HomeMy WebLinkAboutBLD1988-00369 BUILDING PERMIT APPLICATION •
Jefferson County Building 0rtment• County Courthouse •Port Townsel.ash.98368 • 385-9141
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I. LOCATION: geographic name S W SIDE OF / L� �RO,AI,D/ {� FEET
S W FROM INTERSECTION OF ROAD AND CQ f L .! .* Y ROAD
other specific location or landmark: ZiLf 644—
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LEGAL DESCRIPTION: 3••��°-3 51 &�,I., --P t� J J
�� t } Lot Block t Subdivision
C9 () (; )
9-3 1tlgrat—a I Tax Number 1/44Section Section .ownship Range
II.TYPE AND COST OF BUILDING- q ZZDD O /
TYPE OF IMPROVEMENT BUILDING TYPE / MOBILITY
New 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 Trident or
❑Wrecking Indian Island Facilities?
❑Mobile Home
❑Moving (relocation)
, ;21Other—Specify ❑YES ❑NO
❑Foundation only
(:)1 CIA aee---
OWNERSHIP USE
❑Full-time Residence
❑Private (individual,corporation,
nonprofit institution,etc.) /( CISecond 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 -
C7Rq 6 '('° = (tQ, qeeg,C1°
c. Heating,air conditioning
d. Other (elevator,etc.) ��� � Y
• TOTAL COST OF IMPROVEMENT $
III.SELECTED CHARACTERISTICS OF BUILDING -
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPO DIMENSIONS
ElMasonry •(wall bearing) •Number of Stories
❑Public vate
•Total square feet of floor area,
Wood Frame ndividual (septic tank,etc.) all floors,based on exterior •
❑ uctural steel dimensions
❑Reinforced concrete TYPE OF WATER SUPPLY •
Total land area,sq.ft.
❑Other—Specify ❑Public rtv a c3t`�ompany
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
El Coal TYPE OF MECHANICAL
er—Specify Number of {Full
bathrooms
• Partial
i
IV. IDENTIFIC TION- %-\ .
n t
C4 , ` Mailing Address—Number,street,city and State ZIP code Tel No.
Owner [ ,..v ,. — 4 P `t1� ��/l ����
.....52,0.2a cAcf (114LP ,,,,..5.4 9t. —36aa
Contractor State License No.
3
Architect
The owner of this building and the undersigned agree to conform to all applicable laws.
of pp a Address peat' n to
>rature
c�� cL
PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
Ti
APPROVED BY
JEFFER I k Y HE TH DEPARTMENT
APPR(�VP R' PE IT FE ISSUE DATE
+tip PP'' 6; S� RECEIPT NUMBER
J 1118 7g 'CTo I _ I I
BUILDING OFFICIAL ( 7CI�
JEFFERSON COUNTY / t( t ).
PUIN.iING&BLDG DEFT
The Printery—Port Townsend
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APPROVED
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JEFFERSON COUNTY
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