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HomeMy WebLinkAboutBLD1987-00463 Ask BUILDING PERMIT APPLICATION , Jefferson County Buildi[ epartment• Countyervurthouse • Port Tows, Wash.98368 • 385-1310 NE I. LOCATION: geographic name S W SIDE OF ROAD FEET N E S W FROM INTERSECTION OF ROAD AND 77r1431 0 id I_ b ar oc) ROAD other specific location or landmark: q , LEGAL DESCRIPTION: t/..) QarCe l Lot Block Subdivision Ej©1 201"I 009 Tax Number '4 Section Section Township Range II.TYPE AND COST OF BUILDING - TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY • ° , I New building ❑Single Family ❑New County Resident L ❑Addition ❑Multi-Family Is this structure to serve the residential number of units or commercial needs of those employed „ N ❑Alteration CIHotel,Motel, Dormitory at either the US.Navy's Trident or 0 Repair,replacement number of units Indian Island Facilities? 0 Wrecking 2,4obile Home ❑Moving (relocation) ❑l Other—Specify ❑YES ❑NO ❑Foundation only USE OWNERSHIP ❑Full-time Residence ❑Private (individual,corporation, ❑Second Home: Recreation Cabin,etc. nonprofit institution,etc.) ❑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 existing building is being changed,enter proposed use.b. Plumbing \(1D)-7 r28 x 8 ) n ELL)ki 1m e.dCAf -(r c. Heating,air conditioning pi-op€it t\ d. Other (elevator,etc.) (7 • TOTAL COST OF IMPROVEMENT $ III.SELECTED CHARACTERISTICS OF BUILDING - PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL DIMENSIONS ti Masonry❑ (wall eX(5± •Number of Stories bearing) ❑Public or Private 1 •Total square feet of floor area, ❑Wood Frame Individu (septicank t etc.) all floors,based on exterior dimensions ❑Structural steel ❑Reinforced concrete TYPE OF WATER SUPPLY •Total land area,sq.ft. ❑Public or private company Oyth�er�—Specify �[ NUMBER OF OFF-STREET TAD r► C C +ure d )XI Individual (well,cis ern) PARKING SPACES Enclosed PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE ❑Gas Outdoors ❑Oil RESIDENTIAL BUILDINGS ONLY ' Electricity Number of bedrooms F TYPE OF MECHANICAL C'(,^` ❑Coal Number of Full I ❑Other—Specify bathrooms (J�o_�I`)..�OtJ� Partial IV. IDENTIFICATION- - • Name Mailing Address—Number,street,city and State ZIP code Tel.No. 1. 1almes C• yarr _ 9q3 Old Thr Rd/ 371n 73z- Owner 2. CC� Contractor . State License No. 3. Architect The owner of this building and the undersigned agree to conform to all applicable laws. Si f applicant Sign Address Application date •OttOT-.6le ( °_7r/497'---N7----- ai /6q8/8 -7 _ANNING AREA FIRE DISTRICT SCHOOL DISTRICT _WATER DISTRICT `PROVED BY (3I'll f-1/O phi e. )-( a -a--cg 7 cF FEA11ffi DEPARTMENT • VEO 1O PERMIT FEE ISSUE DATE RECEIPT NUMBER '7 5 .C.)0 7 I . 5 O '7 Co 0 81 NG OFFICIAL / �O. d O DJ/2c5 •,�, .T5 rr tery—Port Townsend 7- �� /2--g)18 7 4 APPROVE -, (24‘.FEB 2 8-2 ` � -------------- ^ -� _- '-- - _ - - ~� 7 w~