HomeMy WebLinkAboutBLD1988-00014 BUILDING PERMIT APPLICATION
Jefferson County Building•artment. County Courthouse •Port Townse 1/ash.98368 • 385-9141
N E
I. LOCATION: geographic name S W SIDE OF ROAD J // FEET
S W FROM INTERSECTION OF //,, �,�,�i� ROAD AND 1 :.49 � L'U)--- - j� AD
other specific location or landmark: t f/l/DUI t� od-- rDj t-t/. *r/
LEGAL DESCRIP ION:
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PA—it U Lot Block �� Subdivision
o i5c�Dl// po'{ ) J
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
❑Alteration number of units or commercial needs of those employed
❑Hotel,Motel, Dormitory at either the U.S.Navy's Trident or
El Repair,replacement
number of units Indian Island Facilities?
❑Wrecking �❑Mobile Home
ElV\
Moving (relocation) f '�1 Other—Specify
, CI YES ❑NO
❑Foundation only I
1( USE
OWNERSHIP I�'
❑Full-time Residence
❑Private (individual,corporation,
nonprofit institution,etc.) ElSecond Home: Recreation Cabin,etc.
❑Public (Federal,State or local gov't.) UBC OCCUPANCY GROUP: ❑N„,...4 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 pr osed use.
b. Plumbing a� Q l (0 �� �j
c. Heating,air conditioning /v YY���` ���333 /� ll
d. Other (elevator,etc.►
• TOTAL COST OF IMPROVEMENT $
III.SELECTED CHARACTERISTICS OF BUILDING -
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL DIMENSIONS
❑Masonry (wall bearing) •Number of Stories
El Public or Private
Wotal square feet of floor area,
El Individual (septic tank,etc.) all floors,based on exterior
❑ ood Frame tructural steel dimensions
ID Reinforced concrete TYPE OF WATER SUPPLY •Total land area,sq.ft.
El Public or private co. pany
❑Other—Specify NUMBER OF OFF-STREET
❑Individual (well cistern) PARKING SPACES
' Enclosed
PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIRE' ACE
❑Gas Outdoors
❑Oil RESIDE IAL BUILDINGS ONLY
❑Electri ' y tuber of bedrooms
❑ al TYP OF MECHANICAL
Other—Specify Number of Full
bathrooms
Partial
IV. IDENTIFICATION -
Name Mailing Address— Number,street,city and State ZIP code Tel.No.
1.
Owner
2.
Contractor State License No. I
V
3.
Architect
,\)The owner of this building and the undersigned agree to conform to all applicable laws.
.ignature of applicant r Address' Ap ication d e
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6.(.47.---2.-7_ aA44A____---- ---//i/C96)(1- '
PLANNING AREA FIRIE STRICT SCHOOL DISTRICT WATER DISTRICT
APPROVED BY ^ '
/�( ,- C9Y--
JEFFEFEta T DEPARTMENT
APPROV 'DBY. PERMIT FEE ISSUE DATE RECEIPT NUMBER
ci
PR 988 3/VS / -7/ SYS V‘ I
BUILDING OFJF*tBfQ N COUNTY /
PLANNING&BLDG DEPT n r
The Printery —Port Townsend -ro i-t'Pin y��,7/
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Jefferson County Planning and Building Department
Courthouse,. 3rd Floor
PO Box 1220
Port Townsend , WA 95368
20A-3R5-9141
PFRMTT # RT,i]RR-t)C i 4 DATE.. T SSiJFf. -O4 i 2A/RR
SITE. Aiiijrcr.:l� - 1 60 CTRRS LAKE. RD
CH T MACTJM. WA 9R325
OWNER AT KF.NN .DY PHONF : 73 -4679
MA T T,TNC ADDR - 1 60 CTRRS LAKE Rn
-C HTMACTJJv1 WA 95325
CONTRACTOR . . :Nc7 CONTRACTOR PHONE..
MA T LTNh AI11lR:
CONTR . T.TC #: EXPIRATION DATE :
PARCET, NO. . . : 9O1342017
T,EG;AT, DESC . . :STR 34-29-o 1 WWivi. TAX #
T,OT RT,OCK T,OWFT,T, DAY SP A
DFSCR T PT T ON OF T MPRCVRMF.NT: detached shop
i 3 Footing/Setbacks (Shoreline Setnack) iMohile Home Blorkinn
f i Foundation -
f i Underground Plumhinn/Underground Tnsuiation :
i i FraminglPlumhing Chimney.
f Insulation :
f i Sheetrock :
f i Sewage Disposal System Final :
i i Final/Occupancy Approval :
CAT,T. 335-9141 24 HOURS TN ADVANCE TO SCHEDULE INSPECTIONS.
Office Hours 9 a .m . to 5 n.m.
inspector ' s Hours 9 - 10 a .m.
24 Hour Recorder for Tnsnections.
APPROVED
APR 2 8 ' , : - ,......-7 -5 Ilz-. -?:::PK--0 b't C_ 4.4•at,.....
JEFFERSON COUNTY
PLANNING&BLDG DEPT
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