HomeMy WebLinkAboutBLD1988-00020 BUILDING PERMIT APPLICATION
At
Jefferson County Buildi.epartment• County Courthouse • Port Towr i', Wash.98368 • 385-9141
N E
I. LOCATION: geographic name S W SIDE OF ROAD FEET
NE
S W FROM INTERSECTION OF
ROAD AND
other specific location or landmark: U ►'►N
PELF LPL C�,ESC,F�IPTION: Q
!J 1 ' �=C� Lot Block
70 I a ,of v ` Tax Number %Section Section( '/Township Ra
II.TYPE AND COST OF BUILDING -
TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY
t 11251 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
❑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)
dd Other—Specify ❑YES ❑NO
❑Foundation only ii//\\.a,alo f
USE
OWNERSHIP
❑Private (individual,corporation,
❑Full-time Residence
nonprofit institution,etc.) ❑Second Home: Recreation Cabin,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 , 0 )(L(
c. Heating,air conditioning F7'12 aC/ /��l)�"�
d. Other (elevator,etc.) l (/(�
• TOTAL COST OF IMPROVEMENT $
III.SELECTED CHARACTERISTICS OF BUILDING -
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL DIMENSIONS
❑Masonry (wall bearing) ❑Public or Private •Number of Stories
Wood Frame �f •Total square feet of floor area,
Ilndividua septic tank, tc.) all floors,based on exterior
tructural steel TTT dimensions
❑Reinforced concrete TYPE OF WATER SUPPLY •
Total land area,sq.ft. (•C
❑Other—Specify ❑Public or priv e company L�J J
ndividu, (well, istern) NUMBER OF OFF-STREET
PARKING SPACES
Enclosed
PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE
❑Gas Outdoors
❑Oil
RESIDENTIAL BUILDINGS ONLY
Electricity Number of bedrooms
�❑Coal TYPE OF MECHANICAL
tf qt- r—Spec' Number of Full
\v//v bathrooms
Partial
IV. IDENTIFICATION-
Name Mailing Address—Number,street,city and State �Z?IIPP�coode TTeelll.No.
1.
Owner
t
91-1,0 r-3w2. c.-6 I 1
Contractor State License No.
3
Architect ..
v
The owner of this building and the undersigned agree to conform to all applicable laws.
ature of applic nt Addr s pli lion to
PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
APPROVED BY LI / /� } /� 0,0/1A11
®e4 [� .0Itl.f 'e Ke 1`�,^R`� f rto �rv.c.wc,y Cu,pe t 4,s STtLIb ciu 0
JEFF'2 � HEALTH DEPARTMENT Wes. v�1 t�T (�n cd y� f�� f/�l/86 �y K _
APPROVED B : v e ® PEtRII4IT ,E...F ISSUE DATE RECEIPT NUMBER
I
ER e f `— I- C /97sK/ c/ (e 6)
BUILD & LOG NT? �, ) `�
OEP -00 -o
D-hf ntery—Port Townsend 1 0
/ --
r �
411
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.TF.FF'F r'?_c,C7T3 C=C) ITT391-"V' F t7T T.T)T TT( i=›-R:F?NTT i'
Jefferson County Planninn and Rui ddina Department
Courthouse, 3rd3 Floor
PO Pox 1220
Port Townsend, WA 9536g
205-355-9141
PF.RMTT #. . . _ - RT,T)AA-0020
STTF ADDRFSS .431 SONG DO HOLLOW DATE TSSTTF.T)_ 05/14/58
OTTTT,CF.NF: WA 98376
OWNER •JOHN HORN _
MATLTNC ATrnR - P.O BOX 729 PHONE : 765-36 3A
-CITTTT,CF.NF. WA 98376
CONTRACTOR. . :NO CONTRACTOR
MATTING AT)T)R - PHONE:
•
CONTR. LTC #- EXPIRATION T)ATF .
PARCF.T, NO. . . - 7O1 2g2O1 2
T,FC,AT. DF.SC, -STR 29-27-01 WWM; TAX #
T,OT RT,OCk
DFSCRTPTTON OF TMPROVF.MFNT- new cabin
( ) Pontine/Sethac-ks (Shoreline Sethac:k) /Mohi le Home Rloc:kinn-
( ) Foundation -
( ) T7nderaround Plumbing/Underground Insulation :
( ) Framing/Plumbing/Chimney-
( ) Insulation :
( ) Sheetroc:k-
( ) Sewage Disposal System Final -
( v ) Fin 1 /Oc:r- 3nanc-y Appro
val :
c,ONn ,
CALT, 3A5-91 41 24 HOURS TN ADVANCE TO SCHRT)TTT,E INSPECTIONS.
Office Hours 9 a.m. to 5 p.m.
Tnsner:tor ' s Hours 9 - 10 a .m.
24 Hour Recorder for Tnsnect i ons
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