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Home My WebLink AboutBLD1988-00029 BUILDING PERMIT APPLICATION Jefferson County Building ertment• County Courthouse •Port Townse.1/ ash.98368 • 385-9141 N E a I. LOCATION: geographic name S W SIDE OF . .f ROAD FEET N E qaiyazio S W FROM INTERSECTION OF ROAD AND ROAD i other specific location or landmark: �! / 1- LEGAL DES�R TION: , ° . ,/'✓'s c?-� % �`�'i - / l Lot Block Subdivi ' 7 J t� �J C) C 7— /e e-- — f Tax Number %Section Section Townshi ange II.TYPE AND COST OF BUILDING - <tkl 4 1-0 3 7438. /Jjrri i/ 7or1'sA Z c - /el: TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY ew building tl 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 ❑Repair,replacement ❑Hotel,Motel, Dormitory at either the U.S.Navy's Trident or number of units Indian Island Facilities? ❑Wrecking ❑Mobile Home ❑Moving (relocation) ❑Other—Specify ❑YES ❑NO ❑Foundation only USE OWNERSHIP ❑ II-time Residence ❑Private (individual,corporation, nonprofit institution,etc.) !� Ali Second Home: Recreation Cabin,etc. ❑Public (Federal,State or local gov't.) UBC OCCUPANCY GROUP: // J ❑Second Home: Future conversion to : 1 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 buildl,. is being changed,enter proposed use. b. Plumbing /91?0 4" 6 00) 0 c. Heati ,air conditioning (Y 1 Go-of 360 ,:?'C3U Xg p . Other (elevator,etc.) / 990 • TOTAL COST OF IMPROVEMENT $ III.SELECTED CHARACTERISTICS OF BUILDING - ' r _ ¢ PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE $ •I, �`'. DIMENSIONS Masonry (wall bearing) !� •Number of Stories ❑ 9 ❑Public or Private ....__` •Total square feet of floor area, Private ..� 1 ood Frame Indivi al (septic tank,etc.) all floors,based on exterior ❑Structural steel dimensions TYPE OF WATER SUPPLY ❑Reinforced concrete •Total land area,sq.ft. ❑Other—Specify ❑Public or private company NUMBER OF OFF-STREET ❑Individual (well,cistern) PARKING SPACES Enclosed PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE El Gas Outdoors ._XOil RESIDENTIAL BUILDINGS ONLY Electricity Number of bedrooms ❑Coal TYPE OF MECHANICAL Number of {Full them}—Spe f bathrooms 1i�(J Partial IV. IDENTIFICATION - • Name Mailing Address—Number,street,city and State ZIP code Tel.No. f. c 0( /0P C_Orn, �� _I77/ Own r l'Cp � � , ( i1(' 5.. )' u.,\(..., _ Ci S7,3 ntractor \ ' State Lic se No. 0(1)4,E) c,_ 3. Architect ,The owner of this building and the undersigned agree to conform to all applicable laws. 7fSignatur of applicant Address Appl' atio date .\., --el/Vi 4. #91 /v PLANNING AREA FIR DISTRICT SCHOOL DISTRICT WATER DISTRICT APPROVED BY APP OVEDq /a Q/ ( 7/Iqee, r -J 60, JEFFE OUNTY HEALTH DEPARTMENT APPRO 1 PERMIT F ISSUE DATE RECEIPT NUMBER LANNII & l G 75 � 0V /5 S8 BUILDING OFFICIAL lrg, 8 / 7r1 `—Th�R+7ntery—Port Townsend ,— .T F.F'F F.T F; C)T\T (T C t J 1\r 97 F T T T T.T)T T.J C r�F TR IN4 m Jefferson County P i ann i ncr and Hui i ci i nc Department Courthouse, 3rci Floor Pia Box 1220 Port Townsend . WA g1R388 206- 385i-y 1 4 1 PFRMTT # • RT,ilRF -002q DAT'F. TSSTTFD. :0 7/25i/RR S T TF. AIJTIRFSS ' 251 JANSEN RT/ NnRnLANf . WA g1R35R OWNER .TOE T,AVATO PRONE : 38 -1 771 MA T T,T Nc=, AT)fR : 90 1 NESS CORNER PORT RAnLnex WA q833q CONTRACTOR . . :NO CONTRACTOR PHONE:: MATT,TNG A17T)R CONTR. T,T C # 7 F.XP T RAT T O DATE: PARCET, NO. . . : g77700059 LEGAL ESC . . :S'f R 04-2a-0 i MAIM, TAX # T,OT BLOCK T)ESCRTPTTON OF TMPROVRNRNT • singe family residence i F oot i nar/Sethacks (Shoreline Sethack) /Mnh i i e Home R i ock i nr- i Foundation : ) Underground Plumhinn/underground Tnsulation { i Framing/Plumhing/Chimney- ) Tnsulation : t Sheetrock' 1 Sewage Disposal System Final : i Final /Occupancy Approval : /Cyr CAT,T, , 85-g141 24 HOURS TN ADVANCE TO SCHEDULE TNSPF.CTTONS. Office Hours a a .m . to 5 p.m . Inspector ' s Hours q - in a .m. 24 Hour Recorder for Inspections . 1! SHORELINE SETBACK EVALUATION APPLICANT : ADDRESS: P C9! 1V�i I4-C TELEPHONE: (home) (business ) PROPERTY DESCRIPTION PROPERTY SITE NUMBER: LEGAL: Owner : Address : Tax Parcel Number: '✓ 7 iep c (7 Real Property Description: j- a S j 2s ,e/L )ADJACENT WATER BODY: o��«z EVALUATION ix L -s- ,tirk,q.r...tt41. BLUFF HEIGHT: SOURCE: CffiC..AL an.) '_ BLUFF STABILITY: Cr , SOURCE: ❑ 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: vGJct cn- is 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 : feet This minimum setback shall be measured from: This setback was established by the approval and filing of the pLat. VARIANCE REQUEST: 0 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 . \ _ inner) (d e )