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HomeMy WebLinkAboutBLD1988-00064 BUILDING PERMIT APPLICATIO4 Jefferson County BuiS Department• County Courthouse •Port Tond, Wash.98368 • 385-9141 N E " I. LOCATION: geographic name S W SIDE OF ROAD FEET NE // • S W FROM INTERSECTION OF ROAD AND (2,71..‘n yer--- ROAD fother specific location or landmark: /��4) O� JJJJ k) LEGA P(14'L DE,$CR PTION: � l J-1(c)� - - -7--- Lot Blbck Subdivision 0 / O 6 y.19 Tax Number '/a Section Section Township tan�e---- II. TYRE AND COST OFBUILDING - TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY b- New building JKSingle Family ❑New County Resident ►f •.dition ❑Multi-Family Is this structure to serve the residential number of units ❑Alteration or commercial needs of those employed ❑Repair,replacement ElHotel,Motel, Dormitory at either the U.S.Navy's Trident or number of units Indian Island Facilities? ❑Wrecking ,n Mobile Home ❑Moving (relocation) ■ c -er—Specify ❑YES ONO ❑Foundation only OWNERSHIP USE ❑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 offexisting building is being changed,enter proposed use. b. Plumbing .c- // c. Heating,air conditioning e r 1[_^J yr S d. Other (elevator,etc.) ae, �"Il���.-4..-14J+1 • TOTAL COST OF IMPROVEMENT $ III.SELECTED CHARACTERISTICS OF BUILDING - PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE D65 MENSIONS ❑Masonry (wall bearing) •Number of Stories ❑ •Public or Private •Total square feet of floor area, ❑Wood Frame Individu. septic to k etc.) all floors,based on exterior ❑Structural steel dimensions TYPE OF WATER SUPPLY❑ Total land area,sq.ft. R inforced concrete • th r—Specif ❑Public or private company C/�/f �� �Q lndividucistern) NUMBER OF OFF-STREET �,L 1 J�\ PARKING SPACES Enclosed PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE ❑Gas \ Outdoors a oil RESIDENTIAL BUILDINGS ONLY lectricity Number of bedrooms ❑Coal TYPE OF MECHANICAL Number of Full �] .) 0 Other—Specify bathrooms Partial IV. IDENTIFICATION - Name Mailing Address—Number,street,city and State ZIP code Tel.No. t. tc.4.4q-1flar'`o� (oho .Cp .�1C r-- (� 9 No7 Owner a ode r r (� I\1 2. v Contractor State License No. 3. Architect v yhe owner of this building and the undersigned agree to conform to all applicable laws. Signatur �4f4icanit / ` e^`'' •----- a/1/ Ap7/a o daf [' PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT APPROVED BY i--1 i 1 ✓ `i d JEf'-. HLTHDEPARTMENTENT /i ( APPROVED t PERMIT FEE ISSUE DATE RECEIPT NUMBER JUL1 7 �fl��SS _� 3, 51D 7/?Y / 7 9(& • .PT ' 'J31)The Printery—Port Townsend .-1/ / W IIC `J,/,,/,,/ -^- t- RECElVEt glie• �o� . J ! C 1 '88 • - • tir Aa:5eetre Rtz Zq 5.:,i/ ii.,Le) --4(...- 0 \ 4 t: i--7 -7a4 MAI di I Pi I ZIA . Atli �'�� _ ; /U+ -41 eu¢-tilt►ud2ptry ii , -/o-, cif£g / ' /77.*//t /Am< (iuzw) r 1/4//i 4(61)5 Alki,ZZ ,..._________) -X6e SIA / A / ,/ i 1 \__ _--- Ni _--- -------- ... 1 pi. /2.� APPROVE © JUL 1 4 1988 r� 2 S �JZ t Ptn nkit. C't-C-.U..__. JEFFERSON COUNTY PLANNING&8LDG DEPT (40 0. s - „A- "7 2 B ej - p,,,\