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HomeMy WebLinkAboutBLD1987-00039 E II LDING PERMIT APPLICATION icA—0(3 3 Jefferson County Building©eparent• County Courthouse • Port Townsend, .98368 • :'"35 1310 _21r\ N E 1. LOCATION: geographic name S W SIDE OFF_ ROAD _ .. __ FEET NE S W FROM INTERSECTION OF_ ROAD AND ROAD O Q other specific location or landmark: _ n LEGAL DESCRIPTION: K. H 1✓ Plcd tt,l ..._ g3 Lot Block Subdivision . 70�� t X �zJ x l -/ N 2 s , Tax Number %Section Section Township Ra ge II, TYPE AND COST OF BUILDING - `— TYPE OF IMPROVEMENT BUILDING TYPE I MOBILITY 17rNew building WSingle Family ❑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? f=1 Wrecking Mobile Home ❑Moving (relocation) ❑Other—Specify ----/U YES ❑Nv ❑Foundation only OWNERSHIP USE ❑Full-time Residence ❑Private (individual oration, nonprofit i lion,etc.) ❑Second Home: Recreation Cabin,etc. ❑Pu ederal,State or local gov't.) UBC OCCUPANCY GROUP: 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 b 1�uilding is being changed,enter proposed use, b. Plumbing pp ,1�tc� '\U4,As n7 Fie c. Heating,air conditioning OS' > � d. Other (elevator,etc.) • TOTAL COST OF IMPROVE NT $ III.SELECTED CHARACTERISTICS OF BUILDING-- PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL DIMENSIONS ❑Masonry (weft bearing)/ aPublic or Private •Number of Stories 0 Wood Frame •Total square feet of floor area, )(Individual (septic tank,etc.) all floors,based on exterior 0Structural e` dimensions X� 120 El TYPE OF WATER SUPPLY Total land area,sq.ft. �q Rei reed concrete • Other Specify .Public or private company x�.l 6O X ❑Individual (well,cistern) NUMBER OF OFF-STREET PARKING SPACES Enclosed PRINCIPAL TYPE OF HEATING FUEL - TYPE OF FIREPLACE —' — ❑Gas Outdoors Dr oil RESIDENTIAL BUILDINGS ONLY Electricity — Number of bedrooms • x 3 El Coal TYPE OF MECHANICAL her—Specify Number of Full. •• •• X' bathrooms Partial IV. IDENTIFICATION- • ' Name Mailing Address—Number,street,city and State ZIP code Tel.No. 1. % ,�/ p //�� // �(�, .gyp Owner �y/or�,��tt1 ><PO e[1K 24r3 SA'u!(C�'y21LcJ,xr �g ' YG ‘ �'L!7 — 7, 1/Jj2� r _ 2. Raft 171d br(e._ Q rrri Contractor f*__ - State License No. [ �� 3. Architect _ I The owner of this building and the undersigned agree to conform to all applicable laws. _ i Signatur f applicant K---- Ad ress Application date xIt � - . -0-6,- =--,--5— o.i8,x_ 2-z13 C i/�iG zc1a Q43 Y /NC !/3/r(m PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT APPROVED BY6.-LO- O O` JEFFERSON LINTY HEALTH DEPARTMENT • APPROVED BY: PEMT FEE — ISSUE DATE RECEIPT NUMBER BUILDING O�I 57 cL L to , co a -5 �(p 0 7 50 Ietterson County Bldg. Deft �� The Printery—Port Townsend -TTo G/n f-3 0 V OC„.(i) 1.2 .:7 i: V d k ( soSE 0 /7 --", a -I- .74 . __,_. '24f(--• ' Cd f '., %., XF A .„, *, 1....-..„ , 0 , -....„,...... 1 li I ", --,„, )tx,) is•..., QL, IC ,-\ -.....4...• I • I $.2 41 11%4 Uti e-J ‘), t•I io ;4_, ....' IS W.- • ' ' - • - "Z. ..../ R.y _1( 0 1 '-.• •\ ' lt, ''':-•t ' laAt(C- v . II/ w . 0 • V,c- cLeS'Ij.) ‘A( A.- 't.':,:•4 0 1 • OS . .3 e-4 O....1 V-SIStAl'e-- - i t4 , ... . ,OA • -----____________ , illiVi . , t I li '1.)e 4-011 36 �.s f'i(V te4)•7( crime 3cq\c. M 4 % i \eda\`w1 C v G Q/ Q 4 / f a \ / / /' : Q ,s—, /` // • /� /4 v�/ �// / / , /- / e , d /tr. / /� / / / - / / / s / / 7 / V / Z /\ , // j 1 V 1 4.,V�- A r . / 0 4 1 A/ s' X 31.\ ..2.) /---- sczpg•=.4 - •. M a r 1:: y :1 1:'':s: ..` ?'i, ` li , i `L�1 ,,k ' T boo i N v -5„.r `.....-- — ' . _ :,, eoi- Plateddone ,t)(,t . z- . ///? /ea �1 y(z /ctsee cL v