HomeMy WebLinkAboutBLD1988-00039 BUILDING PERMIT APPLICATION '
Jefferson County Building' -tmentt• County Courthouse.. Port Townser ✓✓ash.98368 • 385-1310
N E
I. LOCATION: geographic name S W SIDE OF ROAD FEET
S W FROM INTERSECTION OF ROAD AND' �( (-rt.i-+ Pore-YT ROAD
other specific location or landmark: 1
LEGAL DESCRIPTION: k
Lot Block Subdivision
62i,2 ,(o � MS- 74r_ 160&J rz ( c
Tax Number Y.Section Section Township Range
II.TYPE AND COST OF BUILDING -
TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY
i 'Gew 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 El Mobile Home
❑Moving(relocation) ❑Other—Specify ElYES ❑NO
Ot
❑Foundation only eACe
USE
OWNERSHIP ��
LJ F-ull-time Residence
le'civate (individual,corporation,
❑Second Home: Recreation Cabin,etc.
nonprofit institution,etc.)
❑Public (Federal,State or local gov't.) UBC OCCUPANCY GROUP: M ( ❑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 3 O )' 7 CDr--- 1`�d,`� ,--..
c. Heating,air conditioning
d. Other (elevator,etc.) F rn\( / W, qQ V
• TOTAL COST OF IMPROVEMENT $ ( tif0).3�
III.SELECTED CHARACTERISTICS OF BUILDING -
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL DIMENSIONS '
❑Masonry (wall bearing) •Number of Stories
❑Public or Private •Total square feet of floor area,
®irOood Frame ❑Individual (septic tank,etc.) all floors,based on exterior
dimensions 2,1
❑Structural steel
TYPE OF WATER SUPPLY
❑Reinforced concrete 3•Total land area,sq.ft. )117❑Public or private company ��
❑Other—Specify NUMBER OF OFF-STREET
El Individual (well,cistern) PARKING SPACES
Enclosed
PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE
❑Gas Outdoors
❑Oil RESIDENTIAL BUILDINGS ONLY
❑Electricity Number of bedrooms
TYPE OF MECHANICAL
❑Coal Full
Number of
❑Other—Specify bathrooms
Partial
•
IV. IDENTIFICATION- •
Name Mailing Address—Number,street,city and State ZIP code Tel.No.
1. t DoO 5 Z.ccc)P �f"Z1 CA 4 rH ebtoOT i2oAt, mowiu-�D, Wt. 1 3 55 38s 7S4'7
aner
e ( (ci 16S-2-1 H'Y gietC tl-tNtscic�vl), Wt4�SF-i/ti=G;TDa�s `► �i7 ?�• 3 (S �}
r Contractor State License No.
p612- mi tZ 7't Ja
3.
Architect
- The owner of this building and the undersigned agree to conform to all applicable laws.
ature of applicant. Address Application date
(ale- bccr ILC21 Ftwy 4q, c6rfu,swaa-0, t-i E65-1 743 -f 555-
PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
APPROVED BY oN. O\C 43-cor. 7*OPIV6) 17 •
6 i'( /
JEFF HEALTH DEPARTMENT J�
AP
V V CIPEERM/FEE ISSUE DATE RECEIPT NUMBER
2 7 1 3 , 5'D clic,1-:? fAi( /353cq
1 BU I LDIIE F9aNFNUNTY (f 3� 1
P ANM &DWG QEPT f'
The Printery —Port T e \ 0 ki I r:::) 9/29
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_TFr.r W1F:1 ; C) c i7iv i i'' iiTT.i T T'Tc -FIr. r'?ivTT 'i'
Jefferson County Planning and Building Department
Courthouse, 3rd Floor
PO Box 1 220
Port Townsend , WA g1S36R
206-385-y 1 4 1
PERM T T # • RT,fRR-00Sq DATF. T SST)FD. : Oy i 27 i RS
STTF urcr.— ! 922 GRTFFTTHS POTNT Rn
:NOR LAN, WA 'JesA 7t5
OWNER •COR)ON SHF.RW00j1 PHONE : 385-2547
MAT T,'I NG A DR ! 92 1 hR T FF T TH POTNT RI)
'NOR LAN) WA ars.inM
CONTRACTOR . . : PF.RMA RT T,T- PWONF : 743-1 5
MAT T,INC ADDR : 1F521 HTIOHWAY r-q
T,YNNWOOD WA 1g8037
CONTR . T,T C #[ PFRMAi T T,79JR FXPTRA-I TON I1ATF.: / /
PARCFT, NCB. . . : 02132 i -Of
T,FCIAT, DFSC . . : STR 32-30-01 FWM, TAX #
LOT STOCK
TiFSCRTPT T CAN OF T MPRO FMF.NT: garage
1 FootinaiSetharks (Shoreline Sethack) /Mohiie Home Siocking: _A
i Foundation !
( underground Plumbing/Underground insulation !
i Framing/Plumbing/Chimney:
i Insulation !
1 Sheetrock :
i Sewage Disposal System Final !
vivirfrore:
410
CAT.T, 3R5-q141 24 HOURS TN ADVANCF To SC:HFDUi,F TNSPRCTTONS .
Office Hours q a .m. to 5 p.m.
Inspector ' s Hours q - 10 a .m.
24 Hour Recorder for Inspections.
rr
Low*.Country Suite B • 16521 Hi99 • Lynnwood, WA 98037-3161
STEE UILDINGS Everett Line: (206) 2 171
Toll Free: 1-800-824-9552
Administrative Headquarters: (206) 743-1555
DIVISION OF R
Quality: Our Future Depends On It'
Site Plan
PLEASE CHECK:
❑Property dimensions ❑Septic and drainfield ❑Access to proposed building
❑Existing buildings ❑Sewer lines El Lot size
❑Proposed building ❑Setbacks of proposed and ❑Elevation of property
❑Easements existing buildings ❑Bodies of water
[Wain road with name ❑Floorplan
Job name: C''rcten -51-%erHioot Job Site Address: 9o20 C rtit tram Rrt
Legal Description 3e 4 C. Tc,x. oa i al 0 t t, / "5
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Owner has verified and approved the location of accessories,orientation of the building to the north, and verifies that all items specified in paragraph
B of the contract are shown on this drawing and vice versa. Customer signature:
i'9984 PermaBilt Industries
nnir•e Iwhitel nrrNuctinn(canary) customer(Pink) 12/87
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