HomeMy WebLinkAboutBLD1988-00024 BUILDING PERMIT APPLICATION
Jefferson County Building DeIIInent• County C^yrfiiou •Port Townsend,S.98368 • 385-9141
N E
I. LOCATION: geographic name , SW SIDE OF_ r ROAD . FEET
N E
S W FROM INTERSECTION OF ROAD AND Q 3 / 0-- OAD
other specific location or landmark:
LEGAL Q ESCRIPTION:
p n U Lot Block Subvion_
/y `�'� zionU r/flJl icap d J� 0 go Tax Number Section Township Range
II.TYPE AND COST OF BUILDING -
TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY
; New building /6�1 Single Family ❑New County Resident
❑Addition ( ❑ ulti-Family Is this structure to serve the residential
number of units
Li Alteration or commercial needs of those employed
❑Hotel,Motel, Dormitory at either the U.S.Navy's Trident or
❑Repair,replacement number of units
ID Wrecking Indian Island Facilities?
❑Mobile Home
❑Moving (relocation)
❑Other—Specify ❑YES ONO
❑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: ��� ❑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 y(^ i t/1 l r_3 cDJ q� 35— l
d,cp
c. Heating,air conditioning C�A� ((�X rag ` 7cR°PYs7 S ga
d. Other (elevator,etc.)
• TOTAL COST OF IMPROVEMENT $ l CJ(f
III.SELECTED CHARACTERISTICS OF BUILDING - G6 ff
I�I�
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE (
El Masonry (wall bearing) CD Public or PrivatNI e C�/ ENSIGNS
•Number of Stories
•Total square feet of floor area,
Wood Frame
ndividu 1 (septic tank,ptc.) all floors,based on exterior
❑Structural steel dimensions
❑Reinforced concrete TYPE OF WATER SUPPLY •Total land area,sq.ft.
❑Other—Specify ❑Public or private company
NUMBER OF OFF-STREET
Ondividu'I (well, intern) 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
(�O her—Spe f Number of Full
�� k bathrooms
.l�-LLLL Partial C �
IV. IDENTIFICATION -
�41J
Name Mailing Address—Number,street,city and State ZIP code Tel.No. -
:%0( Cnarre -3L lb(i to `r 3(
errU e ,
tit actor 3 A ` d State License No.
3.
Architect
The owner of this building and the undersigned agree to conform to all applicable laws. •
ignat d of app'cant Addre
�� ( APPat date
PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
APPROVED BY / /„.., j' czg
(0. 'OA 3 / '----PFD --C-)g(c(
JEFFERS.N COUNTY HEALTH DEPARTMEN
APPROVED .:Y: PFIR IT FEE ISSUE DATE RECEIPT NUMBER
A P p�•.�,, , 4 7 , 4D
� ' ••.: LSD 19 7/0
BUILD' • ' •'�)', p y'
y /6'CN
OFFEHSON COUNTY / / b,,,O/W PCANNINfi Y— t27fri " 06.47
&Btk?G DE, The Printer Port Townsend
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Jefferson County Planning and Building Department
Courthouse, 3rd Floor
PO Box 1220
Port Townsend, WA 95368
206-385-9141
PERMT T # •RT,)F3R-0024 flATF. TSSTTF.fl. -0A/2F3/RF3
STTF AflflRFSS f 32 .TOT,TF WAY
!PORT TOWNSF.ND, WA 9536F3
OWNER •CHART.ES RTTRRTTFT, PHONE
MATT.TNG AflflR : n32 .TOT.TF WAY
PORT TOWNSF.ND WA 98368
CONTRACTOR. . !NO CONTRACTOR PHONE
MATLTNC AflflR
CONTR. LTC #- EXPTRATTON HATE-
PARCET, NO. . . ! OO1 071 030
LEGAL DF.SC . . - STR 07-30-01 WWM. TAX #
T,OT . BLOCK
DFSCRTPTTON OF IMPROVEMENT! single family residence
( ) Fontinn/Sethacks (Shoreline Sethack) /Mnhile Home Blocking
( ) Foundation
( ) Underground Plumbing/Underground Tnsii 1 at i on
( ) Framing/Plumhing/Chimney!
( ) Tnsulationc
( ) Sheetrock-
( ) Sewage Disposal System Final -
( j ) F i na 1 /Occupancy Annrn ra l zsJ( f— `j
CALT, 385-9141 24 HOURS TN ADVANCE TO SCHF.DTTT,F. INSPECTIONS.
Office Hours 9 a .m. to 5 n. m.
Inspector ' s Hours 9 - 10 a .m.
24 Hour Recorder for Tnsnections.
•
N 8 8 ° 51 ' 18VE :662 . 78 . $
4 331. 39 0
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