HomeMy WebLinkAboutBLD1988-00056 BUILDING PERMIT APPLICATION
Jefferson County Building De, ent• County Courthouse •Port Townsend h.98368 • 385-9141
N E r
I. LOCATION: geographic name S W SIDE OF R AD FEET
NE // , �nn
S W FROM INTERSECTION OF R AD AND 7l0 0 (i NLY l�i� Z�/1/� ROAD
other specific location or landmark: . IE� �iv LPL C
LEGAL DE Rl TION:
(� �t c L t Block Subdiyicio�n l l
'D/lil0/3 Tax Number %Section ection Township Range
II. TYPE AND COST OF BUILDING -
TYPE IMPROVEMENT BUILDING TYPE MOBILITY
/ p(J New building ❑Single Family Cl New County Resident
f/❑Addition ❑Multi-Family Is this structure to serve the residential
number of units
❑Alteration or commercial needs of those employed
❑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 ONO
❑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: i�r ❑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 beingr changed,enter proposed use.
b. PlumbingIP �J Y
c. Heating,air conditioning ve 1. 77
d. Other (elevator,etc.) PI ( '/
• TOTAL COST OF IMPROVEMENT $
III.SELECTED CHARACTERISTICS OF BUILDING -
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DI'1:•= DIMENSIONS
Masonry (wall bearin ► �+ , •Number of Stories
❑ 9 ❑Public or Privatepj
❑Wood Frame Indivi 111111 •Total square feet of floor area,
dufil (septic tank, tc.) all floors,based on exterior
❑Structural steel tT�� �— —— dimensions
TYPE OF WATER SUPPLY
❑Re nforced concrete •Total land area,sq.ft.
9ther—S ec• ^ Public or private company
ytI ( Y J4 t n f NUMBER OF SPACES
�V( lJ�-� `-""r�F ndividual (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
❑Other—Specify
Number of Full �X)
bathrooms
Partial
IV. IDENTIFICATION - .
Name Mailing Address—Number,street,city and State ZIP code Tel.No.
1.
14..) 6CY'
Owner in J�
1 I/1l irs.—/
2.
Contractor State License No.
3.
Architect
The owner of his building and the undersigned agree to conform to all applicable laws.
Signa re applicant Address ,,, Ar7 )
date
7,„.._//' ' -.'": :;'6:;?.."'re--1------- --C,t4'. ?0Z— Si/
PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
APPROVED BY 10IN
I /0 9/ `�,
JEFFER N CD HE LTH DEPARTMENT (/
APPROOVEED Y:� PERIV . E ISSUE DATE RECEIPT NUMBER
P ,sue 7 6, 13
BUILDING OFFICIAL .C.-S—
JD-Misfit,mum
PLANNING&SLOG pgpj The Printery—Port Townsend / D p/i "/ 3 J 4
JEFFERSON COUNTY MOBILE HOME INSTALLATION PERMIT
Jefferson County Permit Center
Castle Hill Mall
621 Sheridan St.
Port Townsend, WA 98368
360-379-4450
PERMIT # •BLD88-0056 DATE ISSUED. : 06/17/96
SITE ADDRESS:760 CHIMACUM RD
:PORT HADLOCK, WA 98339
APPLICANT. . . :WAYNE MORAN PHONE:
MAILING ADDR: 760 CHIMACUM RD
:PORT HADLOCK WA 98339
PROPERTY OWNER IF DIFFERENT FROM ABOVE PHONE:
MAILING ADDR:
INSTALLER. . . : PHONE:
INSTAL LIC #: EXPIRATION DATE: / /
CONTRACTOR. . : PHONE:
MAILING ADDR:
CONTR LIC #: EXPIRATION / /
PARCEL NO. . . : 901111013
LEGAL DESC. . :STR 11-29-01 WWM, TAX #
LOT 4, BLOCK , DR ROBERT SCHLADE SP
DESCRIPTION OF IMPROVEMENT: mobile home installation
THIS PERMIT IS VALID FOR ONE YEAR ONLY AND IS NOT RENEWABLE.
THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WITHIN THAT YEAR.
THE EXPIRATION DATE IS 06/17/97.
( ) Footing/Setbacks (If continuous footings are used) :
( ) Blocking/Setbacks/Plumbing:
( ) final S ' ing/V is/Porc s Steps:
G � �
CALL 379-4455 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS.
Office Hours 9 a.m. to 4 : 30 p.m.
Inspector's Hours 8 - 9 a.m.
24 Hour Recorder for Inspections
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APPROVED
SEP 6 1988 - r� u a
COUNTY
PLANNING&SLOG DEPT
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