HomeMy WebLinkAboutBLD1988-00401! '
BUILDING PERMIT APPLICATION
Jefferson County Building 1Wrtment• County Courth use • Port Townser sh.98368 • 385-1310
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I. LOCATION: geographic name S W SIDE OF ROAD _-FEET
NE ` f
S W FROM.INTERSECTION OF ROAD AND math-ono �1I a 912..0 AD
other specific location or landmark: f L
St-
LEGAL DESCRIPTION: )t), ft ( ( - �//�/ �i'-. V U— -.. I.... — 4o ,.
rc �. /_}� L Lot 13ToeK ' Subdivision
5d (Q (. lJ Tax Number 'h Section Secti' 3 on � TownshipRTnge_
II.TYPE AND COST OF BUILDING-
TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY
❑New building ❑Single Family ❑New County Resident
❑Addition ❑Multi-Family Is this structure to serve the residential
number of units to d or commercial needs of those ern
❑Alteration ernplo
❑Hotel,Motel, Dormitory at either the U.S.Navys Trident
Repai replacement number of units
Indian Island Facilities?
❑Wrecking Mobile Home
s ❑Moving (relocation) ❑Other—Specify ❑YES NO
❑Foundation only
USE
\J ' OWNERSHIP
❑F -time Residence
❑Private (individual,corporation, econd Home: Recreation Cabin,etc.
nonprofit institution,etc.)
❑Public (Federal,State or local gov't.) UBC OCCUPANCY GROUP: 3 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 a, r C,o, I q 8+ „ -
c. Heating,air conditioning rP p((to ii P K GSt(1 l r
c r( _ MRy
d: Other (elevator,etc.) w1Th n one, i t J _ —�—�T
• TOTAL COST OF IMPROVEMENT $
III.SELECTED CHARACTERISTICS OF BUILDING -
PRINCIPAL TYPE OF FRAME TYPE OF SEWA ISPOSAL
DIMENSIONS
�K LSt •Number of Stories
Masonry (wall bearing) - ....
Ej❑ ❑Publi r Private •Total square feet of floor area,
Wood Frame XYndividual septic tank, tc.► all floors,based on exterior
1 ❑Structural steel — dimensions —
` ❑Reinforced concrete TYPE OF WATER SUPPLY •Total land area,sq.ft. ... .
Other Specify ❑Public or private company _ 4N—e..
Mn�U 0-Fa
(4 NUMBER OF OFF-ST cT
r V, T Individual (well,cistern) PARKING SPAC
Enclose
PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE
❑Gas utdoors
Doi! RESIDENTIAL BUILDINGS ONLY
�S: Electricity ---- Number of bedrooms •
Coal TYPE OF CHANICAL `J
❑Other—Specify___._____._
Number of Full 6
bathrooms
Partial i
IV. IDENTIFICATION -
Name Mailing Address—Number,street,city and State ZIP code Tel.No.
1. ,B err Von 6u irk &YY adrnr,aUi'stu , PL 98365 H37-
Owner n/1
2.
Contractor State License No.
3.
Architect
The owner of this building and the undersigned agree to conform to all applicable laws.
Signature of applicant Address Application date
Itilf,"74.7--1 /3/' ' 1 2 01/4S/8
/
PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
APPROVED BY I �(`'` �'�o-4- 14V1'tt
b ) ---0 V- 3
JEFFERSON COUNTY HEALTH DEPAT IVIENT )$1 e
APPROVED B : I PERMIT FEE ISSUE DATE RECEIPT NUMBER
APp . I� 13 .00
, 50 5 a � 5
BUILDING . Fit, 988 —7 SO
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pi""Noun i. COUNTY— —a The Printery Port Townsend
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APPROVED
MAR a 1988
JEFFERSON COUNTY
PEAMPONG&BLDG OEPT
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