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HomeMy WebLinkAboutBLD1987-00026 '$ lo BUILDING PERMIT APPLICATI Jefferson County Building Department• County Courthouse •Port Townsend, Wash.98368 • 385-1310 NE I. LOCATION: geographic name S W SIDE OF (( ROAD FEET NE i I R ih(-1 i7 I nt) S W FROM INTERSECTION OF ROAD AND C� ROAD other specific location or landmark: i 1 LEGAL DESCRIPTION: `3 �nt (o('1 1 Qc,{.�.(— Lot Block Pa CzeI n �8 �30 � Subdivision/ iUp Tax Number '%Section Section Township Range II.TYPE AND COST OF BUILDING - TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY ❑New building Single Family ❑New County Resident )addition El Multi-Family Is this structure to serve the residential number of units ❑Alteration or commercial needs of those employed ❑Repair,replacement El 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 �C)rn(1 re. r(")O m USE OWNERSHIP Om a � , ❑Full-time Residence ❑Private (individual,corporation, M^' nonprofit institution,etc.) ❑Second Home: Recreation Cabin,etc. ❑Public (Federal,State or local gov't.) UBC OCCUPANCY GROUP: /2----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 use of existing building is being changed,enter proposed use. b. Plumbing q X 19 P R I t (I 8,L)3 _ I , " l(1 c. Heating,air conditioning �' d. Other (elevator,etc.) • TOTAL COST OF IMPROVEMENT $ 4. III.SELECTED CHARACTERISTICS OF BUILDING - PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL DIMENSIONS ElMasonry (wall bearing) public or Private •Number of Stories Wood Frame •Total square feet of floor area, ❑Individual (septic tank,etc.) all floors,based on exterior �❑Structural steel dimensions TYPE OF WATER SUPPLY ❑Reinforced concrete •Total land area,sq.ft. ❑Other—Specify 2.E�''blic or private company NUMBER OF OFF-STREET ❑Individual (well,cistern) PARKING SPACES Enclosed PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE ❑Gas Outdoors Doi! '' RESIDENTIAL BUILDINGS ONLY ❑Electricity — ; Number of bedrooms ❑Coal TYPE OF MECHANICAL Number of Full ❑Other—Specify bathrooms Partial IV. IDENTIFICATION - • Name Mailing Address—Number,street,city and State ZIP code Tel.No. t. ,nen1-11 .1 uei—h f'0 t3ox (S Co . - ) ; 9E339 ;)F5= Owner )'73 (DI- 2. Contractor State License No. . 3. Architect The owner of this building nd the undersigned agree to conform to all applicable laws. gnat re f applicant Address Application date ----7------ .0./Y1./Y1A:4 ,c,t,4 yt..c, 1 O(051c9c7 PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT APPROVE Y1( (c? F/ /' l Q -2 JEFFERSON COUNTY HEALTH,DEPARTMENT APPROVED B PERMIT FEE ISSUE DATE ci �'�`' �'�� RECEIPT NUMBER ., 7 BUILDING OFFICIAL 3 ( ,50 ` The Printery—Port Townsend �/ 7 L/' 3 /Q/,1 7 vs —)- < fill fl, . The map is for your information. It is not intended to express your exact boundaries nor is it intended to depict the actual location of existing easements, streets, roads and highways. The Company assumes NO LIABILITY for any LOSS occurring by reason of reliar,;,e thereon. --r JEFFERSON TITLE COMPANY , -r \\ \ � _ \ 1 \ \ \ —1-'--�f \ 1 a� -- \ 1 0 1,:c---lc— ,, , Stl. ----- s \ r Iti i } `ter Ji id p„-. - -____. \ yip Itois 0e E I.�- tI , _ Y : tsf _,''\\') . 3 - , ...._ .r. 1. , _ _ ., .4 ___--- .. , . . - , - .L..._ _ _ _ ,_.......„- - -#---is . ,i"--; _ . 3 ,.,... ; i s .., ------- -- , vy/ . - s� _.. _ _ 1 ,ter�. --- .. - /� n s• 77- et°$tv l v{ : -)7. ,„ ',._ _ 1 i rams+ +-F K= C"")Tv' t7i)r7r Y esii 1\C F� F: F?3'V�a -i Jefferson County Planning and Building department Courthouse, 3rd Fl nor PC) Sox 1 2.20 Port Townsend , WA 9t5365 206-3f15-9 1 41 PFRMTT # • RL057-0026 ilATr. TSSURD. ' 1 lJ/03/8 7 ST T"F. AiJUKN.-- ] 2 I i RANOOLPH Rd , : PORT HAIJT,lll;;c. . WA `.9 rs.S.1`-1 OWNER ' A'F-N vTS .THa.:T-TS SLACKI ,M f I '1 N�i �p/� PHiJtvF. - 3rs5-7364 MA T T,T NG AdfR ! 2 1 1 RANDJOJT,PH RD QQ�� ' PORT HAnLocK WA `921.1.1�J CONTRACTOR. . ]Nil CONTRACTOR PHO F. : MATLTNC ADDR : CONTR . LTC #[ FXPTR T"TO IJA1M. t PARC F.T, NO. . . : R94l10-31J4 T FGAT DF.SC'; . . ! STR O2-29-0 i WWM. TAX # LOT BLOCK 3 llr.ac;rcirTTON OF TiviPROVRMFNT : single family addition i Font i nci Sethac-Ks (Shoreline Sethac-k i jMnhi i e Rome Blocking: i Foundation : i Underground Plumbing/Underground insulation : ; Framing/Plumhincr/Chimney- 1 insulation :_ AJ/gyp ( ; Sheetroc k : ufr i Sewage Disposal System Final : Piet. i Final/Occupancy Approval s CALL 385-9 1 4 1 24 HOURS TN ADVANCF TO SCHFDULF. TNSPRCTTC Office Hours 9 a .m . to 5 p. m. inspector ' s Hours `9 - 10 a .m. 24 Hour Recorder for '1 nsnect i ons. IP 0 JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 621 Sheridan St. Port Townsend, WA 98368 INSPECTION RESULTS Owner: i GVAYO l_I 0,/ c. Date: 10(T.. /0'2 Address: "D,) I ►'\AOt WI Contact Phone: 3g5 — 993 Z Permit#: jL 02 3 2(o Type of Insp: 1=-i n a 1 Results: Approved /1 Approved with ❑ conditions Failed ++ '- Must call for reinspection prior to proceeding Failed with penalty ❑ Must call for reinspection and pay reinspection fee prior to proceeding CONDITIONS: 4/i } Y 1 r �+ La I,U - r%N ,erect rt c'a\L h fo ry `r14 r / ereZicAL SIG NE© OF F. 5/8 /9/ • FEEMIT -TA le-i.d cur #07 abe A1'PEA AS -To h.1A tie BEEtJ L c04 PLerCn PR!OR To 199/, I/Prie F127- e/6 isfz / km, GO -ro ' Inspector & Dat -. // /0 w It �cMAP Ll d � q' F0goc 941 BUILDING DIVISION paaacrer CA 44973 (360) 4 50 INSPECTION HOTLINE (360) 379-4455 THIS NOTICE MUST BE KEPT WITH APPROVED PLANS ON SITE ORIGINAL — CUSTOMER COPY - OFFICE H:/Permit/Plnctr/Infobldg/Forms/Inspection Results Form