NTON WA 98055 CONTRACTOR . . r NO CONTRACTOR PFONF _ MATT,TNC ATinR : • CONTR . LTC #: F,XPTRATTON IlA"1 F. PAR(Fi, NO . . . : I02244-001 T,F.CAT, (1F,SC. . • ST"R 24-27-02 WWlvl. TAX # LOT 1 RT,(JCK IIFSCR I PTTON OF TMPROVFMF.N'i : s i ncg l e. family alteration , . l ) F-nnT' inn%SP.T'na(':ks (Shoreline SeTnac:f:) 1'1`v�nn� IA. Home l=S1nC:Ki71CS- Foundation : [innercrrnunn P l umni ngfliinc3ernrounc3 insulation ! 3 Fram i na P l ilmn i na/Chimney T n s l l l a t i o n :__ j 1( /'lA ..._. ) SheetrocK : 46 Sewage. Disposal System Final _ ) Final / c-nunanc-:v Approval : CALL 85-r-J 1 41 24 HOURS TN AIIVANCF. TO SCHF.DiJLF TNSPFCTTONS . Office Hours 9 a .m. to 5 p.m. inspector ' s Hours 9 - in a . m. 24 Hour Recorder for Inspections. 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