HomeMy WebLinkAboutBLD1987-00394 Jefferson County 6uihi:' f) ;p,;rtrncnt • Coo:n:y CC.urt 1:);,�: • r C t
40
N E ROAD FEET
I. LOCATION: geographic name S W SIDE OF ! ' a '�
• ROAD
N E V Q
S W FROM INTERSECTION OF ROAD AND �� l\Il
4
other specific location or landmark:_ n l l
LEGAL ESCRIPTION: SE. �k) C&'o- - 2d) ( PSs Subdivision
V O I 0 7c2. oo'i Tax Number Y.Section Section Township Range
II.TYPE AND COST OF BUILDING -
TYPE OF IMPROVEMENT
BUILDING TYPE MOBILITY
•
Alew building :\\ingle Family 0 New County Resident
❑Multi-Family Is this structure to serve the residential
Addition number of units_ or commercial needs of those employed
0 Alteration ❑Hotel,Motel,Dormitory at either the US.Navy's Trident or
❑Repair,replacement number of units Indian Island Facilities?
❑Wrecking ❑Mobile Home
❑Moving(relocation) ❑Other-Specify ❑YES ONO
❑Foundation only b dr�m
D S- cQ
USE
OWNERSHIP ❑Full-time Residence
❑Private (individual,corporation,
nonprofit institution,etc.) 3 El Second Home: Recreation Cabin,etc.
❑Public(Federal,State or local goat.) UBC OCCUPANCY GROUP:fr- 0 Second Home:Future conversion to.
- permanent residence
(Omit cents)
COST Nonresidential-Describe in detail proposed use of buildings.e.g.,food
• Cost of improvement $
processing plant,machine shop,laundry building at hospital,elementary
school,secondary school,college,parochial school,parking garage for
T
n he the above
but not includedve cost department store,rental office building,office building at industrial plant.
a. Electrical
If use of existing building is being changed,enter proposed use.
a.
b. Plumbing 6d rill -
c. Heating,air conditioning �. �1� e 33 - it aOO
d. Other(elevator,etc.)
•
• TOTAL COST OF IMPROVEMENT $
t III.SELECTED CHARACTERISTICS OF BUILDING -
\`- - DIMENSIONS .w
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPO)Si.Sv'j •Number of Stories
o Masonry(wall bearing) ❑
Public or Private e! t V\ •Total square feet of floor area,
j *Wood •
Frame 'Individual septic tank, tc.) all floors,based on exterior
t dimensions
❑Structural steel 4/
TYPE OF WATER SUPPLY •Total land area,sq.ft.
0 Reinforced concrete r
❑Public or private •
company
i 0 Other-Specify NUMBER OF OFF-STREET
ndivid (we I, istern) PARKING SPACES
V Enclosed
1 -•"-•-" PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE Outdoors
~ �: .�
! ❑Gas K I '.r
i RESIDENTIAL BUILDINGS ONLY e�jfi
ff ❑Oil Number of bedrooms..
Iectricity TYPE OF MECHANICAL ' /
❑Coal Number of Full ► �'-
C Other-Specify bathrooms Partial
IV. IDENTIFICATION- ZIP code Tel.No.
' • Name Mailing Address- Number,street,city and State �� _Q6L
Owner T P ,
2 vo l /`/ �?
StatPLic 1ti7Ntt/ben Contractor )Q
3. 1�
Architect •
The owner of this building and the undersigned agree to conform to all applicable laws.
Address Application date
Signature of applicant Sq///C/ 4 r 9-6 ,, //
43-7
PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
APPROVE BY H / Q
` �`1 ( 0 •
2 , �i '/ GC7c
JEFF 'TH DEPARTMENT ).V \ ate v�APPROVE BY NUMBER
1 PERMIT FEE ISSUE DATE RECEIPT
�
DEB1807 I ,�co a--1 � a co Hs-
_ lS, oa
BUILDING OFtyIt('I-lord"g. DeD't 151 r 60
The Pr;or ry -Port Townsend -r—a i- (0 &-i 7
•
tr-
q
Ex,sr1�9 Q
D 'm;),c,&_z,o
qft
2 xSSO
I
Z x Sa
V
I�
—ee aC 1S S t
fp
*'� L g c-2. \ Z
\l
tr,A
GYM
_ \\-\ s
--7
'syv 'K1-01 4 w np 'v p-{. n14
-�o
cn
Cis:NN)
'" 5--v-ro ,? C') f`"'N »ice v
1--r-rryLl — (b
Q
,
.34
tVtrr -cr <)-0\--D cp‘c- 1-ek.
o
b/.)-
0
•
LB 1 C.
w