HomeMy WebLinkAboutBLD1988-00040 ti UILDING PERMIT APPLICATION •
Jefferson County Building Cltment• County Courthouse •Port Townsen sh.98368 • 385-9141
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I. LOCATION: geographic name S W SIDE OF ? ►ROAD ' ' `J� FEET
N E ( LJ r� (
S W FROM INTERSECTION OF ROAD AND
other specific location or landmark:
e E leE,>�C PT)ON: Li 7 C -/ k)
�(�(� Lot Block Subdivision
`L C S OF B Tax Number %Section Section Township Range
Ii. TYPE AND COST OF BUILDING-
TYPE OF IMPROVEMENT BUILD' TYPE MOBILITY
New building Single Family ❑New County Resident
A 'tion ulti-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 ❑Mobile Home
❑Moving (relocation) ❑Other—Specify
❑YES ❑NO
❑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: }—' ❑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.
C�,b. Plumbing 7, t@�5 /
f
c. Heating,air conditioning ((�� CCC///111 �S lll.���
d. Other (elevator,etc.)
• TOTAL COST OF IMPROVEMENT $
III.SELECTED CHARACTERISTICS OF BUILDING -
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DIIPdialAc/s ENSIONS
Masonry (wall bearing) GC�� •Number of Stories )
❑ ❑Public or Private [6 •Total square feet of floor area,
ood Framendividu (septic tank, tc.) all floors,based on exterior
tructural steel dimensions
❑Reinforced concrete TYPE OF WATER SUPPLY •Total land area,sq.ft.
❑Public or private company
❑Other—Specify NUMBER OF OFF-STREET
Individua well, istern) PARKING SPACES
Enclosed
PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE
❑Gas Outdoors
❑Oil RESIDENTIAL BUILDINGS ONLY i "`` -t..*,_
electricity Number of bedrooms k' "°—r
TYPE OF MECHANICAL •� f bt
❑Coal Number of {Full i ite
❑Other—Specify
bathrooms '
Partial ¢I—{f
IV. IDENTIFICATION - •
Name Mailing Address— Number,street,city and State ZIP code Tel.No.
f. 2 ciAc t 6-4 _op- ?vV 7 C.-o l� 901(7 7swe-
Owner (/\) d C�! ( Q.�e?4 385--(Yy5Iy l
oz t L U Malls ix• 3 7 (i� 7��---
tractor \ 1 { (r tVr/I sC�C C.t/3o� 1�I TllA c(,l i VC�
3. t J�' J�J
Architect
The ow is building and the undersigned agree to conform to all applicable laws.
nature of appli t Assptii�te
•
kLANNIAREA E DISTRICT SCHOOL DISTRICT WATER DISTRICT
AP B Y ba 14 Lslo i hi /O. e//�
(7y_ b-i e...,..CW\ C:)4€-- ts,..p._ c\\(.0 .
JEFFERSON COUNTY HEAL D ARTMENT
APPA PEpE :0 E ® )I'ERMIT� 5E ISSUE DATE RECEIPT NUMBER
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SEP 6 ?9ii8 3 . 5� o Q/Q(o 8 8 3L7 (7SBUILD OFFICIAL
•+ t NiV;h(,a Q1D6 miry
f / ( /.J h 7/�,
The Printery—Port Townsend µ%�j
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rise,,,,,-%-okka IN k_<.,=,-- •
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32'
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Jefferson County Planning and Building apartment
Courthouse . 3rd Floor
PO Box 1220
Port Townsend, WA 9336R
206-3Thr)-9 t 41
PERMIT . # - RT,ilR8-Oi14i) DATE TSStiFf. - i)9/0 i fists
S I TF. A{1fRFSS ' 22AO F MARROWSTOIVF R) ,
i'HJt( 11,AIVl). WA 9835 -
OWNER •RICHARDJ RFiv F.fTCKSON PHONE!
MATT,TNG AflflR [ 9049 o A1, AVE NW
SEAT"""I.F. WA 98117
CONTRACTOR. _ -NO CONTRACTOR PRONE !
MA T T,TNO Ali)R
CONTR . LTC #! EXPIRATION DATE !
PARC;;ET, NO. . . ! 9762O i -6O5
LEGAL DRSC . . : SI"R 33-30-01 FWM. TAX # 43
LOT BLOCK 7/ NORfLANT)
11FSCRTPTTON OF TMPROVEMENT : single family residence
1 Footing/Setbacks (Shoreline Sethacir i iMnhi ie Home Riockina
i Foundation -
i underground P i umh i nn/ nderaround insulation !
f i F ram i ncr/P u Ch;mnev!
iInsulation !
Sheetrn,k ' X(//3-17 '
Sewage Disposal System F ,;i 1
I Final /Occupancy Annr Val!_
CALL 385-9 i 4 i 24 HOURS TN ADVANCE TO SCHEDULE TNSPFCTTONS .
Office Hours 9 a .m. to 5 p. m.
Tnsnectnr ! s Hours 9 - 0 a .m.
24 Hour Recorder for Tnsnections.
SHORELINE SETBACK EVALUATION
APPLICANT : ( — 7 Pt.g--,,t_ ®„)
ADDRESS:
TELEPHONE: (home) (business)
PROPERTY DESCRIPTION
PROPERTY SITE NUMBER: 7 7C Zcv( Cs+ e S�
LEGAL:
Owner :
Address :
Tax ParceL Number:
ReaL Property Description: `%i4 . Y,' --S 3 3 rl o,J eir
ADJACENT WATER BODY: 4/A.:-.:77-://,/> L /�../,
EVALUATION
BLUFF HEIGHT: 1c) SOURCE:
BLUFF STABILITY: —(1—,41-} L cL_ SOURCE: A
❑ STANDARD SETBACK: feet
This minimum setback shaLL be measured from the ordinary high water
mark to the most waterward edge of the proposed structure .
r
❑ BLUFF SETBACK: Li 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:
❑ 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 .
v,.„5 r
�pla ner) (date )