HomeMy WebLinkAboutBLD1988-00035 BUILDING PERMIT APPLICATION
Jefferson County Building Departet• County Courthouse •Port Townsend, Wa•8368 • 385-9141
N E • '
I. LOCATION: geographic name S W SIDE OF AD FEET
NEl� ! {
S W FROM INTERSECTION OF ROAD AND .(/"/J ROAD
other specific location or landmark: ,S CA--) S 6-0 `.e2--6 7c,I r� C�(
LEG , IPTION: - ?` ki
CO-- 2 Lot Block Subdivision
91
91a/0Y3cx Tax Number 'A Section Section Tow ship Range
II. TYPE AND COST OF BUILDING -
TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY
❑New 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 &,
❑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
❑Foundation only /�� ONO
i ��Z nYt_-.-
V )'7)Yn USE
OWNERSHIP
❑Private (individual,corporation,
❑Full-time Residence
nonprofit institution,etc,) ❑Second Home: Recreation Cabin,etc.
❑Public (Federal,State or local gov't.) UBC OCCUPANCY GROUP:
T!,: '
3 ❑Second Home: Future conversion to
COST / permanent residence
(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 �-',� 0 rj
_ t!6/ �•
. P ? 6 S
c. Heating,airyoffditioning / q J
�,.le-
d. Ot)aeP (elevator,etc.) " ,7
CD .
-� -, ..,.-
--1 OTAL COST OF IMPROVEMENT $ ./j
I' II.SELECTED CHARACTERISTICS OF BUILDING -
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE S L D MENSIONS
Ell Masonry Public or Private.Masonry (wall bearing) l7 •Number of Stories
ood Frame x.� •Total square feet of floor area,
,l Individu (septic tank, eta) all floors,based on exterior
❑Structural steel /' dimensions
❑Reinforced concrete TYPE OF WATER SUPPLY
•Total land area,sq.ft.
❑Other—Specify ❑Public or pr. company
ndivid al (well, istern) NUMBER OF OFF-STREET
PARKING SPACES
PRINCIPAL TYPE OF HEATING FUEL Enclosed
TYPE OF FIREPLACE
El Gas Outdoors
❑Oil RESIDENTIAL BUILDINGS ONLY CGS,
Lf Electricity Number of bedrooms ! c�ali 'rrr� �.�ivvn,'
✓✓✓✓�❑�"`/Coal TYPE OF MECHANICAL
(_�L'SI Other—S cif Number of Full
WO bathrooms
/ Partial
IV. IDENTIFICATION -
Name Mailin ddre — Number,street,city and S to ZIP code Tel.No.
1. Ga U i 4c-i-) /
_....
Owner riv
��� /, j
2. '
. .:::
k\s‘-. -
Contractor State License No.
•
3.
Architect
M
T e owner of this building and the undersigned agree to conform to all applicable laws.
i azure of appli a t� Address
P cati n date
lr�� � -12 wit
r�
PLANNING AREA FIRE DISTRICT CHOOL DISTRICT WATER DISTRICT
APPROVED BY 1-1 1 cpe ( �F (/)
L , .
JEF EAL H DEP TMENT C
4PPR D 6' P_E RM FEE ISS E DAT RECEJ5PT NUMBER
Au ` 4 19 i 3
UNTY �
(OST/4/'
3U1LDIrAtim, grf.r • 11 g15D
The Printery—Port Townsend 1
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_� TrF'F' r'�=afi7�T C7. C3t7T397Y 1 t7 i T.i)TT'Tc-2; r=-1 1RF41 rn
Jefferson County Planning and Building Department
Courthouse, Rrd Floor
Pig Rnx 1220
Port Townsend , WA 9R 36S
206-385-9 141
PF.RMTT # •R DRS-0035 DATF. T SStiF.l. - 08/04/rills
S T TF ADDRESS ' 450 RORRTNS RD
NORDLAN, WA yrs.inrs
OWNRR • DAVT M MATSON PH0NF. ! BR5-i 5Fs5
MAT T,TNO ADDR : 450 RORRTNS Rn
-NOR LANT) WA yrs.isnrs
CONTRACTOR . . :NO CONTRACTOR PHONE.
MATT,TNC AnnR
•
CONTR . LTC #! FXPTRATTON DATF.
PARCF.T, No. . . : 921 O93-OO.5s
T,FCAT, DFSC . . - STR 09-29-01 F.WM. TAX a# 42
LOT RT,OCK
DFSi R T PT T ON OF T MPROVFJVW..NT• single family addition
i Fontinc/Setharirs (Shoreline Sethac i /Mohi ie Home Rlockina:
1 Foundation !
i Underground Plumhing/tlnrlerorrnunci Insulation :
i Framing/Plumbing/Chimney.
i insulation !
) Sneetrock -
i Sewage Disposal System Final !
i Final/ ccunancv Annrova
CALL 385-91 4 1 24 HOURS TN ADVANCF TO SCHFT)i7T,R TNSPFCT T ONS .
Office Hours 9 a .m. to 5 p.m.
Inspector ' s Hours 9 - in a . m.
24 Hour Recorder for Inspections.