HomeMy WebLinkAboutBLD1988-00318 LING PERMIT APPLICATION
Jefferson County BuildingeartBUImentD• Ca;�mty Courthouse •Port Townse Nash.98368 385 9141
AK
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I. LOCATION: geographic name S W SIDE OF ROAD FEET
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S W FROM INTERSECTION OF ROAD ANDpgp
other specific location or landmark: 1----��y�{ Ma rce C �l 1(a r_
LEGAL DESCRIPTION: 3--
Lot Block Subd i
CPN
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v b O�� Tax Number %Section Section Township aR nge
II.TYPE AND COST OF BUILDING-
TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY
Aew building ❑Single Family
❑New County Resident
❑Addition ❑Multi-Family
Is this structure to serve the residential
❑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)
ael'Other—Specify ❑YES ❑NO
❑Foundation only
C/T.11-,LijCi'lD--
OWNERSHIP USE
❑Full-time Residence
❑Private (individual,corporation,
nonprofit institution,etc.) ❑Second Home: Recreation Cabin,etc.
❑Public (Federal,State or local gov't.) UBC OCCUPANCY GROUP: /' I ❑Second Home: Future conversion to
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.
a. Electrical If use of existing building is being changed,a ter propose use.
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b. Plumbing f 46 ti //sP V`p 3 / &
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c. Heating,air conditioning
d. Other (elevator,etc.)
• TOTAL COST OF IMPROVEMENT $
:" III.SELECTED CHARACTERISTICS OF BUILDING -
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL DIMENSIONS
m.."l ❑Masonry (wall bearing) •Number of Stories
�° ❑Public or Private
Wood Frame •Total square feet of floor area,
El Individual (sept. ank,etc.) all floors,based on exterior
ID Structural steel dimensions
YPE F W ER SUPPLY Total land area,sq.ft.
❑Reinforced concrete •
❑Other—Specify lic or private company
NUMBER OF OFF-STREET
Individual (well,cistern) PARKING SPACES
Enclosed
PRINCIPAL TYPE OF HEATING FU3.L' TYPE OF FIREPLACE
❑Gas Outdoors
❑Oil RESIDENTIAL BUILDINGS ONLY
❑Electricity Number of bedrooms
❑Coal TYPE OF MECHANICAL
they—Specify Number of Full
bathrooms
Partial
IV. IDENTIFICATION -
Name Mailing Address—Number,street,city and State ZIP code Tel.No.
f. i a . at e L.(,fii�-� ? _al3
Owner J
I 1_::t/
2. t L.)rn
Contractor r w State License No.
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3.
Architect
The owner of this building and the undersigned agree to conform to all applicable laws.
Signature of applicant Addres�r Applica 'on date
ri,4,_,,;t_- C am- ^ s( �
' ANNING AREA FIRE STRICT SCHOOL DISTRICT WATER DISTRICT
-IVED BY /
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")UNTY HEA TH DEPARTMENT
.�E ® PERMIT FEE ISSUE DATE RECEIPT NUMB(QaER
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APPROVED
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