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HomeMy WebLinkAboutBLD1988-00277 BUILDING PERMIT APPLICATION Jefferson County Building�rtment• County Courthouse •Port Townserash.98368 • 385-9141 N E t I. LOCATION: geographic name S W SIDE OF_ ROAD � /� FEET N E q(10 Cr I d S W FROM INTERSECTION OF ROAD AND,` ( ROAD other specific location or landmark: ACRIPTION: 3 Lot Block Subdivision Tax Number %Section Section Township Range 9 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 number of units Li 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) - ..1S1 tither—Specify (1 YES_ (-I NO ❑Foundation only 2.1 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: J9 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 oposed e. b. Plumbing a / i 5-2)-.):7/)W ' S c. Heating,air conditioning d. Other (elevator,etc.) • TOTAL COST OF IMPROVEMENT $ III.SELECTED CHARACTERISTICS OF BUILDING - PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL DIMENSIONS Masonry (wall bearing) •Number of Stories ❑ g ❑Public or Private •Total square feet of floor area, ood Frame ❑lruiviu al (septic i.ank,etc.) all duce s,baser.on exterior Structural steel —_ dimensions TYPE OF WATER SUPPLY ❑Reinforced concrete •Total land area,sq.ft. ❑Other—Specify ❑Public or private company NUMBER OF OFF-STREET ❑Individual (well,cistern) PARKING SPACES Enclosed / PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE ,/ d Outdoors ❑Oil RESIDENTIAL BUILDINGS ONLY ❑Ele 'city Number of bedrooms Q'Coal TYPE OF MECHANICAL ❑Other—Specify Number of Full bathrooms i.✓ Partial IV. IDENTIFICATION • - Nam�e Mailing Address—CNumober,street,city and State ZIP ZIP code 'Tyell}./N�o. 1.Owner 0 L l� 7 l c� '�n J e. 1�.ii' , 9 of/7((J C. I1 ,4I� Contractor State License No. . 3 r,.chiteur i i The owner of this building and the undersigned agree to conform to all applicable laws. Si azure of a licant (/ a 7 Address Applic ion d to � �. (7/3� PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT APPROVED BY D lc w-. -- JEFFER Of C- HEALTH DEPARTMENT FPCP1",a D ��MIT FEE I SUE DATE RECEIPT NUMBER CIDf s p , 4 s� y S 3ii BU IJtFYtitU COUNTY L -7cr sD puoiNtN6 8 SLOG DEM The Printery—Port Townsend i:...:., ..:.: .„, . ............... i 7....,.....,... ............,...:1.:....::.:::::.... .: --i! tL 2\ IP \ 0 i ........i. . . '''. a . \ D n , _I 111 , kli \ > 0 z tit 2 \ 1 - - --- g Lt t.1) kt , 1-----, ) - i! \ V... \ tu ‘ \ 1 -........• 4...N......_,,, \ N.,....... , / / \ ' o' / ,/ / / a i / W(N L .. .. _ . . . . . . 7 CO <r 0 Np )rz. ' I .:, g ki\ tvl -fat. — .--, I ' 1 , • .—. . I -..— \ . _.. t itli . i 71 r : LI ---- . .e A- \ ,------ .._ -- APPROVE © SEP 1 4 j,i JEFFERSON COUNTY PLANNING&BLDG DEPT G,cne >