HomeMy WebLinkAboutBLD1988-00032 7
UILDING PERMIT APPLICATION
Jefferson County Building D tment• County Courthouse •Port Townsencsh.98368 • 385-9141
•
N E
I. LOCATION: geographic name S W SIDE OF ROAD FEET
N E
S W FROM INTERSECTION OF AA ROAD ANQ 5 ROAD
other specific location or landmark: �l�k , I
LEGAL DESCRIPTION: 13
PnLot Block 1 Su vision
CR (k-)
V a R 15m_. Tax Number '/4 Section Section Township Range
II.TYPE AND COST OF BUILDING -
TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY i
(a4t,sry building /P Single Family
❑New County Resident y
❑Addition ❑ ,ulti-Family Is this structure to serve the resid tial
number of units
❑Alteration or commercial needs of those Tfnloyed
❑Hotel,Motel, Dormitory at either the U.S.Navy's Tri¢e'nt or
❑Repair,replacement number of units
❑Wrecking Indian Island Facilities
?
❑Mobile Home l
❑Moving (relocation) /
❑Other—Specify ❑YES /6 NO
❑Foundation only
//
l
/
USE
OWNERSHIP
0 Full-time Residence
❑Private (individual,corporation,
nonprofit institution,etc.) ❑Second Home: Recreation Cabin,etc.
❑Public (Federal,State or local gov't.) UBC OCCUPANCY GROUP:.4Z� ❑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. /y�
OD
b. Plumbing - -r}y t�e 200( .S.', 70 0
c. Heating-air conditioning G�N 700
1/ / / ( t °C)
Sk"Other (elevator,etc.) -7O4{
• TOTAL COST OF IMPROVEMENT $ Y ' 7
III.SELECTED CHARACTERISTICS OF BUILDING -
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE Df MENSIONS
❑Masonry (wall bearing) ❑Public or Private,t •Number of Stories
-, ‘ •Total square feet of floor area,
Wood Frame individua (septic tankJetc.) all floors,based on exterior
Structural steel /�\ -� dimensions
❑Reinforced concrete TYP ATER SUPPLY •Total land area,sq.ft.
❑Other—Specify traor private company
111 ndividual (well,cistern) NUMBER OF OFF-STREET
PARKING SPACES
Enclosed
PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE
❑Gas Outdoors
❑ ail RESIDENTIAL BUILDINGS ONLY ,-7
NI Electricity Number of bedrooms \.—_--
■Coal TYPE OF MECHANICAL
er—Specify{
Number of Full
a0Q bathrooms
Partial
IV. IDENTIFICATION -
Name Mailing Address—Number,street,city and State ZIP code Tel.No.
. `�° I r V1. ,� C0 S l ct eres-3 ?may etas,,--
Owner vn Cjii &J ff J 3r,
2. UU4�, �!/ lXe^ ,
Contractor State License No.
1
3.
Architect
The owner of this building and the undersigned agree to conform to all applicable laws. •
Sig ture pplicant Address
y� a xApplic ion dat
PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
APPROVED BY
q 10 (Cr 7 /JEFFER '•. �+ H LTH DEPARTME
APPRA/FDp. ;$ V PERMI__T FEE IS UE DATE RECEIPT NUMBER
AUG I 88 3,5-0. 7/I
3Cq (07
/s1♦ O O
BU I L D I N C EFEi 0If6UNTY
PLANNING&SLOG DEPT C71 t 11
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TI The Prfery—Port Townsend T 'J�J/ '
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.TF:WWR.R5=a ()N C7,c tTN`'1f"v' Rt;T T.T)T INT r-F.RT'TT
Jefferson County Planning and Bui idino 'Department
Courthouse, 3rd Floor
PO Box 1220
Port Townsend , WA 9636R
206-385-9141 •
PFRMT T # -RT il88-0032 nATF. TSSTiF.T). r Ois I i i !RS
STTF. AIli1RF:SS t 2R i CANAL T,N .
RR T NNON . WA 96362
OWNFR VTR( T T, MAN'KF. PHONE ' 426-536
MATT TNc; AnDR : 2605 LACROSS w 1
SWl LTON WA 95f 54
CONTRACTOR . . -NO CONTRACTOR PRONE :
MATT,TNC AI/i1R '
CONTR . LTC #: FXPTRATTON DIATR -
PARCRT, NO. . . - 50221 3-01 2
T F.CA T T)F.SC . . - STR 2 1 -25-O2 WWM. TAX #
LOT BLOCK .TOT-iNSTC)N SP #2
T)FSCRTPTTON OF TMPROVRMF.NT- single family residence with detached oarag
Fnoting/Sethacks (Shoreline Sethack) /Mnhiie Home Blocking-
) Foundation :
) iindergrnund Plumbing/Underground insulation :
i Framing/Plumbing/Chimney:
i Insulation :
) Sheetrock :
; Sewage itisnnsal System Final
Final /Occupancy Approval : 4-r- 3/9 6
CALL 385-9141 24 HOURS TN AIIVANCF TO SCHFT)ULF TNSPRCTTONS .
Office Hours 9 a .m. to 5 p.m.
inspector 's Hours 9 - 10 a .m.
24 Hour Recorder for Inspections.
i •
SHORELINE SETBACK EVALUATION
APPLICANT : 9LE,Z I n Di /Le.--
ADDRESS: 8.7-(j --.10;s
TELEPHONE: (home) (business ) Gf .4c31
PROPERTY DESCRIPTION
PROPERTY SITE NUMBER:
LEGAL: I
Owner : �rp�( /f'Ja vt ke,
Address : 1j'�-G/ vest- ‘5���)T'ak 99 8's
Tax ParceL Number:
ReaL Property Description: _ � kft 7TS, �.,5 /V- a. L✓
Ito e--a7S a v1.
ADJACENT WATER BODY: Hood G ,4 ,,J
EVALUATION
BLUFF HEIGHT: _ SOURCE: /FU
BLUFF STABILITY: 6 0Q 4 SOURCE: fep6-
❑ STANDARD SETBACK: j( / feet
This minimum setback shaLL be measured from the ordinary high water
mark to the most waterward edge of the proposed structure .
❑ BLUFF SETBACK: j C 1 feet
This minimum setback shaLL be measured from the bank' s edge to the
most waterward edge of the proposed structure .
110 i
❑ 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:
❑ APPROVED ❑ 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 .
planner ) (date)