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HomeMy WebLinkAboutBLD1987-00031 /,,, d(gci. BUILDING PERMIT APPLICATION. -,, Jefferson County Building'Department• County Courthouse •Port Townstd, Wash.98368 • 385-1310 N E I. LOCATION: geographic name S W gi'DE OF ROAD FEET NE S W FROM INTERSECTION OF_ ROAD AND nZ `J' rnUv� > �s..J 04 ROAD other specific location or landmark: P(3* Lu d(0 W 4 i - LEGAL DESCRIPTION: p L_ P (� ' - Lot Block Subdivisi f >C l N TLTocNI\fir �, 2 / C. V-21 ©y a 00 6 TexNumber %Section SS cc lion Township Range II.TYPE AND COST OF BUILDING- TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY • 14lew building El Single Family El New County Resident ✓✓✓/❑`"`Addition ❑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 ENO ❑Foundation only C�a.I'J U L ,/ 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: }I- I El Second Home: Future conversion to JJJ 111 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,a er proposed use. b. Plumbing = c. Heating,air conditioning �— d. Other (elevator,etc.) AgX - /V50 0�� _- (yam • TOTAL COST OF IMPROVEMENT $ l I= ri III.SELECTED CHARACTERISTICS OF BUILDING - PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL DIMENSIONS •Number of Stories ❑Masonry (wall bearing) ❑Public or Private --- •Total square feet of floor area, Wood Frame ❑Individual (sep ' tank,etc.) all floors,based on exterior • ❑Structural steel dimensions ❑Reinforced concrete TYPE OF ER SUPPLY •Total land area,sq.ft. ❑Other-Specify blic or private company ✓/ ❑Individual (well,cistern) NUMBER OF OFF-STREET PARKING SPACES Enclosed PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE ❑Gas Outdoors ❑Oil ', RESIDENTIAL BUILD ONLY ❑Electric' Number of bed ms CI C TYPE OF ECHANICAL N er of Full Other-Specify ` athrooms Partial IV. IDENTIFICATION • - Name Mailing Address-Number,street,city and State ZIP code Tel.No. ,. !V/©yr�-vr�.cl`.,�J . (�U % ^3 L�{7 �`� 97707 �5' 03 — /. Owner C004-e,.. _ �r1 ) 01�... � ili. ll�l 69-3 oR3(7y 2. •a iLr / P7 Contractor State License No. 3. Architect The owner of this building and the undersigned agree to conform to all applicable laws. )2. ignature of applicant Ad ss Applicatio date VO-14•47 g di".*' PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT APPROVED BY Nip 0 ie(d 16 /tMEN JEFFE SON COUNTY ALTH DEPAR APPROV D BY: PERMIT FE ISSUE DATE RECEIPTNUM c), ,.......4 C/Z3 Jf 3,, 1) 3 ()Lic-1 BUILDING OFFICle (33ts`�- o H l 0 tO As7 T 3,, Printer,•--Port Townsend (' y. a=-7. =a s:s TNT CT: r a rz ffir IPs t I r T m R rvi .TAffer:;;an Coon-v P lanr, ir;c; ,- an'..� Sal ; ;�� in;; ;JPpar -=��;it Cni;rthn77se . .5rC7 Flnor •. PO Sox . 22ri Port- 7-r;swnspnr , WA c4n268 C77n- -_a' 4. , P�,RIVITT # • ST,fJ67-00 :'�I ] ;�. Ai7JZJ t'�'S.`'"'.:i:) 2 MATS1�'��,vV' �J�t 7 V t', 'li-S-''�` :`a:i TT?',:3_ {31 23 J Fs'f PORT „tJT)T,O WA qr33fiFi 0TA:7Nn,R • NORMAN 000TF, _ `SH i LING ADflR ° Y, lS . t5SOX '' ii1\1r�, :7t1.5-•'S-:,5-l2s6 IV wJ..S - %T,AT'3S'" "rl;R. in-f q7 2 7 CONTRACTOR . NO CONTRACTOR iv'tA T„1 w:� A I R 3''Y4f S'iV", ° CO 7'R . ,IC #° FXPTRATTON OATS ?ARC:n,T, NO . . . - 11 042-00R T,SGAT, Tlr,,SC. _ STR OJ4-2Fs-iJ; F.WM. TAX # LOT STOCK PORT T,TITTI.OW 41 T)SSCRTPTTON OF 11\4PRtlVSMt,ilS'T . storacsa shed D Font i no„/Setbacks np Setback) lest/ob 1 iP Some Ti nf`.Klnu' + 7 c ,7 n,d-7,at ,n 77 n n e r:-s r o;,n nno/Underarm] i s::rt:�i nrr tsn:'7ertsrntanca i ) r^ram;ng; 1 ,;a n �n�gu C;;i mneve Sheet rock- . ;p T•Sl i s nnsa Sys -PM ;sa' - j 7;na ; /Or.cupannv A Jp t—ova 7 CA`,,, :SrsS-q: 41 ice, s OTIRS TN AT' to tor Hr. 24 Ali,,, r Recorder , . . ..._, ,...„_..., P, 0 , fv,t4 I Gik ‘C7 ---,Z F/,V/1-0 Z- 471 /2_7/90 67e I/Z,i T-r11 S,a",i W, Tr+ er,7e'6 ? 4 O.G. W. 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