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HomeMy WebLinkAboutBLD1988-00421 BUILDING PERMIT APPLICATION ' Jefferson County Building Dejinent• County Courthouse • Port Townsend, h.98368 • 385-914"1 N E I. LOCATION: geographic name _ S W SIDE OF RO D FEET NE C—. S W FROM INTERSECTION OF ROAD AND _. ` ROAD other specific location or landmark: ----tart) LEGAL ES RIPTION: J 19 Lot Block Subdivisi / Cq(,, 0 U op Tax Number %Section Section Town hip Range II. TY�P�AN 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 ❑Alteration number of units or commercial needs of those employed ❑Hotel,Motel, Dormitory at either the U.S.Navy's Trident or ❑Repair,replacement number of units Indian Island Facilities? ❑Wrecking ❑Mobile Home ❑Moving (relocation) r EOily�r—Specify ❑YES ❑NO ❑Foundation only USE OWNERSHIP ❑Full-time Residence ❑Private (individual,corporation, nonprofit institution,etc.) ❑Second 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 buildis being changed,enter proposed use. b. Plumbing CA \t f, , ' c. Heating,air conditioning d. Other (elevator,etc.) • TOTAL COST OF IMPROVEMENT $ 1 III.SELECTED CHARACTERISTICS OF BUILDING - d© PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL DIMENSIO Masonry (wall bearing) !Number of Stories ❑ ❑Public or Private Wood Frame - •Total square feet of floor area, ❑ ❑Individual (septic tank,etc,) - all floors,based on exterior dimensions 0Structural steel e. 'wll TYPE OF WATER SUPPLY Reinforced concrete oc Total land area,sqft ❑Public pivate company • . ❑Other—Specify NUMBER OF OFF-STRE ❑Indfvidual (well,cistern) PARKING SPACES f— Enclosed... PRINCIPAL TYPE OF HEATING FUEL "-TYPE rOF FIREPLACE ❑Gas Outdoors" ❑Oil RESIDENTIAL BUILDINGS ONLY ❑Electricity Number of bedrooms ❑Coal TYPE OF MECHANICAL �. ❑Ot —Specify �' Number of Full bathrooms �, Partial IDENTIFICATION- Mailing Address—Number,st et,city and State ZIP code Tel.No. fSam r kiafAI 11 . 7. 3e/' Owner 70 rzwA, i,a_fre • 2. 3Sl S- 7 e - e Contractor StafL�Lrc nse No. FL. (i9g ----- 3. Architect The owner of this building and the undersigned agree to conform to all applicable laws. Xature applicant I vp Address ea s n to ff t Ce "-.12__----'- A6 PLANNING AREA FIRE Di TRICT SCHOOL DISTRICT WATER DISTRICT APPROVED BY „i f k 07� c7 JEF EER. 1t'OHEALTH DEPART ��/y'8 g APPROVED B ME IS DATEA s 1 9 /�^/(\G/�^�) RECEIPT NUMBER ��QJQENNF��,�E,,,,�RSON CO JL ����` sy -7(a ' UIt_107 Q•l0il&ra( QT . /( —(IK, N The Printery—Port Townsend •. .....................................,....... .. .....),.),.1".1..•.l,•.I;.1,...1;.•.),•.3....Y.•.1 1....),.. a •'?••:•',.•',..',•'•••',./•?,,.',•./•'••:•',•?:.• .?-.•:?..: • i...--... ....—...Z 1 •?!...?!...?!.•?!.•?!...?!.•.?.....•.? ..)"..? ..?"..?!.? 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