HomeMy WebLinkAboutBLD1988-00287 BUILDING PERMIT APPLICATION
Jefferson County Buildiisit. arw?ent• County Court7touse •Port Towns ash.98368 • 385-9-141
N E
LOCATION: geographic name S W SIDE OF ROAD ,,.' p FEET
S W FROM INTERSECTION OF ROAD AND • 1(-2)r-cC ) e' hC`V .) i \G READ
other specific location or landmark: 1�rj I 0-=.4../-' h .3
LEGAL DESCRIPTION: c,Q,2j I'D I
P^n ,L1 Lot( Block Subdivision
ACT/`�3 Q00 O$ Township lge
l(J ? Tax Number %Section Section Range
II.TYPE AND COST OF BUILDING -
TYPE
OF IMPROVEMENT BUILDING TYPE MOBILITY
1ew building Single Family ❑New County Resident
❑Addition ❑Multi-Family Is this structure to serve the residen 'al
number of units
❑Alteration or commercial needs of those em. oyed
❑Repair,replacement ❑Hotel,Motel, Dormitory at either the U.S.Navy's Trid• t or
number of units Indian Island Facilities?
❑Wrecking ❑Mobile Home
❑Moving (relocation) ❑Other—Specify ❑YES ' NO
❑Foundation only
USE
OWNERSHIP ❑ -ull-time Residence
❑Private (indivi corporation, M Second Home: Recreation Cabin,etc.
nonpro ' stitution,etc.)
is (Federal,State or local gov't.) UBC OCCUPANCY GROUP: r ❑Second Home: Future conversion to
permanent residence
COST (Omit cents) r
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 chggid,enter proposed use.
b. Plumbing \
)ry CA 5 R IL4.-/g#' I
c. Heating 'rconditioning I {% / Sj 0
d. her (elevator,etc.) (2lridL 9 cjOp
1l'l //` y {3-7/('lam
TOTAL COST OF IMPROVEMENT $ (11`/ ~r° GG�3 lam"C/
III.SELECTED CHARACTERISTICS OF BUILDING - Fin II coy so 7
`' '`t I "ENS!O''S /
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DSA'L ''"�
`2
•Number of Stories
❑Masonry (wall bearing)
❑Public or Private •Total square feet of floor area,
Tood Frame _j .s fiv_idua septic tank, :tc.) all floors,based on exterior
❑Structural steel dimensions 023a,9--
TYPE OF WATER SUPPLY
❑Reinforced concrete •Total land area,sq.ft.
Ell Other—Specify Public or private company
NUMBER OF OFF-STREET
❑Individual (well,cistern) PARKING SPACES
Enclosed
PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE
«, ;, El Gas Outdoors
DOH RESIDENTIAL BUILDINGS ONLY
„ r
electricity Number of bedrooms
❑Coal
TYPE OF MECHANICAL
I I Cher—Sp ify Number of Full
(k)0 O( bathrooms
Partial
IV. IDENTIFICATION - .
Name Mailing Address—Number,street,city and State ZIP code Tel.No.
Owner
kli \at' ' , , ,U II drill• Neftli a.
`2.
Contractor I
State License o.
3. VQ� . — 616 73
l l
The owner of this building and the undersigned agree to conform to all applicable laws.
Signatu a of applicant / Addr-t i l► �/ s Appli ion da e
y .fj
PLANNING AREA FIRE DD1`STRICT SCHOOL DISTRICT WATER DISTRICT
APPROVED BY
arc �fe(t 4« /,/
JEFFERS r EALTH DEPARfl4EIdT.
APFiidP/Fb t
, 1 !7` fjl1A UEE ISSUE DATE RECEIPT NUMBER
-1't4 -..
c6")
BUILDIIV1Q OC iLNfY 3 ,51D _-- QV CJ( •; 5 ✓ ) v a
PLANNING&BLDG OW 3 t f/�Ve-
�/ I S / IOTIC intery—Port Townsend fY 10 h 4/"cam 4/LA � "4
(tY��S
.
1.--------7---
F7. .
I . • ,
: A
V i
0 ,----r-'
V4
1,1 6
1 r
ril
r A'.
1 ,---.
- ,
TI
-1).j
f'l
....., 0
a •e
C.
e <4
.,. i
ii4 i=
P
1
/ .
lit°I
7 r,
q
q.,
isc t
:74-)
1._, . .
rK
r
il
li
a
�S 'us-
C/J