HomeMy WebLinkAboutBLD1988-00403 BUILDING PERMIT APPLICATION
Jefferson County Building,artment• County Courthouse •Port 'Townse'Uash.98368 • 385-9141
N E
I. LOCATION: geographic name SW SIDE JF_ ROAD FEET
N E
S W FROM INTERSECTION OF ROAD AND �/� / //—R/OAD
other specific location or landmark: / O t/'7 i�ri//,vLQ , / l
f� ..
LEGAL DESCRIPTION:�> _ aA0ri-{4q i_,�
P `fx- — Lot Block 6div'si n jF
( 0/00 Tax Number Y.Section Section Township Range
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
❑Alteration or commercial needs of those employed
❑Repair,replacement ❑Hotel,Motel, Dormitory at either the U.S.Navy's Trident or
number of units Indian Island Facilities? 1
❑Wrecking ❑Mobile Home
❑Moving (relocation) El Other—Specify ❑YES ONO
❑Foundation only //��
! pork,,, _ Ii Tie I-tsysTa,..i,
/200„1„
USE
OWNERSHIP
❑Full-time Residence
❑Private (individual,corporation,
nonprofit institution,etc.) El Second Home: Recreation Cabin,etc.
El Public (Federal,State or local gov't.) UBC OCCUPANCY GROUP: /2-.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 P $ processing plant,machine shop,laundry building at hospital,elementary
.,"'" To be installed but not included school,secondaryschool,college,parochial school,parking
g p g 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 pj.prised use.
b. Plumbing /7 C _` e,Q f'7 7 5
c. Heating,air conditioning p���J sFr ! ' -✓ PnV
; '; ' d. Other (elevator,etc.) '/
°` • TOTAL COST OF IMPROVEMENT $
Z. III.SELECTED CHARACTERISTICS OF BUILDING -
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL DIMENSIONS
F Masonry (wall bearing) •Number of Stories
❑ 9 ❑Public or Private
❑Wood Frame •Total square feet of floor area,
❑Individual (septic tank,etc.) all floors,based on exterior
❑Structural steel dimensions
TYPE OF WATER SUPPLY
❑Reinforced concrete •Total land area,sq.ft.
❑Other—Specify ❑Public or private company _
NUMBER OF OFF-STREET
❑Individual (well,ciste,n) PARKING SPACES
' Enclosed
PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE
❑Gas Outdoors
❑Oil RESIDENTIAL BUILDINGS ONLY
❑Electricity Number of bedrooms E X/S7,,.•S/
❑Coal TYPE OF MECHANICAL
Number of Full
❑Other—Specify A/0
bathrooms
Partial Cf-/c,./yQ
IV. IDENTIFICATION -
Name Mailing Address—Number,street,city and State ZIP/code Tel.No.
1. �2JGs2T .5�2en/.I0N 3307 "e � 7 � i(
Owner C�J�/'I ,
lir J Ilcz7 42-ciA/ri_s 9tPsa -,_.. .-5-??.:.1
der ti State License No.
rn�� P) - /
3.
Architect
The owner of this building and the undersigned agree to conform to all applicable laws.
S' at f a plicant � Address (� (�\ Appli
( 7e
7
PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
APPROVED B
JEFFER^ H DEPARTMENT
APPROVED BY: PERnntr��- IS UE DATE RECEIPT NUM BE
5-0
JE. E Q TY b --- 7 /—***?' ( 3
DING ORAWAING&BLDG DEFT
pg,50 I
I he Printery—Port FTownsend
pvvED
EP 1 a 1988 -
FfIRSOF,1 COUNTY
IN,N6&f1W6 DEPT
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