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HomeMy WebLinkAboutBLD1987-00368 _._ _._._ ILDING 1'Ll“.111 AI t'LiLf,l IUN Jefferson Count,- B.� +Oi f7 artmr ( • County Crturtnoule • Port To»•nsil tidy^ 94•3G8 • 335 1310 • r•"-- -cry E tEET ROAD _ —._v�_--------'— S W Slot or____ - I. LOCATION. puy•ann.r na^i+ _.�----- ROAD N E ROAD AND ' S W F ROM INTERSECTION OF //^0"'vv`I �9.. � + Other sOetrr/r[IOCah Of Or ranOmaN l EGAL DESCRIP 10_N' 6-- 5 Lot Block, cli Jy� [\/'� Tow nsnr0 Rang[ ur.. .:: :______Lc,___ 4,..... . C ( �J �Ct -- �/�/ ^�� Tax Number `/.Section 11.TYPE AND COST OF BUILDING j __-____— TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY Single Family 0 New County Resident 1 ❑New building residential . 0 Multi-Family Is this structure to serve the 0 Addition number of units or commercial needs of those employed glltra UOn at either the US Navy's Trident Or CD Hotel,Motel, (jarmnOry ✓ .. eQair,replacement number of units Indian Island Far.litwes' ' 0 Wrecking 0 Mobile Home ®Moving(relou`ion) 0 Other -Specify 0 YES O ®Foundation only USE 0Full-time Residence OWNERSHIP 0 Second Nome. Recreation Cabin.etc. Private (individual.corporation, _ ---- nonprofit rnslitutron,etc.) OSecond Home- Future conversion t0 permanent residence ❑Public (Federal,Stale or local goVt.) UBC OCCUPANCY GROUP.— ,,, __ • COST (Omit cennl Non' sidential - scribe in de.iad propos`d use of buildings.e.g..food A la ndry boil at hospital• It'^entary v 00 0'd proses rig plant,ma hint shop. lot • S / ch�a1 sCho parking Dora Gott o9 imP cave mint %chi, se ()dory scno 1,college,pa inn ua_ plant `,, C. ---- ..- rental lice budding. Hire bust n9,at in be installed ObuP not,()eluded departments e, the abase cost It use 01 eaist.rig building is be. g changed,enter proposed use. a- Electrical V., ) b- Plunri•ng - c r,-•-' c. Heating,air Conditioning a. r. d. Other (elevator,etc I i • TOTAL COST OF IMPROVEMENT S ] ©OQ i 6 III.SELECTED CHARACTERISTICS OF BUILDING - DIMENSIONS 'tr,,.' PRINCIPAL TYPE OF FRAME • TYPE OF SEWAGE DISPOSAL *Number of Stories Public ar Private •Total square feet of floor area, ' ®Masonry (wall bearing) 0 all floors,based on exterior` Wood Frame 0lnd.vtdual (septic tank,etc.) • dimensions 0 Structural steel TYPE OF WATER SUPPLY •Tool land area,ap- t. []Remlortxd Concrete 0 Public • or private company NUMBER OF OFF-STREET 0Other-Specify 0Individual (well.cistern) PARKING SPACES 1 - Enclosed .` - PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE Outdoors 0 Gas RESIDENTIAL BUILDINGS ONLY ❑Oil __- --_-- --- Number of bedrooms - 0 Etcctr.uiy TYPE OF MECHANICAL Full 0 Coal - Nurroer of bathrooms Panial 0 Other- Speci fy ..-_.^--.....— IV. IDENTIFICATION- ZIP cede Tel No. - _ Name Mailing Address- Number.street,city and State � �J l . -. /� owrie+ cPct s t1? cc // • ? g e/ a. y ou OC %ors Lc �lvu> 7-ZZ � . tateLicense o. Contranor C _ _S/ (d • /U% ...4✓C- 0/J (z, C *, p7/L/- sciQ'S 9 . 3. __( A __ Architect • The owner of this building and the undersigned agree to conform to all applicable laws. Apptrcauondate Adores I 'c FIRE DISTRICT SCHOOL OtSTRICT WATER DISTRICT ., ' PE_ANNING AREA - ----- APPROVED BY !f a C��t,. • a 1 oJrr►rn• crtran'�r~a'sC pew ISSUE OAT PERMIT NUMBER a PER FEE 30( ! APPROVE• 11 !�S- Ica (27 c BUIt DIr.G OF FtCIAL —_ 1. • i e -- o'cY --. .,.etsof; ClwrOv Sta Ofet G.c.k ci 42_ 7as A, 4„2 7_1.c?"--to.r 1,4176.30 e_O C,SAr _ bps-mots z k kott , Y/8/638- C:54.5 A. et ZCAC" C)7& 5144W doe'rereht3 1154 4—.11 IA— 14124C-11.— eZ/L C$15C4, tt —A 109