HomeMy WebLinkAboutBLD1988-00314 Adz UILDING PERMIT APPLICATION
Jefferson County Building Diertment• County Courthouse •Port Townsenu, /sh.98368 • 385-9141
1
N E .
I. LOCATION: geographic name S W SIDE OF ROAD FEET %
N E '
S W FROM INTERSECTION OF ROAD AND 1 ''
other specific location or landmark: Rf id _
DE CRTION: Y �S / -
LEGAL
IP
�� Lot D-� Subdi o
p--pu
( E
3 9OU Q Tax Number 'A Section Secti n Township Range
II. TYPE AND COST OF BUILDING-
TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY
New building
��� Single Family ❑New County Resident
❑\\\Addition ❑ ulti-Family
Is this structure to serve the residential
El Alteration
number of units or commercial needs of those employed
❑Hotel,Motel, Dormitory at either the U.S.Nav
❑Repair,replacement number of units Y"s Trident or
❑Wrecking Indian Island Facilities?
❑Mobile Home
❑Moving (relocation)
❑Other—Specify El YES ❑NO
❑Foundation only
USE
OWNERSHIP
❑Full-time Residence
❑Private (individual,corporation,
nonprofit institution,etc.) ❑Second Home: Recreation Cabin,etc.
❑Public (Federal,State or local gov't.) UBC OCCUPANCY GROUP: Ili ❑Second Home: Future conversion to
1 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.
'CNCa. Electrical If use of existing building is being changed,enter proposed use.
✓ r.
b. Plumbing 4 1`., - t/a. `z� (-I()
//� ^�
c. Heating,air conditioning (��`_ (/ v ` /C✓✓
" ? (- l J oC
i C� D
d. Other (elevator,etc.) 7 C"�O f' 23�
• TOTAL COST OF IMPROVEMENT $ � ! ��o C
III.SELECTED CHARACTERISTICS OF BUILDING - J
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DI L1 NSIONS
❑Masonry (wall bearing) ❑Public or Private r/ •Number of Stories
Wood Frame `""_— •Total square feet of floor area,
ndivid •
a (septic tank,a c.) all floors,based on exterior
Structural steel dimensions
TYPE
❑Reinforced concrete SUPPLY
WATER SUPP •
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
❑Gas Outdoors
w oil' RESIDENTIAL BUILDINGS ONLY
Se Electricity Number of bedrooms
al 4 ,,, TYPE OF MECHANICAL
her—Spe Number of Full C7: --,
bathrooms
Partial
IV. IDENTIFICATION -
Name Mailing Address—Number,street,city and State ZIP code Tel.No.
1. F Iefr WO? /OF ma- '� � 70 19�-9
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v�rer ,6 tV po Lid-) gr c)
c.) 01,
,C7S— 4 E \S pi cs D
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ontractor tl. i ense
3.
rchitect
The owner of this building and the undersigned agree to conform to all applicable laws.
, gna re of applicant Add Applpliicatio date
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b`~ r1tiy ,. J f( t�
PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT_. WATER DISTRICT
APPROVED BY
0 tzcd ( /(ü ;la. /�
JEFFERSOf UTY HEALfTH DEPARTMENT
APPRpNEDDBy,: N 1cf . A MIT FEE ISSUE DATE RECE I PT NUMBER
CID —ID
44 ' LAN ,0 0 6,// • -' .---2,. ,
BUILDING OFFICI� CO
3FF-FUSERO`LuulvTY \ 11
/PPLANNINGBIDG OEPT \ LI3f/ a{r, •Printery—Port Townsend l 0 {�.� I/3 `1/We? . _
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