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HomeMy WebLinkAboutBLD1985-00487! . 1110 BUILDINt; PERMIT APPLICATION. Jefferson County Building Department • County Courthouse' • Port Townsend, Wash. 98368 • 385 1310 I. LOCATION: oyraphrc name ST-N S W SIDE OF !T C�E ROAD FEET S1 �'�J b�l� t3 ROAD S F /`7/4"�'�ROAD AND orher specific location or landmark &/ `! a-e-- - - 4ID665 -r— is 1Ck. AT`- 91...3>.1 ` L S LEGAL DESCRIPTION: �'oc./ Subdivision /` tc.A!°J Lot B 2 / C Tax Number Y.SectionSect Township Range II.TYPE AND COST OF BUILDING TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY ❑New building Single Family ❑New County Resident (Addition -,e i400E.L ❑Multi-Family 'Is this structure to serve the residential number of units or commercial needs of those employed El Alteration Hotel,Motel,Dormitory at either the US.Navy's Trident or []Repair,replacement number of units Indian Island Facilities? O Wrecking ❑Mobile Home �,{ O Moving(relocation) 0 Other -Specify ❑YES RSJNO 0 Foundation only L/t/Gt�S✓A)Y C.Ae 'c r'- ' ��, \\\ _ l �3�,eav-1—/ & i USE OWNERSHIP 0 Full-time Residence OPrivate (individual,corporation, _ ❑Second Home: Recreation Cabin,etc. nonprofit institution,etc.) 3 Second Home: Future conversion to ❑Public (Federal,State or local goVt.) UBC OCCUPANCY GROUP: 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 „, �.,p f� 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. t If use of existing building is being changed,enter pro sed use. a. Electrical Z' b. Plumbing 2y V / c. Heating,air conditioning J a -= 7-•7 t� 0_,) d. Other(elevator,etc.) .yt • TOTAL COST OF IMPROVEMENT 5 ! V/ 0 d J - ivii III.SELECTED CHARACTERISTICS OF BUILDING - GXis7-7..41 5' yam— oc- — Gc__ Ili 1 K $Sl DIMENSIONS 067 PRINCIPAL TYPE OF FRAME TYPE OF SE E DISPOSAL •Number of Stories 2- EX/J. ///Masonry (wall bearing) EDP rc or Private •Total square feet of floor area, /i20�4®Cis7-r 15Z1 • Wood Frame "51 CCr) ndividual (septic tank,etc.) all floors,based on exterior 2 o p•pp S�� dimensions �� o 0 (Structural steel TYPE OF WATER SUPPLY •Total land area,sq.ft. ltLO©p mil! 0 Reinforced concrete -14 Public or private company �'- Other-Specify NUMBER OF OFF-STREET "� ❑Individual (well,cistern) PARKING SPACES J Enclosed /4 PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE Outdoors ❑Gas t`XlST ❑Oil RESIDENTIAL BUILDINGS ONLY ��r Number of bedrooms / Dlectricity `Lurro•- ❑ TYPE OF MECHANICAL ' Coal Full..� jGsrlx?Number ❑Other-Specify bathrooms Full. f"' nJerrt IV. IDENTIFICATION- Name Mailing Address-Number,street,city and State ZIP code Tel.No. aro 0 iv 4-r S?--eZ t— SS— Owner \ _A� eyue c >► 1,3e5o y 7/ 27 I qg � State License No. Contractor r $ y,T Y/6 o , 3. Architect The owner of this building and the undersigned agree to conform to all applicable laws. Signature of appti nt \ Address 5 .3-$8S Application date (-- '' 4.