HomeMy WebLinkAboutBLD1988-00051 w
BIDING ERMIT APPLICATION 0
Jefferson County n9 Buildi Department'P .O . Box 1220SPot Townsend. WA 98368%
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LOCATION 7 / ��
SPECIFIC LOCATION SITE ADDRESS 1 -7- ff( ( r �� rrnb-)`� Gee'
POSTAL DISTRICT IMF /SUBDIVISION
LEGAL DESCRIPTION LOT BLOCK DIVISION TAX NUMBER `-ti
PARCEL NUMBER GUI 0142 (AO 1 / 4 SECTION
SECTION A4 TOWNSHIP v2 1 NORTH RANGE pl". WM
BUILDING INFORMATION
BUILDING TYPE TYPE OF IMPROVEMENT SQUARE FOOTAGE
SINGLE FAMILY )NEW BUILDING MAIN FLOOR II17 CD
❑ MOI1 I LE HOME 0 ADDITION 2ND FLOOR Q(J
❑ MODULAR HOME 0 ALTERATION BASEMENT
❑ DETACHED/ATTACHED 0 REPAIR CARPORT
GARAGE 0 REPLACEMENT GARAGE
❑ WOODSTOVE 0 WRECKING/DEMOLITION COMMERCIAL
❑ MULTI - FAMILY 0 RELOCATION/MOVING INDUSTRIAL
NUMBER OF UNITS `JIYnQI( eo'f-Cellar 18c t,
MOBILE HOMES I )�7( ,L, a $35 �0)9 O
❑ COMMERCIAL SIZE LL.1S_G.1��
❑ INDUSTRIAL
YEAR _� 0 a $ 16 i 1 .320
❑ HOTEL/MOTEL/DORMITORY MAKE 0 a $8
NUMBER OF UNITS
❑ OTHER - SkECIFY ESTIMATED COST OF 0 a $8
,
IMPROVEMENTS TOTAL FAIR MARKET VALUE
UBC OCCUPANCY GROUPS $ $ 5 J 2RC-}
SELECTED CHARACTERISTICS OF BUILDING
PRINCIPLE TYPE OF FRAME PRINCIPLE TYPE OF HEATING FUEL
WOOD.FRAME 0 ELECTRICITY 0 COLLECTIVE SOLAR
°❑❑ MANUFACTURED WOODSTOVE 0 PASSIVE SOLAR
❑ STRUCTURAL STEEL GAS 0 COAL
❑ REINFORCED CONCRETE ❑ OIL 0 OTHER - SPECIFY
❑ MASONRY ( WALL BEARING ) DIMENSIONS
❑ OTHER - NUMBER OF STORIES TOTAL LAND AREA).5A
DEPARTMENTAL REVIEW
HEALTH DEPARTMENT I TYPE OF SEWAGE DISPOSAL NUMBER OF PROPOSED BEDROOMS
❑ PUBLIC OR PRIVATE NUMBER OF EXISTING BEDROOMS
' `& ,; INDIVIDUAL ( SEPTIC ) NUMBER OF PROPOSED BATHROOM ,
APPROVED DATE ,,t:; INDIVIDUAL WELL NUMBER OF EXISTING BATHROOM
PUD TYPE OF WATER SUPPLY
❑ PUBLIC ( NAME OF WATER SUPPLY)
APPROVED DATE 0 PRIVATE ( NAME OF. WATER SUPPLY
PLANNING DEPT . WITHIN SHORELINE JURISDICTION
❑ YES NAME OF ADJACENT WATER BODY
❑ NO
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 0 YES 0 NO
IDENTIFICATION
r,�, NAME MAILING ADDRESS ZIP TEL NO
Cad OWNER
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THE OWNER OF THIS BUILDING AND THE UNDERSIGNED AGREE TO CONFORM TO ALL APPLICABLE LAWS.
JIGN TORE OF APPLICANT APPLICATION DATE RECEIPT NUMBER CHECK NUMBER OR CASH
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APPROV BY PERMIT FEES
A P p �°4)) „�0 BASE FEE INSPECTION
V iv-
3( 5 0 BLDG SURCHARGE PLAN CHECK
D C 1 188 '� //��--
/ fl 00 ENERGY SURCHARGE $ ( ) co TOTAL
JEFFERSON COUNTY REFUND DATE DATE SS E
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Jefferson County Planning and Building Department
Courthouse, 3rd Floor
PO Box 1220
Port Townsend, WA 98368
206-385-9141
PFRMTT # BLD88-0051 DATE TSSUED. : 12/01 /88
STTR ADDRESS: 1771 F. MARROWSTONF.
:NORDLAND, WA 98358
OWNER -ROBERT TTPTON PHONE.: 385-7528
MAILING ADDR:PO BOX 152
:NORDLAND WA 98358
CONTRACTOR. . :NO CONTRACTOR PHONE:
MAILING AMR :
CONTR. LTC #: EXPTRATTON DATE:
PARCEL NO. . . 921042-040
LEGAL DESC. . :STR 04-29-01 EWM, TAX #
LOT , BLOCK
DESCRIPTION OF IMPROVEMENT: SINGLE FAMILY RESIDENCE
( ) Footing/Setbacks (Shoreline Setback)/Mobile Home Blocking:
( ) Foundation :
( ) Underground Plumbing/Underground Insulation :
( ) Framing/Plumbing/Chimney:
( ) Tnsulation:
( ) Sheetrock!
( ) Sewage Disposal System Final :
( ) Final/Occupancy Approval :
CALL 385-9141 24 HOURS TN ADVANCE TO SCHEDULE INSPECTTONS.
Office Hours 9 a .m. to 5 p.m.
Inspector' s Hours 9 - 10 a .m.
24 Hour Recorder for Inspections.