HomeMy WebLinkAboutBLD1988-00422 BUILDING PERMIT APPLICATION
Jefferson County Buildi,lepartment• County Courthouse • Port Towrl, Wash.98368 • 385-9141
N E
I. LOCATION: geographic name S W SIDE;JF ROAD FEET
NE 12I ( hef
S W FROM INTERSECTION OF ROAD AND ROAD
other specific location or landmark:
LEGAL DESCRIPTION:
Pv b Lot Block Subdivisiof Ai /
fax Number 'A Section Secti n Township Range
II. TYPE AND COST F BUILDING -
TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY
New building ❑Single Family
❑New County Resident
El 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 s? Trident or
❑Wrecking
Indian Island Facilities?
❑Mobile Home
/1 El (relocation)
❑Foundation only
4. \ Other—Specify ❑YES ❑NO
J
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OWNERSHIP 61.a 0 AX
USE
❑Full-time Residence
❑Private (individual,corporation,
nonprofit institution,etc.) ElSecond 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 s department store,rental office building,office buildin at industrial plant.
a. Electrical If use of existing building is being changed,enter pr use.
b. Plumbing 0et,'
c. Heating,ai nditioning
d. er (elevator,etc.)
TOTAL COST OF IMPROVEMENT $
III.SELECTED CHARACTERISTICS OF BUILDING -
l
PRINCIPAL TYPE OF FRAME TYPE OF SE WAG 'DI IM NSIONS
R, ❑Masonry (wall bearing) •Number of Stories
❑Public or Private--.----
ood Frame / k. •Total square feet of floor area,
I -lndivid septic tank,gtc.) all floors,based on exterior
❑
ructural steel / r i/ dimensions
ts, ❑Reinforced concrete TYPE OF WATER SUPPLY •
Total land area,sq.ft. / f�
❑Other—Specify ❑Public or private company [ ,-j
NUMBER OF STREET
t►..› ❑Individual (well,cistern) PARKING SPACES
""
Enclosed ,,
r"PRINCIPAL TYPE OF HEATING.FUEL TYPE OF FIREPLACE
❑Gas Outdoors
—.., ❑Oil
RESIDENTIAL BUILDINGS ONLY
C`' a ❑Electric'
",.t Number of bedrooms,'"
❑Coalr' TYPE OF MECHANICAL
L Other—Specify Number"of - Full
aa-tfirooms
Partial
IV. IDENTIFICATION -
Name Mailing Address— Number,street,city and State ZIP code Tel.No.
1. q Oh- F. o . /2 ux- a C,�� - 7
Owner
6)AftAr, _
• U lU 5go�S' �p -
ractor � �� Sit o�.to License No. ��� /
• 3.
Architect
The owner of this building and the undersigned agree to conform to all applicable laws.
y..,,
Sign re of applicant , Ad-16 ,4-- zApplica on d e
1i(� �� i-- �i
PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
APPROVED BY / 0.c.�,
��TI Fb- .cwcr i lc_ �J
JEFFER vfd C; NTY. HEALTH DEPARTMENT
APPIN#0:' (+ liiPERMIT FEE ISSUE DAT RECEIPT NUMBER
A. It r'�1.) -�� 3, S� j/(/
BUILDING OFFICIAL
• / RS57.0
JEFFERSON COUNTY l0s�j rt '
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April 19, 1988
Jefferson County Commissioners
Jefferson County Court House
Port Townsend , WA .
Dear Commissioners:
This letter is to request a variance in the set
back requirement for enclosing an attached carport to
a residence on Hiller Road .
The reason for the request is the carport already
exists and does not meet current set back require-
ments.
Sincerely ,
-r -7L4?
Ken Lund
Lund Construction
for
John Dugan, owner
21 Hiller Road
Hadlock, WA .
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