HomeMy WebLinkAboutBLD1987-00036 I. LOCATION: ycopraphic name S W SIDE OF e
N E - //,^%�j R�O�AD- — FEET
S W FROM INTERSECTION OF l ' TOAD AND 11d G ! 0-X.4±C-C
4 ROAD
other specific location or landmark: Q J t , 4
or
LEGA DESCRIPTION: q At�
Pare Lot Block 7 �'
I / `� Sub con
1c J
?Of D-ci 00? 1C( D Tax Number "p V\ •
Y.Section Section Township Range
H.TYPE AND COST OF BUILDING-
TYPE F IMPROVEMENT BUILDING TYPE MOBILITY
ewbuildingddition 0 Single Family
❑New County Resident
A 0 Multi-Family
Is this structure to serve the residential teration number of units
or commercial needs of those employed
l;L (�. (:' l,!CT=. ❑Hotel,Motel, Dormitory at either the U.S.Na
number of units W t Trident or
❑Wrecking \
Indian Island Facilities?
�Yl Mobile Home
❑Moving(relocation) ///�«
0 Other—Specify
❑Foundation only YES ❑NO
I
f
OWNERSHIP USE
0 Private(individual,corporation, ❑Full-time Residence
nonprofit institution,etc.) ❑Second Home:Recreation Cabin,etc. I
❑Public(Federal,State or local gov't.) '
UBC OCCUPANCY GBOUP: /-3 0 Second Home:Future conversion to F
permanent residence I
COST (Omit cents)
Nonresidential— Describe in detail proposed use of buildings,a g•,food Y
• Cost of improvement $ processing plant,machine shop,laundry building at hospital,elementary
To be installed but not included school,secondary school,college,parochial school,in the above cost
parking garage for
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 , /t Q 177
e. Heating,air conditioning x
d. Other(elevator,etc)•
F %
• TOTAL COST OF IMPROVEMENT $
III.SELECTED CHARACTERISTICS OF BUILDING - -
•
PRINCIPAL TYPE OF FRAME TYPE OF SE 't ''TENSIONS °``'
WAGE DISPO \ •-
0 Public or Private
❑Masonry(wall bearing) 4._.Q7 1 •Number of Stories
❑Wood Frame
�X" tndividual� i Total square feet of floor area,
ptic tank etc.) all floors,based on exterior '
0 Structural steel dimensions i= '
❑ einforced concrete TYPE OF WATER SUPPLY
/� •Total land area,sq.ft.
T} h�_ i�, • 0 Public or private company
` �/ vIndividu (well, 'stern) NUMBER OF OFFSTREET
PARKING SPACES
PRINCIPAL TYPE OF HEATING FUEL Enclosed
TYPE OF FIREPLACE
❑Gas Outdoors
❑Oil
RESIDENTIAL BUILDINGS ONLY
electricity Number of bedrooms■Coal TYPE OF MECHANICAL h ,Y,
illl • her—
® y Number of Full E--
bathrooms E ;f
Partial
IV. IDENTIFICATION- -
t'I-
•
Name Mailing Address—Number,street,city and State ZIP code
Tel.No.
1. 0 IM. 's '111 IMAIIIIMMIKOMMI. L, s 7 . y
Owner -
2. ok ma&L f)Q /"WOK 77 6o -ntrece• S Licens `e No. � ` le .
3.
Architect
r-<
1 o , er of this buiJdmg and the undersigned agree to conform to all applicable laws.
• sire of applica ) Address
a4 /1 /y APNication date
PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT_____
APPROVED BY
R RAJ_ N l0 3 --1—
JEFFERSON ;AL
DEPARTMENT
APPROVED BY: PERMIT FEE ISSUE DATE
•
3 --lei---1s7` Sr RECE1Qr NUMBERE�
BUILDING ,T,,,---,
OFFICIAL ���SD
The Pr,nhvy — Parr Tc.snsend (Jl /0 -Y643, '4,° A'
3--ice--y 1
JEFFERSON COUNTY BUILDING PERMIT
Jefferson 'County Permit Center
Castle Hill Mall
621 Sheridan St.
Port Townsend, WA 98368
206-379-4450
PERMIT # •BLD87-0036
SITE ADDRESS:4677 CENTER RD DATE ISSUED. : 03/19/87
:CHIMACUM, WA 98325
OWNER •L G BAESEMAN
MAILING ADDR:4677 CENTER RD PHONE: 732-4042
:CHIMACUM WA 98325
CONTRACTOR. . :
MAILING ADDR: PHONE:
CONTR. LIC #: EXPIRATION DATE: / /
LOAN LENDER. :
MAILING ADDR:
PARCEL NO. . . :801034024
LEGAL DESC. . :STR 03-28-01 WWM, TAX #
LOT 4 , BLOCK , JOHNSON SP
DESCRIPTION OF IMPROVEMENT: title elimination
( ) Footing/Setbacks (Shoreline Setback) :
( ) Foundation:
( ) Underground Plumbing/Underground Insulation:
( ) Framing/Plumbing/Chimney:
( ) Insulation:
( ) Sheetrock:
( ) Sewage Disposal System Final:
( ) Final/Occupancy Approval:
CALL 379-4455 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS
Office Hours 8 a.m. to 5 p.m.
Inspector's Hours 8 - 10 a.m.
24 Hour Recorder for Inspections
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C.P.lerox -24(ce.
17 0 f Ale-
S0-1- ->1 lux 70 At06,(_ etc(
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Apra)( 152o' ' Fie_ Pfoce ' ..�
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225- '1
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