HomeMy WebLinkAboutBLD1987-00453 BUILDINC1 P FAh.IT APPLICATION .
Jefferson County Buil.epartment• County Courthouse • Port To find, Wash.98368 • 385-1310
N E
I. LOCATION: geographic name S W SIDE OF ROAD FEET
NE --
S W FROM INTERSECTION OF ROAD AND ROAD
other specific location or landmark: G j C M
LEGAL DESCRIPTION:
HUCOGIC,
Lot Block Subdivision
3(._1 30/13/AJ Iu3
f Tax Number '/.Section Section Township Range
'' II.TYPE AND COST OF BUILDING -
UC > TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY •
❑New building ❑Single Family ❑New County Resident
\., ❑Multi-Family Is this structure to serve the residential
� Addition
�; number of units❑Alteration or commercial needs of those employed
0 Hotel,Motel, Dormitory at either the US.Navy's Trident or
❑Repair,replacement number of units Indian Island Facilities?
❑Wrecking 0 Mobile Home
0 Moving (relocation) Other—Specify ❑YES ❑NO
❑Foundation only (nNee r2
QUSE
OWNERSHIP 0 Full-time Residence
0 Private (individual,corporation, ❑Second Home: Recreation Cabin,etc.
nonprofit institution,etc.) �/�
0 Public (Federal,State or local gov't.) UBC OCCUPANCY GROUP:ILL=,& 0 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 a y> '�(0 ` 6a q @R use.
c. Heating,air conditioning
d. Other (elevator,etc.)
• TOTAL COST OF IMPROVEMENT $
III.SELECTED CHARACTERISTICS OF BUILDING -
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL DIMENSIONS
•Number of Stories
❑Masonry (wall bearing) ❑Public or Private
•Total square feet of floor area,
Wood Frame ❑Individual (septic tank,etc.) all floors,based on exterior
dimensions❑
tructural steel
0 Reinforced concrete TYPE OF WATER SUPPLY •Total land area,sq.ft.
❑Public or private company
❑Other—Specify NUMBER OF OFF-STREET
❑Individual (well,cistern) PARKING SPACES
Enclosed
PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE
❑Gas Outdoors
❑Oil RESIDENTIAL BUILDINGS ONLY 3
0 Electricity
TYPE OF MECHANICAL
Number of bedrooms
❑Coal Number of Full
h 0 Other—Specify bathrooms
Partial
C�.C) IV. IDENTIFICATION-
Name Mailing Address—Number,street,city and State ZIP code Tel.No.
,. 140.0lp 31 C 1 r &i I---7 . 9833 7,
Owner 1 -11.AA
-5d)
`J 2 [1 " i .oLiy s No. /t3 C Q �S(oc-( 71S 5J/ -1 t, rJ
•
Contractor ^� � 0/t McP a C4 a 1 f" .
3. f(�
Architect
The owner of this building and the undersigned agree to conform to all applicable laws.
na e of api nt Address Application date
Si,ee_ , #, ��4 a o—gT
PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
APPROVED BY A.' o _ Q ` Z _ 114 7 &LQ
JEFF m-. .•• r . TH DEPARTMENT
AppR s E o \ ` PERMIT FEE 7a LcY ISSUE DATE RECEIPT NUMBER
11-5-0 c9 -1 f-8 7 , (,,l /g.,.
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BUILDING OFFICIA,Ids, pep't 7 3 t
The Printery —Port Townsend HI I C- H/p , a -&7.
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