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Home My WebLink AboutBLD1988-00420 •.LDING ' �'ERMIT APPLICATION g Jefferson County P Buildin De artment*P .O . Box 1220eP L Townsend . WA 98358 LOCATION .� �' ' It 1 ;., a ' SPECIFIC LOCATION' SITE ADDRESS �:�...r .•-.„+ POSTAL DISTRICT L v/SUBDIVI ON \/ pc - n,rH s SOORT pwrtT LEGAL DESCRIPTION LOT,/` J BLOCK _� �y�7DIVISION TAX NUMBER S,,,_,,,,, PARCEL NUMB R /.7-lv�C7�% az;)-- 1 / 4 SECTION SECTION ' _ TOWNSHIP S NORTH RANGE ,.-� WM BUILDING INFORMATION --1 BUILDING TYPE TYPE OF IMPROVEMENT SQUARE FOOTAGE��.� ) SINGLE FAMILY NEW BUILDING MAIN FLOOR '-MOt.7I LE HOME ❑ ADDITION 2ND FLOOR 76}Q ❑ MODULAR HOME ❑ ALTERATION BASEMENT ❑ DETACHED/ATTACHED ❑ REPAIR CARPORT GARAGE 0 REPLACEMENT ` GARAGE -- ❑ WOODSTOVE ❑ WRECKING/DEMOLITION COMMERCIAL ❑ MULTI - FAMILY ❑RELOCATION/MOVING ( INDUSTRIAL NUMBER OF UNITS MOBILE HOMES ) �yJ, ❑ COMMERCIAL SIZE yC/(_0-70 @ $3 5 / .5 ❑ INDUSTRIAL YEAR /`f'?\[21 @ $ 1 6 IC / ❑ HOTEL/MOTEL/DORMITORY MAKE (ff Q@ $8 -30V1)) NUMBER OF UNITS ll S, 0 OTHER - SPECIFY ESTIMATED COST OF � a@ $8 t" - IMPROVEMENTS TOT FAIR MARKET VALUE UBC OCCUPANCY GROUP $ (-to 77 ___1 SELECTED CHARACTERISTICS OF BUILDING PRINCIPLE TYPE OF FRAME PRINCIPLE TYPE OF HEATING FUEL ' WOOD_FRAME U ELECTRICITY 0 COLLECTIVE SOLAR ❑\MANUFACTURED 0 WOODSTOVE ❑ PASSIVE SOLAR ` :. 0 STRUCTURAL STEEL 0 GAS 0 COAL ".. 0 REINFORCED CONCRETE 0 OIL ❑ OTHER - SPECIFY ❑ MASONRY ( WALL BEARING ) DIMENSIONS � 0 OTHER NUMBER OF STORIES TOTAL LAND AREA_ 1/ DEPARTMENTAL REVIEW _ HEA TH EP RTMENT TYPE OF SEWAGE DISPOSAL BEDROOMS I PUBL I C OR PR I VAT'E NUMBER OF EXISTING BEDROOMS_ N� . INDIVIDUAL ( SEPTIC ) NUMBER OF PROPOSED BATHFtOG1Ma„_CQ ` APPROVED DATE I ND I V I DUAL WELL I NUMBER OF EXISTING BATHROOM "' R b fPUD TYPE OF WATER SUPPLY A 0 PUBLIC ( NAME OF WATER SUPPLY) _ ^-,,,,„,,,„„,,,,,,„,,,,-- APPROVED DATE 0 PRIVATE ( NAME OF WATER SUPPLY PLANNING DEPT . WITHIN SHORELINE JURISDICTION 0 YES NAME OF ADJACENT WATER BODY )ci. , _, ---- NO APPROVED DATE x BANK HEIGHT " SETBACK PUBLIC WORKS DEPT ROAD RIGHT-OF -WAY WIDTH „_ ,. ._.m. NAME OF PUBLIC ROAD -..v. NAME OF PRIVATE ROAD oaA,......,...s.a.,w APPROVED DATE ROAD ACCESS PERMIT REQUIRED ❑ YES El NO ------ IDENTIFICATION NAME , MAILING ADDRESS ZIP TEL NO T `. JD/fir, f/}^�� @- J /y, 7f� �, OWNER )( P�.ACT ;6� i ! 'l/ BOX.)'7 3 B J 1f l/1�Jb k,,,�.-;i7. /83- o &Jae A 4 13a r I( j C�JJ j C O N T LUin.t2e rvnc�,.