(930 NC. k TS*.-I-e J._ck.e W lk Too i PLANNING AR \/'J IRE DISTRICT I SCHOOL DISTRICT WATER DISTRICT c \ c APPRO ,, ���t P� . a. J soN` •�M -\ ISSUE DATE PERMIT NUMBER - I APPRO Q�`� PERMIT FEE ��63 p � - " 62 s� /& —S s 4 1 • • t • 9r� Kti \N C\J MeD 2 x S^b os �a \(z\• o c -_'.____ JEFFER • = y . EPARTMENT 802 SHERIDAN AVENUE s ' o INSTALLER PORT TOWNSEND, WASHING'QN 98368 RECEIPT NO. ( / (206) 385-0722 f Y ti �• Gf `� - z -d 7 BUILDER SEWAGE DISPOSAL PERMIT``J� DATE - Submit In Duplicate �-� , • i• rJ 4'3 2 1 L LEA QO A d Ic Q . '� 06k lt� 1 �i L gSS� aZ Owner Address • Phone r- rn reZrA HYi D 1.8 C. k Ts tc e CA lc- (3 AY (Zoo To w pre o Peru- L A o L v J > Directions for ocating site �1Et PF}SSttJV INOrArs 1 SLA-NP 1MCc12Sc�.T+oaJ y0 +►A.-C c K t-ti L.Lc-'l2 tt.Oct-A ON T t+�. Lt FY S'0 . PrPPQdk -2. r I Fug-t'* 'i?, m '�µ tC S f4 Apt P t,(_-1F"{ am)-co bf 1 t_L Q� P1'.PL t�'10 �'o 2.► n S rte. *reNam/ IN 't�2.t- TA-N k Loc./bit(ay.) 1 S SPD t W 41cYLc Pa/J 'Met {S t cT�Ai ii INSTALL NEW SYSTEM 0 REPLACE SYSTEM❑ PARTIAL REPAIRED TANKS -0®- O TYPE OF NO. OF SITE / ' i BUILDINGulLLO BEDROOMS 2 BASEMENT ND -SIZE 60• X B 8 + �� tn_ DRAW DETAILED PLOT PLAN BELOW. STUB OUT PLUMBING ABOVE FOUNDATION FOOTING oq nor* (or draw on attached sheet) S l rt SOIL LOGS ' 0`' C ru o --- LcY4 }� r N12 4 z . ,....- -..‘ ? 4"- cc_,. ,.s•-,.., Q ittit X i • t1� KY i d d c-, t �,g p aCV �C •n 0 I Fr q4 o Z lad 3 a 3 �C Z :`.1 i ..-1} 'u `� -fro 7 v car # �f z Z.ci Tr < _ w — t _w 1 Jl n o Z cx . ' +. © a 9J Dig two ho es per site. inimum ,' al to 4' deep-2' diam.-50' apart & flag location APPLICANT ( `� > z ANY REMOVAL OF OR MAJOR DISTURBANCE OF SOIL IN THE PROPOSED OR AP•'�r 1 'I ' IELD ono 0 AREA MAY CREATE SITE CONDITIONS THAT ARE UNACCEPTABLE FOR THE INS 'T . ' 0 A op SEWAGE DISPOSAL SYSTEM. ANY CHANGE IN BUILDING OR SEWAGE DISPOSAL PLANS INCLUDING O PLUMING STUBOUT LOCATION) AND/OR LOCATION OF HOUSE OR DRAINFIELD INVALIDATES THIS PERMIT UNLESS PRIOR APPROVAL IS OBTAINED FROM THE HEALTH DEPARTMENT. (Call Health Dept. for final inspection). Drainfield Length Width Depth I Lines Tank Size_ _Gal. C 3. COMMENTS: (TWO COMPARTMENTS) IJDv 01.0N 02. . tJ 1.1141 'Yb MAKE P N2+,J (3PYN mo ro tJ t i2 c- f-�11 S 1 tt�0jo GeevoY-r 1 S No,J G-elt.Itr� M.)g Id na-fg 7D mall c` -N e , rn Lot.kt tar) To Fat« i TAT e" • N ENV (,ut AT VS kl live c P i -'6 Ttte. \ 1S (NJor++) 4( J ari r, et Fj(, 2re-r cc- (-4 o nA t . Jt' APPROVED DATE INSPECTED PARTIAUFINAL DATE I certify that this system was installed in a manner approved by the Health Department. INSTALLER'S SIGNATURE DATE DATE INSTALLED JCHDl1-82 eQ O c_,_t r..e..` L 62 I r2 ta e Li