HomeMy WebLinkAboutBLD1988-00003 BUILDING PERMIT APPLICATIOI\ `
Jefferson County Buildir.,, epartment• Countyt.Courtho.use •Port Town M; Wash.98368 • 385-91.41
N E •
I. LOCATION: geographic name S W SIDE OF ROAD FEET
N E II f I-
S W FROM INTERSECTION OF ROAD AND Pf ht I Io rbn r- ROAD
other specific location or landmark: ,3
LEGAL DESCRIPTION: 0 T1 Tax A'
Parcel-4- Lot Block Subdivision
Tax Number %,Section Section Township Range
II.TYPE AND COST OF BUILDING-
TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY
❑
lAew building
/ single Family CI New County Resident
Addition ❑'Multi-Family Is this structure to serve the residential
❑Alteration number of units or commercial needs of those employed
❑Repair,replacement ❑Hotel,Motel,Dormitory at either the U.S.Navy's Trident or
. number of units Indian Island Facilities?
❑Wrecking ❑Mobile Home
❑Moving (relocation)
❑Other—Specify ❑YES ❑NO
❑Foundation only
OWNERSHIP USE
❑Full-time Residence
❑Private (individual,corporation,
nonprofit institution,etc.) Z ❑Second Home: Recreation'Cabin,etc.
❑Public (Federal,State or local gov't.) UBC OCCUPANCY GROUP: J ❑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 inOustrial plant.
a. Electrical If use of existing building is being changed,enter proposed �jse. •
b. Plumbing 1
Vain 1-7 0 tb Caitac) - I 25n
c. Heating,air conditioning `� hf 1 17 O 1# /? I/ /t` 1 p ) 2 `
d. Other (elevator,etc.) r3- i if 2l0J L�),_co ' ( , q r `OJ
-41 } I lS1
• TOTAL COST OF IMPROVEMENT $ ! )(�V) 3o
III.SELECTED CHARACTERISTICS OF BUILDING - f
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL DIMENSIONS ^
❑Masonry (wall bearing) ❑Public or Private •Number of Stories \/.J2
--„sne ) •Total square feet of floor area,
Wood Frame Individua (septic tank tc. all floors,based on exterior
❑Structural steel dimensions
TYPE OF WATER SUPPLY
❑Reinforced concrete •Total land area,sq.ft.
El Other—Specify ❑Public or private company
NUMBER OF OFF-STREET
XIndividu I (well, intern) PARKING SPACES
Enclosed
PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE
❑Gas Outdoors
❑Oil RESIDENTIAL BUILDINGS ONLY
25Electricity Number of bedrooms
❑Coal TYPE OF MECHANICAL
Other—Specify '" f Number of
Full
bathrooms
• Partial I
IV. IDENTIFICATION - •
Name Mailing Address—Number,street,city and State ZIP code Tel.No.
I. Till r 17n -tt-5 i ek cq6r)02 L.5Co P e NE i-I.R3 —
Owner I - 1
�x1c)oci(1--)v'I [t e, 9 8CP_2_ 021_00(;a)
2. Er,
Contractor State License No. `� ��� �
3
Architect
The iwne of th's b ing and th undersigned agree to conform to all applicable laws.
''. ure ap I' Address Application date
> • /I/ , , ,e1 .
10P918t
PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
APPROVED BYl07.4 0 i(,,I (
iy � r 3f IL — Si IS--t— LL— o‘C-..
JEFFERSON COUNTY HEALTH DEPARTMENT
APPRCAIP P'R O V E D PERMIT FEE ISSUE DA E RECEIPT NUMBER
5 q o . OCR !
JAM L1 � '�'
4 MN 15 , C_Ca I / l `7 :3/ 5 BUILDING�f R3�9V .000 O
9'L�1#r 1#!�?A tl6b�i�rFP# ���1 J �Q
The Printery—Port Townsend TO I /° l _,Cy
#�
t•. 3;" Y+" 7'. K aLJiv' 411
111
C C)TiiNT7 T 1V17T T.ii T 1\TL; iNT r=-i. T C i T C)T\T
Jefferson County Planning and Rl)i 1 d i ng Department
Cci rt iouse . 3rd Floor
PO Box 1220
Port Townsend , WA s.• t- -s
206-3R5-9141
PFRMTT a# •R DRRi-0003 T)A-T F. RFC;FTVF.O. : 0 i /1 5/9 1
STTF ADDRESS - 54 1 PLFASANT HARROR
-RRTNNON. WA 95320
OWNER •MART.YN KOTTS T CK PHONF. : 453-0260
MATLTNC Aili)R - 20002 1 56TH AVF. ivR
-W0OfTNVTLT,F. WA 95072
CONTRACTOR . . :NO CONTRACTOR PRONE!
