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HomeMy WebLinkAboutBLD1988-00322 BUILDING PERMIT APPLICATION Jefferson County Building. artment• County Courthouse •Port Townse Nash.98368 • 385-9141 a N E I. LOCATION: geographic name S W SIDE OF ROAD FEET NE S W FROM INTERSECTION OF ROAD AND Ft- rr&) 60 ROAD other specific location or landmark: 13r0 iwo©tom' 6/cA,/ mr16.D SC IPTION: , 4 Lot Block Subdivision )C� (p DO 0/3 // Lij Tax Number Ye Section owns ip Rann ge II. TYPE AND COST OF BUILDING - TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY .•I New building ❑Single Family ❑New County Resident ❑ •edition ❑Multi-Family Is this structure to serve the residential ❑Alteration number of units or commercial needs of those employed LI Hotel,Motel, Dormitory at either the U.S. Navy's ❑Repair,replacement number of units Trident or ❑Wrecking Indian Island Facilitiess?? �. tt Mobile Home ❑Moving (relocation) ❑ tether—Specify ❑YES ❑NO ❑Foundation only USE OWNERSHIP ❑Full-time Residence ❑Private (individual,corporation, nonprofit institution,etc.) 2 ❑Second Home: Recreation Cabin,etc. ❑Public (Federal,State or local gov't.) UBC OCCUPANCY GROUP.. ❑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,enter proposed use. b. Plumbing s- --i52- --- // ? ( c 4' c. Heating,air conditioning ^^c 19 7 d. Other (elevator,etc.) r/)� J� — f i • TOTAL COST OF IMPROVEMENT $ �J l vc 1 7 III.SELECTED CHARACTERISTICS OF BUILDING - k PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DI• y r '�,, DIMENSIONS ,''v, ❑Masonry (wall bearing) ❑Public or Private •Number of Stories ",,J'• , 'O� ndividu •Total square feet of floor area, ❑Wood Frame (septic tank,a .) all floors,based on exterior ''-i ❑Structural steel dimensionsC ❑Reinforced concrete TYPE WATER SUPPLY •Total land area,sq.ft. Public or private r. company ther—Speci NUMBER OF OFF-STREET /kJAn I f 1�SLtX ❑Individual (well,cistern) PARKING SPACES / - --- TYPE PRINCIPAL TYPE OF HEATING FUEL OF FIREPLACE Enclosed �y ❑Gas Outdoors - I CI oil RESIDENTIAL BUILDINGS ONLY tgGlectricity Number of bedrooms Coal TYPE OF MECHANICAL keNrgThij\sr-Q---"" Number ofFull bathrooms Partial „........0"------- IV. IDENTIFICATION- Name Mailing Address—Number,street,city and State ZIP codt. Tel. No. 1. :.k.Ngi 1 t414- 4 ' ow -7/y Owner p 1-- 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 Addr s Applicat' n dat PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT AP.P.ROVEBY J 43,h JEFFERa'7 C EALTH DEPARTMENT 'I' `` A P P R CA 951 al PERMIT FEE VSSUE0 RECEI 'T NUMBER , 7 d '( (}.0`9 � BUILDING(OFFICIAL B r SZ� /0 /� PtAAlytNb $lfl 1)rP �TfePrinter 3,2 "`S/// T y—Port Townsend .-- r ' k M •, 4- • , r s. r r , -� Y.f. i w.'i. '.+- ... ,..„ _ .' •I. , aq o I Qa. / 3 / a x! p a-4 • ..�. _ !C; Ft- �' // y I S. p. f' I 1' I.. t o' 4 i i 1 1 —71 ' i ' ? . 4f gt i o I i -o 4 ( 'n I � � 4-- D 93' A .. in FL 't ki. t 3 i 7 0 v, , f. . ._ n r 3 ,r1 (� V E Dj I ( r r (11 X. r z M� t tip —� Fi(((((( x ' `i te o BI (� f , :E r, O --1 b I5' 91 4' i . I s to' I i '4. -to r - P -0 I ��_ -, g.,-i•tt'l g , Y ...,.4 p tit N 7 1V ..-;____ *ire- ‘.......t.: , 5 * ; 0 j Bier,Ywr iirtA t I ca Ma . { r— , ; Grp S v, t j Ij 1 1 I 110' y I I us .ems , 1 /55 e 7��" c j` T -e-�4,14, is c,d*FFERSOv f',,t1,, 6/c- ,4.Qr. /l/ —gyp cr- ---1:14it j, a i c_ 0 ?in., ii,4 c- X)otc-/././ry--efis ///,,,, c 2_ '2:1:4 .-I 0c_ ,tki,_ Cil) _____ h �1/ /21.5.,--- ///-7— K:j;i-4-ie ei::) (et-4k-3 (Z___.) -5"14.;fte.- , // , . ,X)? -- h ,‘,. / ---- -. - 1` COun—,..) 0.,.,..--n,„) ,3c... .,,:_ix.--4.) it.,;..,„1 (..40 To.44_,„. ,, ,‘. 4 11/4 (-, ._') --- 61 k ,,,,.„,, y —,. e 5_,,ru444 _ 7-2. 607 -- „ ,.._„,_._ . _.----- mac_ SHORELINE SETBACK EVALUATION APPLICANT: (Zt ! z.. Cxi ADDRESS: P D �� )< 7/ 7 0--( cr. -7.1-.>�,_c c,V� TELEPHONE: (home) =,(-Sla (business ) PROPERTY DESCRIPTION PROPERTY SITE NUMBER: LEGAL: Owner : Address: Tax ParceL Number: ReaL Property Description: // 21 ) £ (ti! 4 c / 3 o f ate.< <..> �✓/64�.; ADJACENT WATER BODY: C L ,.,.t C,-z g i_ ( _ • EVALUATION / r BLUFF HEIGHT: ___ /11--- /0 _ SOURCE: N ZO/ BLUFF STABILITY: SOURCE: STANDARD SETBACK: 0 feet This minimum setback shaLL be measured from the ordinary high water mark to the most waterward edge of the proposed structure. ❑ BLUFF SETBACK: feet This minimum setback shaLL be measured from the bank' s edge to the most waterward edge of the proposed structure . . ❑ AVERAGE SETBACK: feet This minimum setback shaLL be measured from the bank's edge to the most waterward edge of the proposed structure. This setback is based on the foLLowing caLcuLations of adjacent residentiaL structures . Right House (facing waterward) : • Setback from bank or ordinary high water : feet • Distance to the proposed structure: feet Left House (facing waterward) : • Setback from bank or ordinary high water : feet • Distance to the proposed structure: feet ❑ SUBDIVISION SETBACK : feet This minimum setback shaLL be measured from: This setback was estabLished by the approvaL and fiLing of the pLat. VARIANCE REQUEST: ❑ APPROVED ❑ DENIED DATE: 1 ACKNOWLEDGEMENT' The above evaLuation was determined on information provided by the appLicant. ShouLd any of this information be found inaccurate, the setback requirement may be re-evaLuated . i c ;17 firInner (date