HomeMy WebLinkAboutBLD1988-00041 ____
UILDING PERMIT APPLICATION ak
Jefferson County Building i rtment• County Courthouse • Port Townsenash.98368 • 385-9141
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I. LOCATION: geographic name S W SIDE OF • ROAD FEET
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S W FROM INTERSECTION OF ROAD AND l08 —1 lU Oak 'IL.Ju j \(' ROAD
other specific location or landmark: P'—
LEGAL DESCRIPTION: 0I(E P i flC mC.n i. rn (lx`-) Ch TT-.
V�a.rce1 T, Cot Block v _ $uboivisio
BoZ1042 ) I� Section - `'��i' �
Tax Number %Section Township Range
II. TYPE AND COST OF BUILDING -
TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY
New building ❑Single Family ❑New County Resident
❑A dition El Multi-Family Is this structure to serve the residential
number of units
or commercial needs of those employed
El 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 ❑NO
❑Foundation only l
/ 40 rk i° USE
OWNERSHIP (�tlJ���� ��
" it 1"-�&A ❑SecoFull-timend
Recreation
❑Private (individual,corporation, fl nonprofit institution,etc.) AN
❑Second Home: Recreation Cabin,etc.
❑Public (Federal,State or local gov't.) UBC OCCUPAN 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 beingJ changed,enter proposed (�use. �] `/
b. Plumbing I X J -- �Csi }: �- co J f 1 Erm Y .
c. Heating,air conditioning
d. Other (elevator,etc.)
• TOTAL COST OF IMPROVEMENT $
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,
Wood Frame `Individual (septic tank,etc.) all floors,based on exterior
❑Structural steel dimensions
TYPE OF WATER SUPPLY❑Reinforced concrete -
Total land area,sq.ft.
❑Other—Specify ❑Public or private company
NUMBER OF OFF-STREET
'IndividuaV(well,cistern) PARKING SPACES
Enclosed ��
PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE
❑Gas Outdoors
❑Oil RESIDENTIAL BUILDINGS ONLY
❑Electricity Number of bedrooms
❑Coal . TYPE OF MECHANICAL
q-Other—Specify Number of {Full
bathrooms
Partial
IV. IDENTIFICATION -
Name Mailing Address—Number,street,city and State ZIP code Tel.No.
1. `r- t'
Owner [ '�t1 l HI 1 I Co :� L% 1_ � � 01C;B(Cb .3 )
2.
Contractor State License No.
3.
Architect ,,
The owner of this building and the undersigned agree to conform to all applicable laws.
Sjgnature of applicant Address Application date
a 7/029/( 6
PLANNING AREA 7 FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
APPROVED BY/
JEFFER •ON OUNTY HEAL.T DEPARTMENT
APPACO- @i,i' PERMIT FEE IS UE DATE RECEIPT NUMBER
P 9;; 3 ,56 F,22k( 0 �f �
. ,°7 BUILDING OFFICIAL v
93e 0
JEFFERSON COUNTY
rU5NNING&BLDG DEPT
The Printery—Port Townsend --
F1'l'1T i.T)Ti4t r-fir' r'?iviT 'T`
Jefferson County Pinning and Building DepartmentCnurtho s'e, 3rd Floor
J
PO Box 1220
Port Townsend , WA 9536R
2O6-385-9 i 41
PF.RMTT # - RT.fJRR-0041 1JATr. TSSI',F.f). : Oq /27iRR
S T TF. AffJRF.SS : 6S f i OAK BAY RD
! PORT I.I1f/T.IJw,. WA 9?1.1fl
OWNER - FRANK WAT.1. PHONE : 43 7-25 i 7
MAILING Af1f1R : 6591 OAK RAY RI)
: PORT I.l'1I11.1JW WA -fs.inn
I;ONTRACTOR . . :NO CONTRACTOR Pt'O F : '..
MATT.TNO A oR :
•
•
CONTR . L T C #- FXP T RAT I ON f JA'1 F. :
PARCEL NO. . . : 52 i 042-i 1 2
T.ROAT. DJF.SC . . : ST-R 04-2 R-0 i FWM. TAX
LOT 6Fss , BLOCK OLYMPUS REACH TR
DF.SCRTPT"T ON OF IMPROVEMENT: garage no heat nn plumbing
) Foot i ng iSethacks (Shoreline Sethac iivioh i i e Home Blocking: —V
i i Foundation :
Underground P i umh i nci i Underc7rnund insulation :
1 Framing/Plumbing/Chimney:
) Insulation :
i Sheetrock :
j Sewage Disposal System Final :
; Final Occupancy Annrova ' q 3*Z -
CAL.T. 555-91 41 24 HOURS TN ADVANCE. TO SCR .ULE TNSPWCT I ONS.
Office Hours 9 a . m. to 5 p.m.
Tnsnector ' s Hours y - 10 a .m.
24 Hour Recorder for Inspections.
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(DANK 'BAY g.OAD
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EXISTIIx.. 1 PARKING AREA
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I ' INK0RMA 1J OLYMPUS
I TRACT !og i -(' ,ACT lob $GAGH TZACT5
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