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HomeMy WebLinkAboutBLD1988-00067 UILDING PERMIT APPLICATION 1 Jefferson County Bui, ag Department• County Courthouse •Port Townsend, Nash.98368 • 385-9141 NE I. LOCATION: geographic name_ S W SIDE OF ROAD FEET NE • • S W FROM INTERSECTION OF ROAD AND +/ \f I C.1y O r t C.L. Lcn n ROAD other specific location or landmark: PT i � LEGAL DESCRIPTION: / l (gyp P. ( `j P c3 r e_ C) I V Parc)sl ,.�. Lot Block I- Subdivisia -37 8O010r1 1.�. 'RC, .2c� Tax Number Y.Section Section Township Range II.TYPE AND COST OF BUILDING- TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY • (New building single Family ❑New County Resident ❑Addition /❑`Multi-Family Is this structure to serve the residential ❑Alteration number of units 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 RECEIVED ❑Moving (relocation) ❑Other—Specify . ONO ❑Foundation only ❑YES • DEC 2 9 1997 JEFFERSON COUNTY OWNERSHIP USE Prth"9"0f.&RUOI nrPT ❑Full-time Residence ❑Private (individual,corporation, nonprofit institution,etc.) ❑Second Home: Recreation Cabin,etc. ❑Public (Federal,State or local gov't.) UBC OCCUPANCY GROUP: /2 -� ❑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 being changed,enter proposed use. b. Plumbing .MA-if.‘ t``i3c311- 2'30 T *35: 413,050 c. Heating,air conditioning .C am„_r S/7` A O . • I I d. Other (elevator,etc.) 1 ,-� ! 2.S C i (, -* Q ` 5 f c`2�4 • • TOTAL COST OF IMPROVEMENT $ u 53� �� [ C�>Q III.SELECTED CHARACTERISTICS OF BUILDING - PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL DIMENSIONS Masonry (wall bearin ► •Number of Stories ❑ g ❑Public or Private f1G'W •Total square feet of floor area, Wood Frame Xndividut septic tank etc.) all floors,based on exterior []Structural steel dimensions TYPE OF WATER SUPPLY Total land area,sq.ft. ❑Reinforced concrete • Public or private company ❑Other—Specify /T NUMBER OF OFF-STREET ❑Individual (well,cistern) PARKING SPACES Enclosed PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE ❑Gas Outdoors ❑Oil RESIDENTIAL BUILDINGS ONLY /Electricity heotf rump Number of bedrooms ❑Coal TYPE OF MECHANICAL ❑Other—Specify Number of Full bathrooms • Partial IV. IDENTIFICATION - . • Name Mailing Address—Number,street,city and State ZIP code Tel.No. 1. Rnbtr±. Cam. Uno1 lh(&'r\a kp.n Dr, ` ?8 99 51B- Owner -c)(: -t.e,c I ck.Cc)(Y10- 0-)arrz 582-(0 8/45) _c1(p Cu)) 2. \‘.1� �CIO�S�t. �ca c��t �.t or r. eve . on►y PNics 697— Cont State License No. 4/p . 3 Architect The owner of this building and the undersigned agree to conform to all applicable laws. Signa9t applicanrt ; r��� Address Application date �.�r 1 a aq/8-r l PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT APPROVED BY ©'G I�� }�ee.sr'ti t !S Etc,wra JEF NTY HEALTH EPART APPRO PERMIT FEE ISSUE DATE RECEIPT NUMBER 4/3(2150 } 5 r 00 jq/ 755BUN $8DN4gUNT 0 ILDI NC&Bum WEPT10 0 r - — 'ort Townsend O 1[n (Z(��y 4. I 0 (T ITE 041,04 r 12-60 z-r ro g•e-fT : 4cA : 111 = LU'-off e01 7 42 38 II LCIAL. i I I I\ vi ;in 0 o - o z j 8� yo' ti ZZ� ` - m -I -I-L49.h-¢ +?kl-r +2¢15-F w m o fZci,si-F nil ® o 2 z _ I o i1�a21- r. O FU-I. FL. +zgz- 0 0 a GiAr. FL. f t.,' pME. FL t 2 4Z N "< z rn .4- mrc-1+ N � -FL43-0 e/ I I +Z ©-e l-..J hPPrw +29s.y-F 17A L jLpI 1 I 4 reAl 1Fi 4 1 la 1 J _1 i k__ D. +24Z \I kc-tor I oL 1-,O0p Or(ve d 5 , r D C ���cJ --- v a ff v✓. c Ccce-X