MATT.TNC; ADDR -
•
CONTR . T.T i # - F.XPTRAT T ON i)ATF.:
ARCH T TFCT/ . . _ PRONE:
fl1 S T GNRR •
MA i i. i NO Al1TIR
PARCF.T, NO. . . - 5021 04004 HFAT.TH-
T.FOAT. i1FSC. . : STR 10-25-02 WWM. TAX * RV! • T)ATR
LOT 2 , RT.00K . TT, TAX A SHORF.T,TNFS -
�p RV: DATE-
6 :w.n ; i P'I TON OF TMPROVEMFNT : new single family
Rii T T.TTNO TYPE -RFS RRT)ROOMS--- RA T RROOMS-- MAIN FT . . . : 1 750 sf
TYPE. OF TMPROVF.MFNT'-NF.W FXTST. _ 0 RXTST. : 0 2NT) FT. • 1170 sf
OARAOF/CARPORT PROP. . . 3 PROP. . _• 3 3RT) PT. • 1120 sf
WOODSTOVR •Y TOTAL. : 3 TOTAL. : 3 RASFMF.NT . . . • 0 sf
URC OCCUPANCY CROiiP:R3 SFWACF. T)TSP. . - SFPTTC CARPORT. . . . 0 sf
TYPF OF CONST WATER SUPPLY. -PR T VA T F (;ARAOF 0 sf
UNITS . : 1 STORTF.S : 3 HEAT T'vPRS . :F.RR/ / )F.CKS 0 sf
it T MRNS T ONS : MORTLF HOMF COMMFRi TAT.- 0 sf
FRAME 'TYPE.:WOOD MAKE: YR - TNf/iiSTR T AT. - 0 sf
F.S T- COST. . - 55930 S T 7F : RANK WT. . . - 0 ft
PRO.T CRC. . _ 1 074 SF SF.TRACK- O ft
Owner/agent FFFS
Signature: type amount by date recant
PRMT $ 5a0 . O0 0 1 /04/R8 31753
Tate: PT.CK $ 15 . 00 01 /04/55 31753
B. C . $ . . 50 01 /04/55 31 753
issued Ry-
Date:
$ Fibs . 50 TOTAL
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Filed for the record at the request of: MAR f E.eRBOLIRY • ' -,EVER.Mi COATI'LtiefTOR
Jefferson County
• County Courthouse
PO Box 1220
Port Townsend, Washington 98368
•
•When recorded, return to: -
Marlyn Kottsick
- • •
20002 156th Ave NE 3 39768 • . - °
Woodinville WA 98072
. •. • . • . . . .
NOTICE IS HEREBY GIVEN TO Marlyn Kottsick, his heirs and assigns, and
1 the general public.
DESCRIPTION OF REAL PROPERTY AFFECTED: That Lot 2, Section 10,
Township 25 North, Range 2 West, WM. (Assessors Parcel 502 104 004).
STRUCTURE TYPE INVOLVED: Single familly addition -
ADDRESS OF STRUCTURE: 541 Pleasant Harbor, Brinnon WA
NOTICE IS HEREBY GIVEN THAT: The chimney does not have the proper
2 inch minimum clearance in the above referenced structure, therefore,
the building department will not and cannot attest that the
installation was consistent with the requirements of the 1988 Uniform
Building Code and RCW 19-27.
Dated this ZZ day of 41* _I".%1 , 1991.
•.
.
•-;71.1IIMPP-oldsrrith, Director
Jefferson County Planning and Building Department °
• •
Acknowledgement
Subs
do of
•
and s orn.t before me this 22.4.1
•l'Ot;* -:!3`•f;:';,• , 1991.
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