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HomeMy WebLinkAboutBLD1988-00323I BUILDING PERMIT APPLICATIIIII • Jefferson County Bui, ing Department• Cavity Courthouse •Port To f„send, Wash.98368 • 385-9141 N E I. LOCATION: geographic name S W SIDE OF ROAD / � � FEET S W FROM INTERSECTION OFF ROAD AND l 1 \ /1/0 CI\ (.'-`„",y ROAD other specific location or landmark: IZA JIIU 1c1.47--e40 &,,0 (0 n E L D S IPTION: a/ (73?, IJ���`�i Lot Block Subdivision � ^ l . lll�JJ r} (`o Tax Number 'A Section ction Tow Range 'S,,„,. II. TYPE AND COST OF BUILDING - 0 TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY (...) ✓ New building Single Family ❑New County Resident --4-- �w,.r.f ID Addition El lb-FamilyIs this structure to serve the residential ��'f l El Alteration number of units_ or commercial needs of those employed `0' 1 ❑Repair,replacement ❑Hotel,Motel, Dormitory at either the U.S.Navy's Trident or number of units Indian Island Facilities? ❑Wrecking ❑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. El 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. I b. Plumbing ThaPYI . 301? V 4 ' I (ADP q i• c. Heating,air conditioning G J`vim, ©! 0 ,0_ lse td. Other (elevator,etc.) /�"',r,,,� `` �/ VO A 6• TOTAL COST OF IMPROVEMENT $ �� J D� • Y Si III.SELECTED CHARACTERISTICS OF BUILDING - PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE M DIMENSIONS El Masonry (wall bearing) ❑Public or Privet V •Number of Stories •Total square feet of floor area, �❑j Wood Frame... Indivi ual (septic tank tc.) all floors,based on exterior ❑Structural steel / dimensions ❑Reinforced concrete TYPE OF WATER SUPPLY •Total land area,sq.ft. El 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 ❑Oil RESIDENTIAL BUILDINGS ONLY electricity Number of bedrooms ii/1' ❑Coal TYPE OF MECHANICAL ' El Other—Specify , Number of Full bathrooms ) Partial e),\ IV. IDENTIFICATION - • Name Mailing Address—Number,street,city and State ZIP code Tel.No. 1. ���� . �r> 'C . qa 0 -"rr 6_ i?' q,7 Owner MCC'162 , )0Z, ( 3- 2. Contractor State License No. 3. Architect T e owner of this building and the undersigned agree to conform to all applicable laws. ig at re of a plicantn Ad ss Applic ion da PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT APPROVED BY r ii o P-C( � /C2�" �' JEFFE-.�•IV C � HEALTH DEPARTMENT APPAl, 1.Y: PERMIT E ISSUE DATE NUMBER (P S , l RECE I�'T MAR p 31}�"p -•�` 3 .S� C 23188 I L 7� BUILDING OFFI( ( `. , c PtANNIy�&B log per S , ODhe Printery—Port Townsend TO IID 3//6—AS-C? Q f /,' �� -__J . N., icli r P �9FR\y • /25i i G' �"c 1 Fes- --=- �- ys a�M I a�D R pj F/,v��. ,�� ICI GARRGE z 6o°SE L e -� (f �fiJGFy4vF 1 o :( Homesite for: - -• -- Donald and Hazel Moore / �o�° ' 22332 Clearcreek Rd. - Poulsbo , WA 98370 // �` - - — I - -' phone 779-3428 / /1 �' �ew.4• .ion septic system installer: °S ---- — — 6D ' � -_ _ it, Dick Holmes X I_to' yr } `c: Bldg. type: frame --- -- ____, No. bedrooms: 2 Basement: no Site size: as sketched , , scale 1"=25 ' ;I- XI ti- Location of site: end o- �R1. 5 z_� Finch Lane . . . Harold Ste,-i�e - o�. ��,• a block from site , will �%NQ if derired. 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