HomeMy WebLinkAboutBLD1988-00017 ok
BUILDING PERMIT APPLICATION
' i Jefferson CountyBuila npartment• Countg Courthcuse • Port Town , Wash.98368 • 385-9141
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: -72/ r;/(Ja !J6 g Ae ,pa
(")
LEGAL DESCRIPTION:
Lot Block Subdivision
p ,„4 -'D02-2y2-0/6 Y 2/ k 2 2-63
Tax Number 1/4Section Section Township Range
II.TYPE AND COST OF BUILDING -
TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY
>(New building Single Family CD New County Resident
❑Addition Multi-Family Is this structure to serve the residential
number of units
❑Alteration — or commercial needs of those emnloved
❑Hotel,Motel, Dormitory at either the U.S.Navy's Trident or
❑Repair,replacement number of units
Indian Island Facilities?
❑Wrecking ❑Mobile Home
❑Moving (relocation) ❑Other-Specify LI YES ❑NO
❑Foundation only
USE
OWNERSHIP
❑Full-time Residence
❑Private (individual,corporation,
nonprofit institution,etc.) ❑Second Home: Recreation Cabin,etc.
❑Public (Federal,State or local gov't.) UBC OCCUPANCY GROUP: -3 ❑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
j 156 MQk ...,k a 3s--= So 7So
Jv
•
c. Heating,air conditioning t 6V`P Z'-t9 *qeJ,._. 16�-- I 2 88
d. Other (elevator,etc.)
I
• TOTAL COST OF IMPROVEMENT $ I T�6 3
III.SELECTED CHARACTERISTICS OF BUILDING -
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL DIMENSIONS -2--
Masonry (wall bearing) •Number of Stories
❑ 9 ❑Public or Private •Total square feet of floor area,
Wood Frame • [j'�ndividual (septic tank,etc.) all floors,based on exterior
❑Structural steel dimensions -2-2_1
❑Reinforced concrete TYPE OF WATER SUPPLY •Total land area,sq.ft. X
❑Other-Specify El Public or private company , ' � �`�
NUMBER OF OFF-STREET
ndividual (well,cistern) PARKING SPACES
Enclosed
PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE
R(Gas Pas+0ov..._ Outdoors
Oil \ RESIDENTIAL BUILDINGS ONLY
❑Electricity Number of bedrooms >; 4:;
❑Coal TYPE OF M ANICAL ,F
❑Other-Specify
Number of {Full fJN
bathrooms
•
Partial ;,
!V. !DE!UT!F!CAT!ON - 1
Name Mailing Address-Number,street,city and State ZIP code Tel.No.
1. A;e.k. hip+!;Ira,L .) X. 1341 LI --- 8 c,;,., 7/c- 1.1':q 6:,,/1 Nic/F.i41 41 i6
Owner _
0
2. - '" 'I1 Ei: ( zy3_51-40
Contractor State License No.
3.
Architect
The owner of this building and the undersigned agree to conform to all applicable laws.
\S�i-g a applecan j )
Address Application date
/
I PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT -__ WATER DISTRIC�-
APPROVED BY H (°
( 0 c Ll f 4 (t ( ( s(2
JEFFERSON COUNTY HEALTH DEPAR IJIENT
APPROVED BY: PERMIT FEE I ISSUE DATE I RECEIPT NUMBER
S aIDt�c�{o„� 3 Sti a_____
) oc/s--------
BUILDING 0 RRCI1A s�� ^g , Ic SQO /i /wli
JEFFERSON COUNTY , 106 ° The Printery-Port Townsend
PLANNING&BLDG DEPT
04
m
. .7 r—. -r-r. rF F C)T T C C)i 7 TWT" " FVU T T T.Ti i Tv c; 1P ir. F TvT T m
Jefferson County Planning and Ru i l d i ng Department
Courthouse, 3rd Floor
PO Rox 1220
Port Townsend , WA 9836E
206-385-9141
PERMIT # •RT,fAR-0017 DATE TSST'IET). -04/11 /RR
STTF. AIJfRESS • 72 1 WA WA POINT Rfl
RR T NNON. WA 98320
OWNER • .TACK HART.OW PHONE : 246-4388
MATTING A1111R : 18445 RTH S
: SEATTT,E WA 981 4R
CONTRACTOR. . -NO CONTRACTOR PHONE
MATLTNG A DR :
•
CONTR . LTC #- EXPIRATION DATE !
PARCET, NO. . . : n022420 1 6
LEGAL DF.SC. . : STR 24-26-02 WWM. TAX #
LOT BLOCK
T)ESCR T PT TON OF IMPROVEMENT: s i no i e family residence
f i Footina/Sethacks (Shoreline Sethark) /Mohi i Home Riockina:
i i Foundation !
i i iinderciround P i nmh i no/TJnderoround Tnsu i at i on
f j Framing/Plumhino/Chimney•
i 1 Insulation !
i i Sheetrork:
i ; Sewage Disposal System Final :
( 1 Final /Occunancv Approval :,
� � // 3 /� �
CALL 385-91 41 24 HOURS TN ADVANCE TO SCHEDULE. INSPECTIONS .
Office Hours 9 a .m. to 5 p.m.
Inspector ' s Hours 9 - i0 a .m.
24 Hour Recorder for Inspections.
_ s
Applicant ' s Name TIC/j t yU°NNE v„J
2 c! (— SP 8' (work)Phone (home)
N R,� T,2�
Building Location (legal description) S �
Ay...v AL, ed".
'Parcel Number oct
Adjacent Water Body
cJ/4 CK.rv/1 Cd✓L
Based on the information, the most waterward side of the proposed structure must be set
back at least LI 0 feet from the high water ma
k
feet from the edge of the bluff or bank
not able to be determined without additional information
Additional comments:
,qRc/> uc 17P 5
Signature, Jefferson County Shorelines
Administrator
Jefferson County Planning & Building Dept.
County Courthouse
Port Townsend, WA 98368
385-1427
.1/7t4 tro/�?r Bluff stability
Bluff or Bank height ---
Adjacent residential Structures within 300 feet? yes no
7
If yes, existing setback of adjacent homes:
Home E2:
Home �1:
foot setback from bank .�--
foot setback from bad k ---- T property
• foot distance from applicant s
_foot distance from applicants proper;=_
Much of the above information is supplied by the applicant. Should any information be -
inaccurate, this setback requirement may be changed.
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