HomeMy WebLinkAboutBLD1988-00026 BUILDINC PERMIT APPLICATI
Jefferson County club, g Department. + arty Courthouse • Port T ;rld, Wash.98368 • 385-9141
N E �4,
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I. LOCATION: geographic name S W SIDE OF ROAD FEET
NE
S W FROM INTERSECTION OF ROA AND ? "0 ROAD
other specific location or landmark: PO "fl \ c R
LEGAL DE CRIPTION: 3 P 1
pft Il n Lot Block Subdivision r
2,/ (A1
,(20a ial v®' Tax Number %Section Section Township Range
II.TYPE AND COST OF BUILDING -
TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY
ew 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. Navy's Trident or
❑Repair,replacement number of units
Indian Island Facilities?
❑Wrecking ❑Mobile Home
❑Moving (relocation) (Other—Specify
VV'�� ❑YES ❑NO
❑Foundation only
USE
OWNERSHIP
r/^/ ❑Full-time Residence
❑Private (individual,corporation, !L/ � J ❑Second Home: Recreation Cabin,etc.
nonprofit institution,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 p •posed use.
b. Plumbing ke ,• `- C i , i ill
c. Heating,air conditioning ' -
K. ( . - .5oC I• t' -4110 4. QS
d. Other (elevator,etc.) - de/'
• TOTAL COST OF IMPROVEMENT $ "If
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 (sep ' ank,etc.) •
all floors,based on exterior
Structural steel dimensions
❑ Reinforced concrete TYPE OF IN ER SUPPLY •Total land area,sq.ft.
lic or private company
❑Other—Specify NUMBER OF OFF-STREET
Individual (well,cistern) PARKING SPACES
Enclosed
PRINCIPAL TYPE OF HEATING FUE TYPE OF FIREPLACE
CI Gas Outdoors
❑Oil RESIDENTIAL BUILDINGS ONLY
❑Electricity Number of bedrooms
CI Coal TYPE OF MECHANICAL
her—Specify Number of
bathroom
Partial
HIV. IDENTIFICATION -
Name Mailing Address—Number,street,city and State ZIP code Tel. No.
lie N K 11 W ( • 7 (y- s/y/
Owner (}-i
2. +I VOoa.A, 'e --? — � 7 5'2
„r....t..,..xo, State License No.
3.
Architect
The owner f this building and the ndersigned agree to conform to all applicable laws.
c
Signal re f applica t Add ss Applica[ n d ? 7
PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
APPROVED BY
.� a tea-__
JEFIE -jam UNTY HEALTH DEPARTMENT
APPROVED :i V E ® r PERMITlE1EE ISSUE ATE RECEIPT NUMBER
JUNl ' 77,E 62/3
3 (05
Bu I L Di NiNS g, tpaNT .,.,: :''''''---_. . A C�. 5l./The Printery—Port Townsend
_-.T r.I r Ti:R_-; t-3T4 C;C3TTN'9'V' RtTT T.T3 T iv`c; R .R1V T i
Jefferson County Planning and Rig i l d i ncg Department
Courthouse, :lyd Floor
PO Box 1220
Port Townsend . WA y8 6R
208-385-914 1
PFRMTT # •RT,fSR-002n T)ATR TSSiiRD. • 0fi/03/RR
STTR AfT)RFSS : 821 MCMTNN Rn
PORT T0Wi3SF.ND . WA 98388
OWNER •ORE.( M T T CHFT i PT-Tow, 385-5 1 4 1
MATT,T NC ADDR :ROX 1187
PORT T OWNSFNT) WA 98388
CONTRACTOR. . !NO CONTRACTOR PHONE.:
MA T LTNc AfDR
CONTR . LTC #! FXPTRATTON DATF
PARCH, NO. . . :002121005
LF.t;AT, T)FSC. . -STR 1 2-30-02 WWM. TAX #
LOT R RLOCK PUMA SHORT PLAT
DF.SCRTPTTON OF TMPROVF.MFNT- workshop/storage
i 1 Footing/Setbacks (Shoreline Sethack) /Mohile Home Blocking!
( ) Foundation !
i 1 Underground Pl umh i na/iindercrrnund insulation !
( ) Framing/Plumbing/Chimney:
( ) insulation -
( ) Sheetrockr
f i Sewage Disposal System Final !
) Finai /Occupancy -J
CALL 385-q 1 41 24 HOURS TN ADVANCE. TO SCHFDULR TNSPF.CTTONS .
Office Hours A a .m. to 5 p. m.
inspector ' s Hours q - 10 a . m.
24 Hour Recorder for inspections.
I
_ 20
/JO
X 24 MINTED ON NO. 100M CI AXMINT