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HomeMy WebLinkAboutBLD1988-00298 BUIIING PERMIT APPLICATION III Jefferson County Building epartment•P .O . Box 1220'Port Townsend, WA 98368 LOCATION , SPECIFIC LOCATION' SITE ADDRESS 1 1 (' ( (J ( j�- n C t )nn. td POSTAL DISTRICT 14 /SUBDIVISION LEGAL DESCRIPTION LOT BLOCK DIVISION TAX NUMBER �5� PARCEL NUMBER Grip( I H T DOS 1 / 4 SECTION SECTION II TOWNSHIP NORTH RANGE ( I.O WM BUILDING INFORMATION BUILDING TYPE TYPE OF IMPROVEMENT SQUARE FOOTAGE ❑ SINGLE FAMILY > NEW BUILDING MAIN FLOOR MOBILE HOME ❑ ADDITION 2ND FLOOR ❑ MODULAR HOME ❑ ALTERATION BASEMENT ❑ DETACHED/ATTACHED fl REPAIR CARPORT `;4 GARAGE ❑ REPLACEMENT GARAGE ❑ WOODSTOVE ❑ WRECKING/DEMOLITION COMMERCIAL ,, ❑ MULTI - FAMILY ❑ RELOCATION/MOVING INDUSTRIAL 4. .O NUMBER OF UNITS_ Cam°!, ❑ COMMERCIAL MOBILE HOMES F ❑ INDUSTRIAL SIZE �� X � p� $35 ❑ HOTEL/MOTEL/DORMI TORY' YEAR Iq'78 (V) a $ 1 6 MAKE Net, ,�G(U 0 @ $6 NUMBER OF UNITS ❑ OTHER - SPECIFY ESTIMATED COST OF 0 @ $8 IMPROVEMENTS TOTAL FAIR MARKET VALUE UBC OCCUPANCY GROUP $ $ /2-3 SELECTED CHARACTERISTICS OF BUILDING PRINCIPLE TYPE OF FRAME PRINCIPLE TYPE OF HEATING FUEL ❑ WOOD FRAME )ELECTRICITY ❑ COLLECTIVE SOLAR ,,, X MANUFACTURED 0 WOODSTOVE ❑ PASSIVE SOLAR ✓ 0 STRUCTURAL STEEL 0 GAS ❑ COAL ❑ REINFORCED CONCRETE ❑ OIL 0 OTHER - SPECIFY ❑ MASONRY ( WALL BEARING ) DIMENSIONS ❑ OTHER NUMBER OF STORIES TOTAL LAND AREA DEPARTMENTAL REVIEW } HEALTH DEP RTM' NT TYPE OF SEWAGE DISPOSAL NUMBER OF PROPOSED BEDROOMS 2 ( 1 ❑ PUBLIC OR PRIVATE NUMBER OF EXISTING BEDROOMS ��. v �� +�� ► I ND I V I DUAL ( SEPT I C ) NUMBER OF PROPOSED BATHROOM I APPROVED DATE Ai, I ND I V I DUAL WELL NUMBER OF EXISTING BATHROOM PUD . TYPE OF WATER SUPPLY (7 l Ciii �(`(� XPUBL I C ( NAME OF WATER SUPPLY.,14:) ._/ PROVED DATE ❑ PRIVATE ( NAME OF WATER SUPPLY) PLANNING DEPT . WITHIN SHORELINE JURISDICTION `_❑_,YES NAME OF ADJACENT WATER BODY 15� N O APPROVED DATE BANK HEIGHT SETBACK PUBLIC WORKS DEPT ROAD RIGHT-OF -WAY WIDTH NAME OF PUBLIC ROAD � J NAME OF PRIVATE ROAD ` APPROVED DATE ROAD ACCESS PERMIT REQUIRED ❑ YES ❑ NO IDENTIFICATION r NAME MAILING ADDRESS - ZIP TEL NO t OWNER Imo)()�`I�h ll ) PL--- 9 b3/(a • A1.2)7 - el/1 I C OD(�J I� t 'r^dl J�Ti / I O.I 60 1 00 CONT 1 k J Cr rnTerl ARCH • THE' OWNER OF THIS BUILDINC�JAND THE UNDERSIGNED AGREE TO CONFORM TO ALL APPLICABLE LAWS: $lN RE OF PLIC NT /// APPLI AOTIONDA E RECEIPT NUMBER CHECK NU BER OR CASH .,,,. PPROVED BY PERMIT FEES A V E 75, l'C) SASE FEE INSPECTION P 1989 L3 ,SO BLDG SURCHARGE PLAN CHECK JEFFERSON COUNTY ENERGY SURCHARGE S 2 , 5 O `J ��// TOTAL PLANNING&BLDG DEPT 9 1 i NUMBER I REFUND DATE I T E BUILDING OFFICIAL DATA 0 ( 9//s — tN riJAV NVOI J '" 1E!J1.4 1w uW_J-2., . y3NS t0 �d f't — 1311blS � • 1 1 3°od P^^�,I(17 v vs,- CliAAD14 (24,`P_.9 • '..) -Ps !coo 'c° .,- , iit,4 ..-- _ F a rC - _ a - - ---- ' vU t 10 JSzx \. • If / t / \ .---.' Ni PLO c [� - - _ CC• ('5(? loco o4�`e{ d`� T ! . (--- --- .---7--------- --„--_, -_. _ -- __SJ �'- L ( `,, .�- i • C G\Ic rvk cx cu o-\ 6-(=t SEP 2 J 1988 ------.17 1 JS ll ,_41 T-ef‘..w1/4,x "- JEFFERSON COUNTY PLANNING Si MG OEPT 7 p en--- / z...,7,1_,,s --Ze,..._ -------- 6/ pl2 a J cx..._ c— h.'4 Of-1 e-e.— ye—t- —r,v ,z 0.1(1 I AK"/". ) r — /244 J L t f/.e kost Cr 41/4.4 K_ Q.I`C 0.01-bt.(1 (.5D 4i2 ck, 'Z/' C.)a 0 c 144 naCcc,.c_ a ©e-F'Q S 0 `r, A't c Fc O 1 , 36 `C c -1 -++-�.r ,d,. Otd.)„Lc/L._ c,.. ,..,, contA-Lterr-- A0:406.4._ 61/,/, c7:',/; - i 9 I 0,A7 ,,,,3_,2,j— /ge Tun y w R.L (Aix (4_ (.,0 t,(K, (Lutt cc _(///ic„0 siv 0_t _J_ m a3 ? b `116 5-11/ 96 ` N ile Fi FPI) -- AI c 113 J. A) G v&i.4,- , la 7/ON 2 . L L r s S 47270 -,,- ga qi ( 2c/?1 - Me.M. 7L--ii4V - -Fra:ZES _ A-0 pe-w-ti- W --- - A Ai v-e-- I . I . P ' S e Gam' cry, '1-1/ U - 9/e/ve_t_ 00JClL V1,-)•1t r.. /off IA{ q I