HomeMy WebLinkAboutBLD1988-00362 Ai BUILDING PERMIT APPLICATION
Jefferson County Bui! , .�Department• County Courthouse •Port To nd, Wash.98368 • 385-9141
N E
I. LOCATION: geographic name S W SIDE OF ROAD FEET
NE
S W FROM INTERSECTION OF ROAD AND AD
other specific location or landmark:
pL, GAL DESSCRIPTION:
C.Q.
7 r��--�r�� /at 13 Block ) f Subdivision
O, 0400c, Tax Number Y.Section Section Towns ip Range
II.TYPE AND COST OF BUILDING -
TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY
CI New building ❑Single Family ❑New County Resident
❑Addition ❑Multi-Family Is this structure to serve the residential
number of units
❑Alteration or commercial needs of those employed
Ej Hotel,Motel, Dormitory at either the U.S.Navys Trident or
❑Repair. eeplac"ernen
number of units Indian Island Facilities?
❑Wrecking
(Mobile Home
❑Moving (relocation)
❑Other—Specify ❑YES ❑NO
❑Foundation only
12.0_ ,c.r<<., e KAS1-1 i..ti
/./Lc1 bi�Il 1 t - '.
OWNERSHIP USE
❑Full-time Residence
❑Private (individual,corporation,
nonprofit institution,etc.) y CI
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 \ 1 /`7/x /
c. Heating,air conditioning i ,-. / q `T/i`�
c -' d. Other (elevator,etc► m CUtl
• TOTAL COST OF IMPROVEMENT $
III.SELECTED CHARACTERISTICS OF BUILDING -
2 PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DI ^( „ DIMENSIONS
❑Masonry (wall bearing) ❑Public or Private , 6/��/ •Number of Stories
•Total square feet of floor area,
CS:�("N ❑Wood Frame individual septic tank etc.) all floors,based on exterior
) ❑Structural steel dimensions
❑Reinforced concrete
TYPE OF WATER SUPPLY Total land area,sq.ft. /�
CI Public
J
Other—Specify Public or private company 7 (pQ
NUMBER OF OFF-STREET
-CI4C7:21 $26ndividu(we9istern) PARKING SPACES
Enclosed
PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE
,/'1 j ❑Gas Outdoors
❑Oil RESIDENTIAL BUILDINGS ONLY
Electricity Number of bedrooms
' �� CI Coal TYPE OF MECHANICAL
Number of Full
❑Other—Specify bathrooms
Partial
IV. IDENTIFICATION - .
Name Mailing Address—Number,street,city and State ZIP code Tel.No.
1. ,r t 121..rnJ r o G(,). _L ' Vay210 9E,S6 76,S`
Owner
2.
Contractor State License IJo.
3.
Architect
The owner of this building and the undersigned agree to conform to all applicable laws.
Sign re o -pplicant t Addres
�� Appli,`ion da e
.„.„..fili
/A C(14"--19--- L/ c-/-
PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
APPROVED BY 1. I I0 C 16
/C 77/S/f(
JEFF :• •. H ALTH DEPARTMENT
-
APPR a :1�' IU 1 • PERMIIT(�FEE I/7/
E DATE c NUMBER
+� `7S � l/ V RECEI. T
APR 71989 q
5R0 5- 7
BUILDINGEOEKVA iIUNTY 7 q/ LJ v
PLANNING&RI nG DEPT
The Printery—Port Townsend 7 o H 7 to 5'/�/
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JEFFEASON COUNTY
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