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HomeMy WebLinkAboutBLD1988-00048 ELDING PERMIT APPLICATION Jefferson County Buildi ,g Department•P .O . Box 12200ort Townsend. WA 98368 LOCATION /' n SPECIFIC LOCATION SITE ADDRESS &. / - 1 Q C xoc' r 1a , 'TA-A_ I POSTAL DISTRICT /SU DIVISION LEGAL DESCRIPTION ESCRIPTION LOT BLO DIV S 1�1 3 0 1/4 A XII C NUMBER % � 1A� PARCEL NUMBER00p!) k� 1 / 4 SECTION „ SECTION, ..TOW LNORTH RANGF { WM BUILDING INFORMATION BUILDING TYPE TYPE OF IMPROVEMENT SQUARE FOOTAGE '.SINGLE FAMILY NEW BUILDING MAIN FLOOR ❑ MOBILE HOME ❑ ADDITION 2ND FLOOR ❑ MODULAR HOME ❑ ALTERATION BASEMENT ❑ DETACHED/ATTACHED 0 REPAIR CARPORT GARAGE ❑ REPLACEMENT GARAGE ❑ WOODSTOVE 0 WRECKING/DEMOLITION COMMERCIAL ❑ MULTI - FAMILY ❑ RELOCATION/MOVING INDUSTRIAL NUMBER OF UNITS ❑ COMMERCIAL MOBILE HOh1ES0 SIZE $35 a�ab ❑ INDUSTRIAL ( J/ j ❑ HOTEL/MOTEL/DORMITORY YEAR `� $ 16 � G=� NUMBER OF UNITS MAKE $8 ❑ OTHER - SPECIFY ESTIMATED COST OF 0 @ $8 IMPROVEMENTS TOT FA MARKET VALUE UBC OCCUPANCY GROUP .I.,,: $ $ . SELECTED CHARACTERISTICS OF BUILDING PRINCIPLE TYPE OF FRAME PRINCIPLE TYPE OF HEATING FUEL WOOD FRAME S ELECTRICITY ❑ COLLECTIVE SOLAR A. ❑ ANUFACTURED 6 WOODSTOVE ❑ PASSIVE SOLAR ❑ STRUCTURAL STEEL ❑ AS ❑ COAL ❑ REINFORCED CONCRETE ❑ OIL ❑ OTHER - SPECIFY ❑ MASONRY ( WALL BEARING ) DIMENSIONS ❑ OTHER - NUMBER OF STORIES TOTAL LAND AREA DEPARTMENTAL REVIEW HE LTH DE ARTMENT TYPE OF SEWAGE D I SPOSAL NUMBER OF PROPOSEQ BEDROOMS (-- CIS- ❑ PURL I C UMBER OF EXISTING BEDROOMS I ND I V I D UA ( SEPT I C; N NUMBER OF PROPOSED BATHROOM / APPR VED DATE ❑ I ND I V I DUAL - NUMBER, OF EXISTING BATHROOM PUD TYPE OF WATER SUPPLY �4C3 OACA 1 < U r/ 'PUBLIC ( NAME OF WATER SUPPLY) ifs APPROVED DATE ❑ PRIVATE ( NAME .OF WATER SUPPLY) PLANNING DEPT . WITHIN SHORELINE JURISDICTION ❑ YES NAME OF ADJACENT WATER BODY ( ho APPROVED DATE BANK HEIGHT SETBACK PUBLIC WORKS DEPT ROAD RIGHT-OF -WAY WIDTH NAME OF PUBLIC ROAD NAME OF PRIVATE ROAD APPROVED DATE ROAD ACCESS PERMIT REQUIRED ❑ YES ❑ NO IDENTIFICATION NAME MAILING ADDRESS ZIP TE^L/(/NO OWNER 5 —/c2 4 CONT .P / , ARCH THE OWNER OF THIS BUILDING AND THE UNDERSIGNED AGREE TO CONFORM TO ALL APPLICABLE LAWS; _ SIGMA RE OF APPf�1CANT APP CA ON D E RECEIPT NUMBER CHECK NUMBER OR CASH _..-/' 3(1e(14) C7_, APPRO ED BY PERMIT/ ^E-b FEES�, -5 Q. S C BASE FEE 1 NSPECT I ON A P R w�. cn BLDG SURCHARGE PLAN CHECK 948 \--------__ /5, (`0v Q ENERGY SURCHARGE 9f � TOTAL PIJEFf SON UbitizE v a 0 9 1 1 NUMBER REFUND DATE DA 1 SSU=D N. BI. IVOfaf FICIAL 9# ♦f 111 * .TF: TRSC)N C:CYt i\TPV 1Rt7T T.T) r NCB 3�FRMT rn Jefferson County P l ann i ncr and Building Department Courthouse, 3rd Floor PO Box 1220 Port Townsend, WA 98368 206-385-9141 PERMTT # .RT,T)AA-004A DATF, TSSUED. :09/23/AA STTE AT)T)RESS: 651 1 CAPE GEORGE RD :PORT TOWNSEND, WA 98368 OWNER •AT,TSON SNRF.T) PHONE: 385-1 254 MATT,TNO ADfR :PO ROX 292 :PORT TOWNSEND WA 98368 CONTRACTOR. . :NO CONTRACTOR PHONE: MATT.TN( AT)DR : CONTR. LTC #: EXPTRATTON DATE: PARCEL NO. . . :.OA-1 rWY t--0 o /-3°/- O3`47 T,F.(AL T)F.SC. . :STR 30-30-01 WWM, TAX # 21 LOT A , 'BLOCK T)ESCRTPTTON OF TMPROVF.MENT: single family residence ( ) Footing/Setbacks (Shoreline Setback) /Mobile Home Blocking: ( ) Foundation : ( ) TTnderoround Plumbing/Underground Tnsu l at i on : ( - ) raminc7/P umhnrr/rhimnev: ( Y1 Tnsulation : 5 I vLv/ 5eT ShPPtrnrk : dK ( ) Sewage Disposal System Final : ( ) Final/Occupancy Approval : e'&yc ( y0-3' CALL 385-9141 24 HOURS TN ADVANCE TO SCHF.T)UT.F. TNSPECTTONS. Office Hours 9 a .m. to 5 p.m. Tnsnector 's Hours 9 - 10 a .m. 24 Hour Recorder for Inspections. • • • .',. Q.. ....z. • ':t.) -NA -- 0, 4, . •_(‘ . . . vimoow bXl._ T P z ..-, II--a--- 1 _ — 1 ; o•.: (1 1 ..z2• cb Z. I.1 q -......•1, i et v% i r1 ;•'', 11; ----- 1 • 1,, .1 i. ••• 1 t ... i4P. N I 104-41" • i 3 SI/4w 1 fia • -ix N I ! L."?' N.DiN. Gt.. 1 V t•- ; i 0: ! - . &(-0. so.,,o,e-4 • • 1 -4 '••••_ . ze•vec* • • --, . x• z • z•N ul ?-) " ,11 c>.)• ; 1 ------ ; t • • N3 V 1 I rN 1 .‘4 1 , t ....,r- 1 1 , will ., 1 t i -... 4'• I . I a. i 1 ' 1 1- ___ ___-r s1---4-2 15'• i iN, t' - - l':' '147 1 ,• 1 k k l ' . r. , g •__= aN Kf.- tcl .. *.„ = - C‘I tl, c• -3. / ....Z c• 0 1 I_r - _ L I- r ___, •_ X_ ' 1 I t I / . ,.... k I 1 . .. -... f , • 2 • '' Ut „ii tr;. -- ..--7 ;1- NI Z: 4______- -I L •7 1.. 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