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HomeMy WebLinkAboutBLD1987-00418 BUILDING PERNIIT APPLICATION Jefferson County Building artment• County Courthouse • Port Townse4Vash.98368 • 385-1310 e N E I. LOCATION: geographic name SW SIDE OF ROAD FEET NE • S W FROM INTERSECTION OF ROAD AND A ROAD �MI other specific location or landmark: r! 0" AC/ � "a�Q LEGAL DESCRIPTION: ' 3.- r't tOJO ,2 Parc�I Lot 61YI 1J Subdivision / 1 D lPOO /3-5 Tax Number %Section Section Township Range II.TYPE AND COST OF BUILDING - TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY 'New building Single Family ❑New County Resident ❑Addition ❑Multi-Family Is this structure to serve the residential number of units❑Alteration or commercial needs of those employed ❑Hotel,Motel, Dormitory at either the US.Navy's Trident or ❑Repair,replacement number of units Indian Island Facilities? ❑Wrecking ❑Mobile Home ❑Moving (relocation) CJ Other—Specify ❑YES ❑NO ❑Foundation only --- USE l OWNERSHIP 0 Full-time Residence •`( 0 Private (individual,corporation, 0 Second Home: Recreation Cabin,etc. nonprofit institution,etc.) , 0 Public (Federal,State or local gov't.) UBC OCCUPANCY GROUP: ❑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 exis tin building is being chhaaan_ged,enter proposed use. -7^ /� b. Plumbing {�YICL! 146 ?. 33,�� : 3 3 (D6 c. Heating,air conditioning �{qp— c 7�0 e7` /6 l/ d. Other (elevator,etc.) '��'"`" rrVV(( �� 6 07,2D • TOTAL COST OF IMPROVEMENT $ III.SELECTED CHARACTERISTICS OF BUILDING - PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL DIMENSIONS ❑Masonry (wall bearing) •Number of Stories ❑Public or Private •Total square feet of floor area, �Q'rWood Frame ❑Individual septic tank,etc.) all floors,based on exterior ��❑`Structural steel dimensions TYPE OF WATER SUPPLY ❑Reinforced concrete •Total land area,sq.ft. E1 Public •r private company ❑Other—Specify NUMBER OF OFF-STREET ❑Individual (well,cistern) PARKING SPACES Enclosed PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE ❑Gas Outdoors 0 Oil RESIDENTIAL BUILDINGS ONLY Electricity Number of bedrooms c.2— ❑Coal �L��kJ� TYPE OF MECHANICAL Number of Full O. Other—Specify bathrooms Partial IV. IDENTIFICATION- - ' Name Mailing Address—Number,street,city and State ZIP code Tel.No. t. e A) Po-t-©I►'cry 111`0 I CO4)do i C_CM1 e PL - .933(6---- Owner 5rr"P°`\-- '2. > (-6f o PO CZY4S s i r O r 130( ic2, NOC OC,l( 3 7 1001 Contractor State License No. F--t� ('GT.1 L ,!g l F R�7 3. �3 Architect er of Is bui g a e undersigned agree to conform to all applicable laws. c ure ofj.ppli Address Application date pa, 6 /fig, lac 7oc// r` .� c -a_?/ PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT APPROVED BY ------ d•C7— ..o C-e SPA 1 e t` or(AA...,.... JEFF COUNTY TH DEPARTMENT - APPROVED PERMIT FEE ISSUE DATE RECEIPT NUMBER . ,.., ,_ , t,, 877 /s,/r5o V 3 7 <2 ( 09s BUILDING OFFICIAL © r 00 Jetteuson Coup Bld' Dept �� 7 � g. gig —Port Townsend `�� ��� s 1 •v. 1/4 t40. LANE � .U� o N w N r J �t 0 O _ a _-tkl 1 N 6 ° !o fie ,. act, J osi ce' 1 NI c!n k t,k,Q Af O° Z O. O"A!_ 80. Oo -- _ ti, gal co oO I ( (-II ` h 1 e ,, ,,.1 ) ( ) A .. CI ft' ' ,,,./7-- '' 4t -� .-.-- �f,a '�d // if > . r R 3a` ::::i —_....( tit ry '4` F 0 , k s `F w� to # y4wk O� ,{ a Q \11.1 LLI p'� !' 1 , ' • . .. 1 © Jw .4,41:1f$A" ' 1.7.:*-11L'''''' NI W �� � •; �, 0. l"` '4' s z 4 `�0 s.-'��`` `d � IR �9flr 7. + 0 ' , Id •. j i ti 31 0 (77`� _1.1 i' ;1 k +i h a. -�r ° OO /8zoR•x h� 8© Z 7 rr O N PLAT OF PT. zoc,cOw' pER ® ✓oc. G, Yam. 4/-4,6 . n4'CoRCl/ ®A' ,e,rf'ERJo/v c'o., wA. 11i • ,,.rson Gom y tg. Dept { lc . . . ( 1 2- , 7 ---' T--t---( - L-.T - --. 7/7/465,7 , , 3tG ,,s-?— -----Na.c.._ ) . j6\et W Icy � d . = ^��, BUT - -- CSD - l NA.S‘IS2 r?::.e_sQ.N4,) I e'er C ✓ ,,,,,,, 7-712,)„.)A.,t, „. , p 4''''- 1-6,,.. A L,.. 1 1-2,a„.4)-- V„ovi,_ itke„,-----"/ I . v ( � 13 \ ? s��; /1 AL., OK, E-Xce ,A- cj.,'4''' ''V's*c� IS M1 A. c_ 0y 1(? ,-5 I 2,/ le, '-- Lst(..,...x Jr.__ (.,„. or.>0 S-1—'s'4 LS' "L'174: 4"-a 6L(7 -------- Lite.- t d L ,_L _ntij 15.30 . J ____