HomeMy WebLinkAboutBLD1988-00294 BUILDING PERMIT APPLICATION ,
Jefferson County BuildingOartment• County Coi,:rthouse • Port TownseINash.98368 • 385-9141
N E
I. LOCATION: geographic name S W SIDE OF r./� - ROAD FEET
"----0
N E (`/3
S W FROM INTERSECTION OF ROAD AND !rfer_
Q ROAD
other specific location or landmark:
o it_
LEGAL DC I TION:
Lot Block Subdivision 1(-,
07-) C)( OCR 3 TTx Wtimber 'Y Section ection ownship Range
II.TYPE AND COST OF BUILDING -
TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY
New building Single Family CI New County Resident
ddition (Multi-Family Is this structure to serve the residential
number of units or commercial needs of those employed
❑Alteration P Y
CI Repair,replacement ❑Hotel,Motel, Dormitory at either the U.S.Navy's Trident or
number of units Indian Island Facilities?
El Wrecking El Mobile Home
El Moving (relocation)
❑Other—Specify El YES El NO
❑Foundation only
USE
OWNERSHIP
❑Full-time Residence
❑Private (individual,corporation,
nonprofit institution,etc.) r CI Second Home: Recreation Cabin,etc.
❑Public (Federal,State or local gov't.) UBC OCCUPANCY GROUP: /Z-3 Cl Second Home: Future conversion to
permanent residence
COST (Omit cents) Nonresidential— Describe in detail proposed use of buildings,e.g.,food
21'- • 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.
c�,I a. Electrical If use of existing building is being changed,enter proposed use.
:-‘‘, b. Plumbing Mat/ 9 O9'
c. Heating,air conditioning -- '(°5 P J
7.-/ "D
d. Other (elevator,etc.) ., — /07/ / 1
\
• TOTAL COST OF IMPROVEMENT $ C$ (Dal a 77 / r� 10
III.SELECTED CHARACTERISTICS OF BUILDING - 1 -
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE'D
DIMENSIONS
❑Masonry (wall bearing) •Number of Stories
�— ! ❑Public or Private
•Total square feet of floor area,
Wood Frame ndividu septic tank•etc.) all floors,based on exterior
`'G ' —�� dimensions
❑St ctural steel
El Reinforced concrete TYPE OF WATER SUPPLY •Total land area,sq.ft. `�
NlkfPublic or private company >
El Other—Specify NUMBER OF OFF-STREET
❑Individual (well,cistern) PARKING SPACES
Enclosed
PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE
El Gas Outdoors
❑, Oil RESIDENTIAL BUILDINGS ONLY
ip'J Electricity Number of bedrooms
❑ oal TYPE OF MECHANICAL
Oth Number of Full
p ify
1 } bathrooms
lJ Partial
IV. IDENTIFICATION- •
Name (5/ Mailing Address— Number,street,city and State IZIIP code Tel.No.
o_le,1 i , Pq
r 3
Contractor\ �,'�' State License No.
�1 .
3.
Architect
The owner of this building and the undersigned agree to conform to all applicable laws.
,,S nature of applica t Addre
Applicati n da
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PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
APPROVED BY� LRALcITMEN
JEFFERSON COUDEP v/ 0
APPROVED B : I21ER� ISSUE DATE RECEIPT NUMBER
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BUILDII' trBlF �I B I( IAs
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JEFFERSON COUNTY i '°�
P Townsend 10 W/0 .D 1 1 /c
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