HomeMy WebLinkAboutBLD1987-00030 "` ii.l ,,.'�; 1 ,, I , t,i i Lk,;'; i fL..:
Jefferson County Building.ment• County Courthouse • Port Townsen ch. 98368 • 385-1310
N E
I. LOCATION: geographic name S W SIDE OF ROAD F
EET
N E VAX
S W FROM INTERSECTION OF ROAD AND
•
other specific location or landmark: " L_
/,LEGALrIPTION: 1C O 3 I !1C/. �1� Lot Block Subdrvon isl ^^4..,
/ 0 ?SOD3 LS Tax Number %Section Section Tdwnship Range
II.TYPE AND COST OF BUILDING -
TYPE OF IMPROVEMENT BUILDING TYPE `MOBILITY
❑New building p�Single Family ❑New County Resident
__/
A(1 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) 0 Other-Specify ❑YES ❑NO
❑Foundation only VO-illh I � I
n 7 l�►\I tiny, USE
��l -)Th Q
OWNERSHIP ❑Full-time Residence
❑Private (individual,corporation, Z ❑Second Home: Recreation Cabin,etc.
nonprofit institution,etc.)
❑Public (Federal,State or local gov't.) UBC OCCUPANCY GROUP:
❑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 6' Xc .C) I ao 0 z/c2CD
c. Heating,air conditioning , ' ---7 #e- g5---,/ ''2 cD
d. Other(elevator,etc.) a0 x Q Co ew Lin) ✓,c'C
• TOTAL COST OF IMPROVEMENT $ ,-,P. 7 c7Q2 c
III.SELECTED CHARACTERISTICS OF BUILDING -
6°-
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DI DIMENSIONS
El Masonry (wall bearing) ❑Public or Private •Number of Stories OZ-3
_�' •Total square feet of floor area,
r C
�vvood FrameIndividua septic tantc.) all floors,based on exterior
Structural steel dimensions
TYPE OF WATER SUPPLY❑Reinforced concrete •Total land area,sq.ft.
❑Public or priv._- company
❑Other-Specify NUMBER OF OFF-STREET
' llndivi. :I (well, .istern) PARKING SPACES -
Enclosed
PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE
O Gas / Outdoors -
1 RESIDENTIAL BUILDINGS ONLY r✓1C;�� k
❑Electricity Number of bedrooms
TYPE OF MECHANICAL
❑Coal Number of Full
')ErAM ier-Sggcify l bathrooms
V -3- 4���(`� Partial 1yLAA',„5k-'IV. IDENTIFICATION- •
Name Mailing Address-Number,street,city and State . ZIP code Tel.No.
1. Ql - . ,C' � Oxu , - 9' s 6.27—
Owner t-------] 7V5 c7
7 l
2. .
Contractor State License No.
3.
Architect
The owner of this buildi nd t undersigned agree to conform to all applicable laws.
S gnatur appli nt Address Ap lication date
- .e."----, --,--- ei,g7)- -k Al.,- .. 419 }-c____, -a 1- .,,2
PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
APPROVED BY,f5-,c\�P etin.�'9QpT g`--2Jto
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JEFFERSON COUNTY T DE PAR TivENT
APPROVED BY: IPPERMIT FEE. ISSUE DATE RECEIPT NUMB R
ii
3 i 50 1 0009 '_3 -
BUILDING OFFICIAL [ 01 S--0
Th 1;' n•itery - Pot To,.. sncl 3.I ` P/
1 S
r+.Fry r�. a'?� c'3iu C C)Ti1\T-i-;r 1RTIT T.T)Tivc;
.TPffprsnn County Piannincj and R11i idina partmPnt
Courthouse, 3rd r inor
PO Rnx 1 220
Port Townsend , WA 9R365
206-355-914 1
.'N.RMT-T # •RT,)5 -0030 y/ T)ATE TSSIIFTI. . 1 0/29 /5 7
T TF. ADDRESS S RAY VTFW DR UU rr
: PORT, T,tl'T1T,OW. WA 9R365
OWNER •Rt1RT SI+.N.T,t+.Y PHONE: 437-9439
MAILING ADDR : 201 S RAYVTM.W DR
:PORT TJIDT,OW WA 98365
CONTRACTOR. . :NO CONTRACTOR OR P'riilur. :
MATT,T Nip ADDR :
CONTR. T,T C #: EXPIRATION DATE:
PARCET, NO. . . : 970R00-:s i 2
T,FGAT, 7FSC. . : STR 33-29-01 FWM. TAX #
LOT 19 • BLOCK 3 , MATS MATS REACH
DESCRIPTION OF IMPROVEMENT: single family addition to living room
i Wontinc-/Sethacks iShorelinP Sethac:k; jMobi1e HnmP Riorking:
i Foundation :
i i1ndPrground Plumbing/Underground Insulation :
1 rraminn/Piumhing/Chimnpv:
i Tnsuiation -
i ShePtrnck :
1 Sewage Disposal System Final :
Final/Occupancy Approval : Q -Clor� C IZ Q3 10/
CALL 355-9141 24 HOURS TN ADVANCE TO SCHEDULE INSPECTIONS .
Office Hours 9 a .m. to 5 p. m.
Tnsnec:tnres Hours 9 - 10 a .m.
24 Hour Recorder for Inspections.
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