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HomeMy WebLinkAboutBLD1987-00350 Jefferson County Building Def ent • County Courthouse • Port Townsend,1l.9836S • 335-1310 N E I. LOCATION: geographic name S W SIDE OF ROAD_ FEET NE • 0 S W FROM INTERSECTION OF ROAD AND ' ;AD other specific location or landmark: FT— i c-\\I LEGAL D CRI TION: Lot Block 7 bdivision a1 \ ©O /07/ G/./ ��zVP�„6t/�✓ LLD Tax Number %Section n ownship Range II.TYPE AND COST OF BUILDING - '' TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY • 1 10./building ❑Single Family ❑New County Resident \ ❑ _.Addition ❑Multi-Family Is this structure to serve the residential IC ❑Alteration number of units or commercial needs of those employed V ❑Hotel,Motel,Dormitory at either the U.S.Navy's Trident or ` v\ ❑Repair,replacement 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, nonprofit institution,etc.) ❑Second Home: Recreation Cabin,etc. ❑Public (Federal,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 building is being changed,enter proposed use. ( b. Plumbing / // ' c. Heating,air conditioning )/' d. Other (elevator,etc.) • TOTAL COST OF IMPROVEMENT $ III-SELECTED CHARACTERISTICS OF BUILDING - N`� DIMENSIONS / ! PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPO Ak ❑Masonry (wall bearing) \ •Number of Stories t t ❑Public or Priv 1\`v •Total square feet of floor area, `, �J ❑Wood Frame individual septic tank tc.) all floors,based on exterior CD ❑Structural steel • __ -- dimensions Q ❑ eh ced concrete TYPE OF WATER SUPPLY •Total land area,sq.ft. Other er—S ify ❑Public or private company NUMBER OF OFF-STREET s t ❑Individual (well,cistern) PARKING SPACES l _ Enclosed PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE 1 ,.0. ❑Gas Outdoors v ❑ it RESIDENTIAL BUILDINGS ONLY lectricity Number of bedrooms '- — ❑Coal • TYPE OF MECHANICAL Number of (Full --�/ ❑Other—Specify bathrooms Partial IV. IDENTIFICATION- . • Name Mailing Address— Number,street,city and State ZIP code Tel.No. . Ucjv ;c( - 7/C � v ia6 PCB � /(l�.0 7036ce ___ R(o Owner L p. ,k1,IC 2. Contractor State License No. 3 Architect The owner of this building and the undersigned agree to conform to all applicable laws. Sign re of applica Addr ss Application to 1 -- \D 1 e � Above _ - �: PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT APPROVED BY JEFFERSON DEPARTMENT • APPROVED BY ` — RMIz FFE ISSUE DATE RECEIPT NUMBER BUILDING OF F IC! r C/ l� [[ �� +�41d RZep'tw O (g(0/ rater —Port Townsend ( 0 f/Th s - ' 1 / P cLa P in dm Q ro ig 0 Q M rrov);\A- �a i.r- ' I\C1 a a 0 �U �' v, P 1 Q (;--) çy N k/P-P3 ? '51)/i —21^y^v 1 Th IV/ -1-Cric, 7177—ir 17,/ "7"ce , , --• c" 7c)W — e 27 .07A addki