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Home My WebLink AboutBLD1988-00021 BUILDING PERMIT APPLICATION Jefferson County Buildil partment• County Courthouse •Port Towns: Wash.98368 • 385-9141 , N E , I. LOCATION: geographic name S W SIDE OF ROAD FEET N E 4 T-0,4, 1S W FROM INTERSECTION OF ROAD AND .�,Il.rr1f� ROAD other specific location or landmark: V4. `-—"'Y l�/` .�l I 2 �jc LE A�L QDCRIPTION: t4 a al / i / P v"`, co/o ,/ `2, Block 'S ,\ 7Subdi isip,tl / lik._,.) Tax Number 'A Section A Section Township Range II. TYPE AND COST OF BUILDING - TYPE O''F IMPROVEMENT BUILDING TYPE MOBILITY New buildingfk Single Family ❑New County Resident ddition ❑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.Nav s Trident or ❑Repair,replacement number of units y ❑Wrecking Indian Island Facilities? ❑Mobile Home ❑Moving (relocation) El Other—Specify ❑YES ❑NO ❑Foundation only OWNERSHIP USE ❑Full-time Residence ❑Private (individual,corporation, nonprofit institution,etc.) ❑Second Home: Recreation Cabin,etc. ❑Public (Federal,State or local gov't.) UBC OCCUPANCY GROUP:fr ❑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 t CAD 1.� dIA, c. Heating,air conditioning � C12 / I _/ 6" 0 d. Other (elevator,etc.) /‘ g ��/'1,�- • TOTAL COST OF IMPROVEMENT $ �'( > III.SELECTED CHARACTERISTICS OF BUILDING - /� '� DIMENSIONS : PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE D F; � ❑Masonry (wall bearing) ❑Public _ •Number of Stories l/\or Private •Total square feet of floor area, Wood Frame .Individual eptic tank, tc.) all floors,based on exterior ❑ tructural steel dimensions TYPE OF WATER SUPPLY❑Reinforced concrete - Total land area,sq.ft. ❑Other—Specify ❑Public or p ' e company __ _ NUMBER OF OFF-STREETIndividu (well, 'stern) PARKING SPACES Enclosed PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE El Gas Outdoors ❑Oil RESIDENTIAL BUILDINGS ONLY ,Electricity Number of bedrooms oal TYPE OF MECHANICAL:;;:cc { t er,— �ec�fy Number of Full y' / ` 'i�1 Q/ bathrooms Partial IV. IDENTIFICATION- a . Name Mailing Address—Nu er,street,city and State ZIP code Tel.No. 1. 6 /S-5- � /� rn /0E- Owner Contractor State License No. `^s 7. 3. Architect , The owne .t this building and the undersigned agree to conform to all applicable laws. JSignat .f applicant V.D..c . Addres Applic ion V PLANNING AREA IRE DISTRICT SCHOOL DISTRICT WATER DISTRICT APPROVED BY ptc �� 4-A155:), /00 ' JEFFE SO C NTY HEALTH DEPARTMENT ��L" APPRO Aif —WRM FEE ISSUE DATE RECEIPT NUMBER 0 -/* /, ')Y` (P/W ,, , 0 ) BUILDINj�r f ICIAL 3� PtA /Rsak�Q (033 �a 4ofN. M Gd� The Printery—Port Townsend -bHOD /f/ .TFFFFr.TR C7N . C7'C7Y7NTV F3TTT T.T)T 7VC; 1=)FFcMT T Jefferson County Planning and Building Department Courthouse, 3rd Floor PC) Box 1220 Port Townsend; WA 98388 278-385-9141 PFRMTT # •RT.T)SR-C)C)21 DATE TSSUET). : C)Fi/1 S/RR STTF. AT)T)RESS •45C) SMTTH T,ANF •C)TJTLCFNF . WA 98378 OWNER -GEC) DFVRTF.S PHONE : -'7 MATT.TNC-; ADD : 1 5544 12TH AVE.. ME !SEATTT.F WA 98155 CONTRACTOR. . -NC) CONTRACTOR PHONE MATT.T NC AT)T)R : CONTR . T.T C #! EXPIRATION DATE : PARCFT, NO. . . - 501 C)S201 2 T.F.C;AT. DESC . . ! STR 03-25-01 WWM. TAX # LOT . RT.00K p T)FSCRTPTTON OF TMPROVE..MF.NT! c4/Ykc 1te "6 ( ) Fnotinrr/Seth cks (Shoreline Sethack) /Mohiie Home Blocking! Ale ki. 4 El - ( ) Foundation - ( ) Underground Plumbing/ilndergrnund Tnsulationr ( ) Framinc7/Plumhincr/Chimney 1. iv'r' b / 1;in-11/0 L. 77 G _ ( ) Tnsu1ation - ^,"4.,.4 / /2-7 /p Q' - = ( ) Sheetrock ! Gvwib.�fi j 3 / 3--( 0 -.Z ( ) Sewage Disposal System Final ! ( %/(eFinai /Occupancy Approves C) -1 CALT. 385-9141 24 HOURS TN ADVANCE. TO SCHF.T)UT,E TNSPF.CTTONS. Office Hours 9 a .m. to 5 p.m. Tnsnector ' s Hours 9 - 10 a .m. 24 Hour Recorder for Tnsnections. • - 1 14 _.---- 72-sn. NI -or ./.. 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E... .,.• pe 1E iv 1 1:3 I Ci. 14 ID it-:4-1-E I t9—'3 0—i •=.7.'.1. e.6; i I SHORELINE SETBACK EVALUATION APPLICANT: GFo„,t ve(6_,c ADDRESS: 1-C-15-`-/` rr TELEPHONE: (home) (business ) PROPERTY DESCRIPTION PROPERTY SITE NUMBER: LEGAL: Owner : N/1- Address: Tax ParceL Number: / ReaL Property Description: G.,o /-a 4e7-/ ADJACENT WATER BODY: 7 6C_ • EVALUATION i BLUFF HEIGHT: Cl _ SOURCE: ZO / 77--�� c BLUFF STABILITY: 6145 SOURCE: C- 079 ❑ STANDARD SETBACK: feet This minimum setback shaLL be measured from the ordinary high water mark to the most waterward edge of the proposed structure . ❑ BLUFF SETBACK: feet This minimum setback shaLL be measured from the bank' s edge to the most waterward edge of the proposed structure . ❑ AVERAGE SETBACK: feet This minimum setback shaLL be measured from the bank's edge to the most waterward edge of the proposed structure. This setback is based on the foLLowing caLcuLations of adjacent residentiaL structures . Right House (facing waterward) : • Setback from bank or ordinary high water : feet • Distance to the proposed structure: feet Left House (facing waterward) : • Setback from bank or ordinary high water : feet • Distance to the proposed structure: feet ❑ SUBDIVISION SETBACK: /0 0 feet This minimum setback shaLL be measured from: 7 of 0f-f • This setback was estabLished by the approvaL and fiLing of the pLat. VARIANCE REQUEST: ❑ APPROVED 0 DENIED DATE: ACKNOWLEDGEMENT. The above evaLuation was determined on information provided by the appLicant. ShouLd any of this information be found inaccurate, the setback requirement may be re-evaluated. (pLanner) (date)