HomeMy WebLinkAboutBLD1987-000281 bBUILDING PERMIT APPLICATION '
Jefferson County Building Department• County Courthouse • Port TownsenT, Wash.98368 • 385-1310
N E
I. LOCATION: geographic name S W SIDE OF � /, ROAD FEET
,
S W FROM INTERSECTION OF ROAD AND —/ /f(�/ //lle�ive r` PS, ROAD
other specific location or landmark: P l.►-
PLEGALnn � �DESCRIPTION:
f7'C,l/Ci L-.' Loy, Block Subdion I L
ga 1 otLI 01 L/ Tax Number 14 Section Section Township Range
II.TYPE AND COST OF BUILDING -
TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY
TY
( 4z/v building Single Family ❑New County Resident
❑Addition El Multi-Family Is this structure to serve the residential
❑Alteration number of units or commercial needs of those employed
❑Repair,replacement ❑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
USE
OWNERSHIP
❑Full-time Residence
❑Private (individual,corporation, ❑Second Home: Recreation Cabin,etc.
nonprofit institution,etc.)
❑Public (Federal,State or local gov't.) UBC OCCUPANCY GROUP: 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.
Mai
b. Plumbing /1 . aWatt 757C,E. 3,c. cA 0//(CO
c. Heating,air conditioning ! 1 jC/CO --/ 9 6 7 t'
d. Other (elevator,etc.)
Q? - aye=.76e. /6 ' qgi c
• TOTAL COST OF IMPROVEMENT $ 4, 3 D n_
III.SELECTED CHARACTERISTICS OF BUILDING - �-- „� 2 (�/J
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE D1190 ;"�
DIMENSIONS
Masonry (wall bearing) •Number of Stories
❑ Y 9 ❑Public or Private •Total square feet of floor area,
Wood Frame Individua se tic tank c.) all floors,based on exterior
ructural steel dimensions
❑Reinforced concrete TYPE OF WATER SUPPLY •Total land area,sq ft
El Other—Specify ❑Public or private company
NUMBER OF OFF-STREET
❑Individual (well,cistern)
PARKING SPACES
• Enclosed
PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE
❑Gas Outdoors
❑Oil '' RESIDENTIAL BUILDINGS ONLY
Electricity Number of bedrooms
❑Coal TYPE OF MECHANICAL
›p�0 (- J�if ,, Number of Full
/, �Y 7J t bathrooms
WW ( Partial
IV. IDENTIFICATION- •
Name Mailing Address—Number,street ci and State ZIP code Tel.No.
1. M►C,nCA Ile/1 GUo _ j 6s V??'-
Owner )(_,.
`� L Qs -
2. {J
Contractor State License No.
3.
Architect
T e owner of this building and the undersigned agree to conform to all applicable laws.
S' nature of applicant Addr ss Applicati n d e
, Ae/ 4 Ld4e1,----
jz).._
(9--bat_
PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
APPROVED BY / / 0 ,0 /p
JEFFERSON COUNTY HEALTH DEPARTMENT
APPROVED BY: PERMIT E ISSUE DATE RECEIPT NUMBER
W, b c- -----L. 3 .5'0 30 y a
BUILDING OFFICIAL
J 1 r The Printery—Port Townsend
_J tom.r M_ /AV c(TAJ ' Q=stIT s i i TTt� F e �v�T i
Jefferson County Planning and Building Department
Courtho;,JsP, 3rc3 Floor
PO Rnx 1220
Port -T ownsPnc3 . WA 96366
206-365-9 14 1
PRRMTT # • Ri,F 7-OO2R DATE TSSTTF.L _ 1 it lilts i R7
S T TR ADn1RRSS : 44 1 WF.RNF.R Rn
PART 1.UIJI.l)W. WA :-1t5..5nn
OWNER -M'i CRAFT, OSF.l, P4O R : 4.3 7-2F 2
MA T T,T NG ADflR : 4.41 WERNF R Rn
: PORT L 1 )0W WA 98365
CONTRACTOR. . 7 1NO CONTRACTOR PHONE.
MATT,TNC A nR
CONTR . LTC #' RXPTRAT T 111V'' DATE. :
PARCT+T o. . . : R2 i na4-Oi 4
T,F,t;AT, nIRSC . . : ST'R o -2R-tJ1 RWM. TAX #
LOT BLOCK
n1F.SCR T PTTON OF TMPROVF.MF.NT - single family residence
) Fnntina/Sethacks (Shoreline Sethacki /Mohiip Home Rinckina:
1 F n t n d a t i o n
) T7nderyroijnd P i umh i nci T1nderarnund 's nsu i at i nn •
i Framing Piumhina Chimney!
i Insulation !
i Sheetrock :
Sewage Disposal System Final !
1 Final/Occupancy Approval !
it7/W42:-- // /9 3 .
CAT,T 5-9 1 4 1 24 Hor7RS TN An)VANCF. TO SCHFn)T11,F. TNSPF.CTTOJNS .
(Office. Hours 9 a . m . to 5 p. m.
Tnsnector ' ss Hours 9 - 1l7 a . m.
24 Hour Recorder for inspections.
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1000 4_0(
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