� S '-1 r'' �`s' C7 c 4JO' c.lG f STATk LIG NSE: NO __ I .._...�. !- Cr 1 f �` (11N13ctt'�l`3jd:3 rZ t m ____._ �t - 6criTiu 00 ..a i 11 1 yes _-�- THE OWNER OF THIS BUILDING AND THE UNDERSIGNED AGREE TO CONFORM TO ALL APPLICABLE LAWS, SIGNATU E OF APPLICANT APPLICATION DATE RECEIPT NUMRE. CHECK NUMBER OR CASH 40 �jj / 7AP R VED BY PERMIT FEES A P , BASE FEE INSPECTION .0 2 i2 BLDG SU:: ,,,, RCHARGE PLAN CHECK ENERGY SURCHARGE $ qq3 (JD TOTAL JEFFERSON COUNTY ""' TOTAL PLANNING&BLOC DEPT 911 NUMBER (REFUND DATE DATE ISSUED©© BUILDING OFFICIAL j� O z. --...,,..14 I) ^ >, � � rn c y0 Fa a) 2 J 7D DC J ci_ 4 g _c a) co cL y' >_uO C 7 00 F- I.-i c N O w O ..c O ^ U) J t) co Z r-1 O �Q )-) U U) F-i T 0 -H VI '4 0 C)•H Cl) +- a) C) a) U Oh W a N C E Cr al 4- W M •,- U C I A i (1) r-i 4- S •H • O Z i.1 J kg CC) _CI -4--) w O CO U) 4- +� -i-, O CO ill in F 0. U) C co C Q CL) LU m (.0 r' co +� I__ E 0 C - 1 Cr 2 r E c 3 U) CL N 4- I- 0 Cl) •r-i \O W 0 F� 0 0 cC I U) C L N w •• O cc. !4.1 O C +-) CD 0 O W - 0 3 N ') 0 ♦., •,.i C0L4- F-4U) CS "O Q S Z 1L a.v O�Z rn 'Z _C 0 Cn O O CU C ^ uU a_ ii o O (Il U) o a) Ci E C R3 C I t`t d -1 N CO Ci L F� N Q) •• F-4 0 0 •• � I- F- •• q -i 3 „ a� c a) +� +� cu rn Z Z O yt F-i C C1 a) 0 L --1 c •-i C 0 W W Z {1 (^ 4! 2 0 CO X ^ 0 4- E r--I -N E Q) O Q) 0 I Z `y v UI m 0 C U) 0 U) O as O) D L f-- L L CO I- 1- F- F. O N £ N h m 0 F-- a) ,-1 •-i C J co LL U) CL co cc c H o C • C (4- +-) > •H L CL CL CL ki o '} C• t#/ 4i 4 CO . 1 4- R) 4- U) • OOd 0 6 a7tiW W/ '- 0 ••H • f-, a) or-4 c 4- a) LU W w j�d ! y ,1 C0 W m 0 J W •r-I O 3 0 w lu h k IL � 1• P` CJ03000 Z Z Z WWH I" k? ci �fJ IY J C z o 0 0 {� J'�� J J J ktIt i g U to CY I� Z C�7 Z CD H H H �V Z Q i• ,3, 03 J g O O O O O S✓ C� flma7m d1v 3 .�� r`y O �� J T K Y 3W ,-:41 t V. vg- -.1 0 0-s * liCji:b'll'i 11. ‘i A. In .Z. 14 a * k ill V -a ,� K Z E Q Hi 3 Q.,rim LU s 4' k g_iii/ W N %I Q �'/r z Q �C" -I ,, • 0 1SI -- ) 8—rz-3 9 - -pv c L. At '17 7-0:77".."' (7 i'.- ci 5-1 3 t 1 5 Q.) -kci.64%At— Sc ILL,Ar Ci> 2_ Lai ikraic. AtL Ct..) -- 44/...e. 21' c-c--'eco q...-4.. ( c‘, ,.....,..., ..... 211 In 321oe-4,/ - - 37/37 6/76- (c,,e,"<7,„, e.,,...0„.„..,_ 0 Afr: /j ^640— C.1)i/14.1 , A _r/L f lx;,,, c .. --I-0 2_ ,z4. ..,,,._ ___ 1-- f77C-C_ o-, ( 14 1 e-orr" .&-odoekty, I - c i . , 64,1p_ 73-- s/zz.c., ea- i J Se,144,,,_ _____ ros A--tcA se ‘k-ic4;714,49 eirs, e_ Y) 11±Y • !4, 1 0 eVi" IW o'iN 41444, -..... Lir 00 L( L Algol V -J\--/--- ,-. -//2/ d - 0 fe I i ' .