HomeMy WebLinkAboutBLD1988-0023 BUILDING PERMIT APPLICATION
Jefferson County Buildin )artment• CountyLourthduse • Port Towns.Wash.98368 • 385-9.1 41
N E —
I. LOCATION: geographic name S W SIDE OF ROAD( { FEET
) iT
S W FROM INTERSECTION OF ROAD AND f ( [dd If'� Rd
(n� ROAD
other specific location or landmark:
LEGAL DESCRIPTION:
Pjlt(-CeJ CA Lot 14 Block Subdivision 1l/.-CJ`
or65-2 ozq Tax Number Y.Section Section Township Range
9
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.Nav
❑Repair,replacement number of units Y"s Trident or
Indian Island Facilities?
❑Wrecking
❑Mobile Home
❑Moving (relocation)
Other—Specify ❑YES ❑NO
❑Foundation only / \
_LS-f-nrnge /,,Ba.rn
USE
OWNERSHIP
❑Full-time Residence
❑Private (individual,corporation,
nonprofit institution,etc.) CDSecond Home: Recreation Cabin,etc.
❑Public (Federal,State or local gov't.) UBC OCCUPANCY GROUP: CD 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 CC)
4 4g ` " 1) ma
c. Heating,air conditioning tl
d. Other (elevator,etc.)
•
• TOTAL COST OF IMPROVEMENT $
III.SELECTED CHARACTERISTICS OF BUILDING -
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL DIMENSIONS
LI Masonry (wall bearing) •Number of Stories
❑ •Public or Privat _,�
Wood Frame % •Total square feet of floor area,
Individual (septic tank/etc.) all floors,based on exterior
❑Structural steel dimensions
TYPE OF WATER SUPPLY Total land area,sq.ft.
CI Reinforced concrete •
❑Other—Specify ❑Public or private company
\gIndividu( NUMBER OF OFF-STREET
(well cistern) PARKING SPACES
Enclosed
PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE
❑Gas Outdoors
❑Oil
RESIDENTIAL BUILDINGS ONLY
❑Electricity Number of bedrooms
El Coal TYPE OF MECHANICAL
CD —Specify Number of Full
—
bathrooms
Partial
IV. IDENTIFICATION -
"'' Name Mailing Address
—Number,street,city and State ZIP code Tel.No.
Owner1. OnalU�R�b(�LSQ(1 PC) IL(O ( ) PT- 3 ),3(Q'°
2. Pa ,-
Contractor State License No.
3.
Architect
The owner of this building and the undersigned agree to conform to all applicable laws.
��igna u e of appl' ant , Address
t Application date
CA(0/0219
PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT /
APPROVED BY —
fl/r--,- 0\c_v...1--- -
JEFFERSOd COUNTY HEALTH DEPARTMENT
APPROA P •VI:1 lyy It6::VED PERMIT FEE ISSUE DATE RECEIPT NUMBER
JUN 1 sea 3 . 5-0 (e777W 65�
BUILDING OFFICIAL (n � y�JEFFERN P_n ry�SA • ��
t72L.0 _00?-
PLANNING&WOG OW The Printery—Port Townsend 'To /T,0 f o/Oz -
•
.TFr.'FP'Fr Fr.RSCITNT C17C)TTN'1"57. RTTT T.T)T TNT P'Tr.TRT'4T T
Jefferson County Planning and Ruildinn Department
Courthouse, 3rd Fl onr
PO Rnx 1220
Port Townsend; WA 9R:388
208-385-9141
PERMTT # •RT,D8R-0023 DATE TSSUED. !0Fi/07/RR
STTR ADDRESS- :371 MTDDLF.POTNT RD
PORT TOWNSEND. WA 983E 8
OWNER •DONAT.D RORTNSON PHONE::
MATLTNC; ADDR :P. O . BOX 140q
PORT TOWNSEND WA 98368
CONTRACTOR. . :NO CONTRACTOR PHONE
MATLTN( ADDR :
CONTR. LTC #: E:XPTRATTON DATE:
PARCF.T, NO. . . :001 052029
T.F.t,AL DESC . . :STR 48-30-05 WWM. TAX #
LOT . BLOCK
DESCRIPTION OF TMPROVEMENT: storane/harn
( ) Fontinn/Setbacks (Shoreline Sethack) /Mnhile Home Blocking!
( ) Foundation :
( ) Underground Plumbing/Underground Insulation :
( ) Framing/Plumbing/Chimney:
( ) Insulation :
( ) Sheetrock:
( ) Sewacre Disposal System Final :
( Final /Occupancy Annroval - j
CALL 385-9141 24 HOURS TN ADVANCE TO SCHEDULE TNSPECTTONS.
Office Hours 9 a .m. to 5 p.m.
inspector ' s Hours 9 - 10 a.m.
24 Hour Recorder for Inspections.
--- -- - it
•
si
■ ■■
�"��,��� � a -- mu■■■ ■1®-_ ansuiL
■
ENE m,
■lk
11111111 ill 1) k .1 ''' N inn MEM
■
EL_ Ill v 1
ENEE
D.
y ■ tIr % ni..
IIollo WAiti
IiiIEijF. :U. ,..
,,,,,
.,,,,,„ I.
i1i11IiI
.. mi
7
w.
,,_
..e., tt&
1•
....in..
.,
MI
MEM
S1 1 li
111111111.11
1
=INN m ^ ti. P--' is
■■■mmoms
■■■■■®_
■■■ ■®1 L t
1
UI'#UIIiL..
mml N
•iiiuici
*L„,•••- - ���.�����® NNE ENE® _■