HomeMy WebLinkAboutBLD1988-00025 iilLDING PERMIT APPLICATION
Jefferson County Building Depent• County Courthouse•Port Townsend, 6 .98368 • 385-9141
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1. LOCATION: geographic name S W SIDE OF ROAD FEET
N E /^�
S W FROM INTERSECTION OF ROAD AND r.5( J AC el mu ,.13c .\ ROAD
other specific location or landmark: PT
LEGAL DESCRIPTION:
Parcel Lot Block Subdivision
13.2'(("!�� 03 2 Ya � .�0 I lk)
I Tax Number Section Section Township I Range
II.TYPE AND COST OF BUILDING -
TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY
El New building ❑Single Family ❑New County Resident
Addition ❑Multi-Family
Is this structure to serve the residential
number of units
❑Alteration or commercial needs of those employed
El Repair,replacement
❑Hotel,Motel, Dormitory at either the U.S.Navy's Trident or
number of units Indian Island Facilities?
❑Wrecking ❑Mobile Home
El Moving (relocation)
Other—Specify ❑YES ENO
El Foundation only
Rd. -P cper-
OWNERSHIP 14" USE
�R�t-.1L �:,W and
,• _ � ❑Full-time Residence
El Private (individual,corporation, �pV4-00 \'up- kt°Mt AA042 A.0
nonprofit institution,etc.) El Second Home: Recreation Cabin,etc.
El 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 - 9.nel (Ur- c l n5e+ ( et-[_1 ans
c. Heating,air conditioning W V/� '"� '1)7
d. Other (elevator,etc.) W of
• TOTAL COST OF IMPROVEMENT $
III.SELECTED CHARACTERISTICS OF BUILDING -
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL DIMENSIONS
❑Masonry (wall bearing) •Number of Stories
❑ •Public or Private
Wood Frame •Total square feet of floor area,
❑Individual (septic tank,etc.) all floors,based on exterior
❑Structural steel dimensions
TYPE OF WATER SUPPLY T
El Reinforced concrete • otal land area,sq.ft.
El Other—Specify ElPublic or private company
NUMBER OF OFF-STREET
El Individual (well,cistern) PARKING SPACES
Enclosed
PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE
CI Gas Outdoors
❑Oil RESIDENTIAL BUILDINGS ONLY
Electricity Number of bedrooms
Ell Coal TYPE OF MECHANICAL
Number of Full
❑Other—Specify bathrooms
Partial
IV. IDENTIFICATION - .
Name �/' q Mailing Address—Number,street,city and State ZIP code Tel.No.
1.Owner 5+ as�C"Q—hero 1 50 _Ace Imo. �t >c l."l ecl PT 98-(UQ
2. CI 32 V�1"1 T�'C�tPtl r' �- ci i S `7�3 -
Contractor �Q IS C�r�h��—fir`, State License No.
3.
Architect
The owner of this building and the undersigned agree to conform to all applicable laws.
Signs awl Address Application date
06)/ro r J88
1
PLANNING AREA /IRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
APPROVED BY
APPR V D `/ 6tc
JEFFER I NTY\HEALTH DEPARTMENT
A PPRJU I PERMIT F� ISSUED TE RECEIPT NUMBER
/3 7
J ((JJ SON COUNTY
PLANNING&BIDG DEFT `'S 0 -
BUILDING OFFICIAL —�(5�— �f
The Printery—Port Townsend
_TF:Ty F'F:RF;C7N (;c)TTTJ V'Y 1liTT T.T7T 1\TCI; RF:RMT 'T
Jefferson County Planning and Building Department
Courthouse, 3rd Floor
PO Box 122O
Port Townsend, WA 9836B
206-385-91 41
PERMIT # •RT,DAR-0025 DATF. TSSTTED. ! 06/03/AR
STTR ADDRESS ! 1 50 ADET,MA REACH RD
-PORT TOWNSEND, WA 9A368
OWNER , ST T C OSTERRERC PHONE
MATT,TNC ADDR : 1 50 AT)ET,MA REACH RD
-PORT TOWNSEND WA 9R36R
iONTRACTOR . . :NO CONTRACTOR PHONE!
MATT,TN(, ADDR
CONTR . LTC #: EXPIRATION DATE:
PARCEL NO. . . :001 324031
LECAT, DESC . . !STR 32-30-01 WWM, TAX #
LOT , BLOCK
DESCRIPTION OF IMPROVEMENT! singe family addition ! hook-up for kidney machine
( ) Footing/Sethacks (Shoreline Sethack) /Mohile Home Rlnckina!
( ) Foundation
( ) Underground Plumhinit/Underground Insulation !
( ) Framing/Plumping/Chimney!
( ) insulation !
( ) Sheetrockr
( ) Sewage
Disposal System Final -
( L Final /Occupancy Approval -
CALL 385-91 41 24 HOURS TN ADVANCE TO SCHEDULE INSPECTIONS .
Office Hours q a .m. to 5 p.m.
Tnspector ' s Hours q - 10 a .m.
24 Hour Recorder for Inspections.