HomeMy WebLinkAboutBLD1988-00285 BUILDING PERMIT APPLICATION
Jefferson County Building DStment• County Courthouse •Port Townsenoash.98368 • 385-9141
N E
I. LOCATION: geographic name S W SIDE OF ROAD FEET
NE
S W FROM INTERSECTION OF ROAD AND 51`I'E'Cict La/h0 - D-
other specific location or landmark: rid k ,.. J
LEGAL DESCRIPTION: II 1 n/ f P
�� Dlo� Subdivisionci CA7k) ie__
36-/6OO 0 I, I Tax Number %Section Section Township Range
II. TYPE AND COST OF BUILDING -
TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY
lew building ingle Family
( S
❑New County Resident
❑Addition ❑Multi-Family Is this structure to serve the residential
number of units
El 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?
El Wrecking ❑Mobile Home
❑Moving (relocation) ❑Other—Specify ❑YES ❑NO
❑Foundation only
USE
OWNERSHIP
❑Full-time Residence
❑Private (individual,corporation,
nonprofit institution,etc.) ElSecond Home: Recreation Cabin,etc.
❑Public (Federal,State or local gov't.) UBC OCCUPANCY GROUP:-3 ❑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 Ifn use
(�o�f,existing building is being changed,enter proposed use. ?/b. Plumbing fi iAt\ IC `-t 54 e-;� J�P v v
c. Heating,air conditioning '/\ C S� t� l�0 _
d. Other (elevator,etc.) 6 at � e- q
, • TOTAL COST OF IMPROVEMENT $ S—7a / C2�J
III.SELECTED CHARACTERISTICS OF BUILDING - / 7 !�
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DIShla DIMENSIONS
Masonry (wall bearin ► •Number of Stories
}0Vood
❑ 9 ❑Public o •Total square feet of floor area,
..--- Frame ndivic(uef'se.nic tank, tc.) all floors,based on exterior
Structural steel C dimensions
TYPE • . ,TER SUPPLY
❑Reinforced concrete .....6.°— •Total land area,sq.ft.
❑Other—Specify 4 Public o private company
Inn.w NUMBER OF OFF-STREETidual (well,cistern) PARKING SPACES
;y Enclosed
`r�(d7 PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE
❑Gas Outdoors
❑Oil RESIDENTIAL BUILDINGS ONLY
Electricity Number of bedrooms
El Coal TYPE OF MECHANICAL
er—S cify
Number of Full
bathrooms
rf/c.4 Partial �=v
IV. IDENTIFICATION - �Q
Name Mailing Address— Number,street,city and State ZIP code Tel.No.
f. a r-r- ' 10 IV) W q(r r'' 7g10 7
er
2: __ r -o l A) D&) Lam ,Z� 6/ 7-
(te) tractor r State License l�o.
OA
3.
Architect
The owner of this building and the undersigned agree to conform to all applicable laws.
Signature of applicant Addre s Applic3,tion dat
PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
a APPROVED BY
:, I .- ( v � ,-( /2 uW
JEFF , CO•NTY HEAL Tt j DEPARTMENT
t , APPRO, PERMIT FEE IS UE DATE
RECEIPT NUMBER
11 E
APR �� 53 , S'O
8 18 , U Oa � � c/ � 41�
BUILDItalt¢,,,�CIAL l :7 O v , t,
Pt�NNrNc&tfeQG DEpr \ 7 Cf Tp Pr toy—Port Townsend (''� F/ t/) r� 1 - -y���� iJ
• 0
•
-IL
rIIPH
111
1. ,:.vi.:;-T-1 J\!)°
j
w
z ",7'---7-----\\
o
[ ,
\...32/ i
1y ;fir / !
;'� ' (d / r O
• _ ��
i J i•
p. Q.)
3
•
- � I
! 1 ,,,, /
i 5L-::: - - J'
,_t/
- -_
i
, -) / / .1
, / !
pn
//
.r
rr
/ /
---77c
,r
(y A/1s c° 5 -'7<"
.6 _,,p a't_
—
(7_ ,F-8‘ „v.() /‘4)--)-"'t-e 7,30Z
1
Cl2e) PC- C444 \
Et„.1
c3D -- 116T<Iv
c*\-2.56s .
d�- SCE-- c/a—