HomeMy WebLinkAboutBLD1988-00316 BUILDING PERMIT APPLICATION
Jefferson County Building DO:rrfent• County Courthouse •Port Townsendsh.98368 • 385-9141
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I. LOCATION: geographic name S W SIDE OF ` ROADD( FEET
S W FROM INTERSECTION OF ROAD AND ' Fit ` ROAD
other specific location or landmark: (-2D
LEGAL DESCRIPTION: 1C • '`
Lot Block Subdivision
Co //�� /c 2Cc� x i
l J 1 c2Z-,1 Tax Nurntrer ''A Section Section Township Range
II.TYPE AND COST OF BUILDING -
TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY
New building ElSingle Family ❑New County Resident
//////❑Addition ❑Multi-Family Is this structure to serve the residential
number of units
❑Alteration or commercial needs of those employed
❑Hotel,Motel, Dormitory at either the U.S.Navy's Trident or
❑Repair,replacement
number of units Indian Island Facilities?
❑Wrecking ❑Mobile Home
❑Moving (relocation) Other—Specify ❑YES UNO
❑Foundation only
Y o,%
USE
OWNERSHIP
❑Full-time Residence
❑Private (individual,corporation,
nonprofit institution,etc.) t ❑Second Home: Recreation Cabin,etc.
�, ❑Public (Federal,State or local gov't.) UBC OCCUPANCY GROUP:nit.
I ❑Second Home: Future conversion to
tc.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 instal/ed but not included ' school,secondary school,college,parochial school,parking garage for
CX in the above cost department store,rental office building,office building at industrial plant.
a. Electrical If use of existing building is,b(eing changed,enter proposed use.
b. Plumbing O or..�Yu
Z Z X/o Z
c. Heating ' conditioning !/.0(20 Z I, [
d. er (elevator,etc.) ,)/ r [�-' . k
TOTAL COST OF IMPROVEMENT $
l III.SELECTED CHARACTERISTICS OF BUILDING -
PRINCIPAL TYPE OF FRAME TYP„E OF SEWAGE DISPOSAL I DIMENSIONS
Masonry (wall bearing) •Number of Stc-;es —
❑ 9 ❑Public or Private •Total square feet of floor area,
Wood Frame ❑Individual (septic tank,etc.) all floors,based on exterior
L L]Structural steel dimensions f
❑Reinforced concrete TYP OF WATER SUPPLY •Total land area,sq.ft.
Public or private company �'El
❑Other—Specify NUMBER OF OFF-STREET
1' Ell .�.
Individual (well,cistern) PARKING SPACES " - -a.
Enclosed .... . �.
PRINCIPAL TYPE OF HEATING.FUEL TYPE OF FIREPLACE
CI Gas y~ Outdo'
❑Oil RESIDENTIAL BUILDINGS ONLY
❑Elec ' ity Number of bedrooms
•
oaI TYPE OF MECHANICAL
Number of I
❑Other—Specify
bathroom
Partial
IV. IDENTIFICATION - •
Name Mailing Address—Number,street,city and State ZIP code Tel.No.
,.
1. is k
Owner
2.
Contractor State License No. I
3.
Architect
The owner of this building and the undersigned agree to conform to all applicable laws.
Signature of applicant Addres447cL
Application date
�
PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
APPROVED BY _ /
I'�j CMCfwC___
JEFFER^ ,I D 1NTY HEALTH DEPARTMENT
APARpVp D E PERMIT FEE I UE DATE RECEIPT NUMBER
6J
Z ,C._137 ROL oc-r 307g5)
n 3573/(
r UG t. I/vd 2KFee_
BUILDING OFFICIAL i
JF.F RSDN CDUNTY 3S' J'u a
PLANNING &BLDG DLfT
------"T e etery—Port Townsend
APPROVED
An 3 0 1900 13/- k- �„02 L c�
JEFFERSON COUNTY
PLANNING&BLDG DEPT
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