HomeMy WebLinkAboutBLD1988-00030 BUILDING PERMIT APPLICATION
Jefferson County Buildirpartment• County Courthouse.• Port Town•', Wash.98368 • 385-9141
N E
I. LOCATION: geographic name S W SIDE OF R FEET
NE
S W FROM INTERSECTION OF ROAD AND
other specific location or landmark:
LEGAL DE CRIPTION:
Lot Block Su isio ' nge
17Ce7 (3 5 Ci O'i
Tax tuber /.Section ct To ip
II.TYPE AND COST OF BUI DING -
TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY
iew building ❑Single Family ❑New County Resident
• A. ition ❑Multi-Family Is this structure to serve the resid' tial
number of units
❑Alteration or commercial needs of those • ployed
❑Repair,replacement ❑Hotel,Motel, Dormitory at either the U.S.Navy's Tr•.ent or
f�� number of units Indian Island Facilities?
El Wrecking l((Mobile Home
❑Moving (relocation) ❑I 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:f/5
❑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 �'� ' ` J/'y� ._
c. Heating,_air'conditioning I
i- (�il�-/d..00fher'(elevator,etc.) -� e Z - . 1e4
+~A TOTAL COST OF IMPROVEMENT $ / �� ` �r1 l.�J
III.SELECTED CHARACTERISTICS OF BUILDING -
7
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DI DIMENSIONS
❑Masonry (wall bearing) V05 •Number Stories
❑P .lic or Private
•Total squareof feet of floor area,
❑Wood Frame ►* Individup tic tank,e .) all floors,based on exterior
❑Structural steel dimensions
TYPE OF WATER SUPPLY
■ Reinforced concrete •Total land area,sq.ft.
Public or private company
other—Specify NUMBER OF OFF-STREET
C .sz.c.9_, ElIndividual (well,cistern) PARKING SPACES
Enclosed
PRINCIPAL TYPE O EATING FUEL TYPE OF FIREPLACE
❑Gas Outdoors
❑Oil RESIDENTIAL BUILDINGS ONLY
Electricity Number of bedrooms
❑ al TYPE OF MECHANICAL
❑Other—Specify
Number of Full
bathrooms
Partial ..
IV. IDENTIFICATION -
,Nar�ne / ; Mailing A d-ess—Numb ,street,city and State r ZIP code Tel. No.
1. !`y'y6115 q(x `/t 7
Owner
_ I , /97R r State License No. i-& y /o Go 6g3
S7-7 fre$ 5).D•
3• ___-/
li���1 r t
�_
,,
e owner of this building and the undersigned agree to conform to all applicable laws.
ignature of applicant)cb'Yh
'/ Add.res Ce1 App/ te
1
PLANNING AREA F •E DISTRICT SCHOOL DISTRICT �r ,^y�WATER DISTRICT
APPROVED BY , , __4 ems. 7,8eQt____D O U _1� �
JEFFER • CO ailik EAL. DEPARTMENT
APPROVE: :' t"' Wilk PE MIT
7 REGE 16'T I E DAT NUMBER
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' 1 2 '88 3 5 ///ci
or
BUILDING O,
S�N COUNTY .,igj.S--0 i cl /65)e
PlANN1NO&gum01 The Printery—Port Townsend � tY j . -7/A5?
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Jefferson County Planning and Tiuiidina department
Courthouse, 3rd Floor
J a
PO Box 1220
Port Townsend , WA g8368
206-385-914 1
PFRMTT # -RT,fRR-003O TATF TSSTTFn. - 07/O1 /nR
S T'TF ADDRESS : 1 53 hS UFRFRR Y H T T,T, RI)
:PORT T,TiDT,OW. WA 5:353 5
OWNER •KATHY MAKT PHONE! 437-2876
MAT T,'i NIA AT)DR ' 1 53 RT,UFRF.RRY H T L Rd
!PORT T UDLOW WA q8365
CONTRACTOR . . [NO CONTRACTOR PHONF. 7
MA T T,TN(=, AnnR
•
CONTR . T,TC #7 RXPTRAT'ION DATE
PARC;F.T, NO. _ _ ' 521 334O49
T,FCAT, dF.SC. . : STR 33-2n-01 FWM. TAX #
LOT BLOCK
dr.ac;rrIPrIuN OF TMPROVRMRNT: mobile home installation
i Fnotinrr/Setbacks (Shoreline. Setback) /Mohiie Home Flocking:
•
i Foundation !
i Underground Plumbing/Underground Tnsu i at i nn
j Framingr/P lumping/Chimney:
( 3 insulation :
1 Sheetrock- •
i Sewage disposal System Final : •
i Final /Occupancy Approval !
4 . •
CALL 385-91 41 24 HOURS TN AT)VANCF. TO SCHFT)UT,F TNSPF.CT T ONS .
Office Hours 9 a .m. to 5 p.m.
inspector ' s Hours g - 10 a .m.
24 Hour Recorder for inspections.
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