HomeMy WebLinkAboutBLD1988-00431 BUILDING PERMIT APPLICATION
Jefferson County BuifdinOpartment• County Courthouse •Port Town Wash.98368 • 385-9141
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I. LOCATION: geographic name S W SIDE OF OAD FEET
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S W FROM INTERSECTION OF ROAD AND LJ ROAD
other specific location or landmark:
Ot yvutp« nc:arc flo -4- ( 4,17
LEGAL DESCRIPTION: CCD CC; f Le
parcel 41- Lot Block Subdivision
Tax Number 'A Section Section Township Range
II. TYPE AND COST OF BUILDING-
TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY
''', ANew am building ❑Single Fily ❑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?
Cr ❑Wrecking
Mobile Home
❑Moving (relocation)
❑Other—Specify ❑YES ❑NO
❑Foundation only
OWNERSHIP USE
❑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 building is being changed,enter proposed use.
b. Plumbing
H1-2S ) )14 X con `sk�( ,nP`^-
c. Heating,air conditioning
r d. Other (elevator,etc.)
• TOTAL COST OF IMPROVEMENT $
III.SELECTED CHARACTERISTICS OF BUILDING -
-;,_CJ PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL DIMENSIONS
.a ❑Masonry (wall bearing) Public or Private •Number of Stories
❑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
` a.V\i) -ac--tu red ❑Individual (well,cistern) PARKING SPACES
Enclosed
PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE
❑Gas Outdoors
CI oil RESIDENTIAL BUILDINGS ONLY
QQElectricity Number of bedrooms e
❑Coal TYPE OF MECHANICAL
~.. {Full l
( Number of
t3Other—Specify
���� . f ,.,,,r �,_}_O bathrooms
1 Ve, Partial
IV. IDENTIFICATION - •
Name Mailing Address—Number,street,city and State ZIP code Tel.No.
,. Chris Cfprk P(' <I 3x 3 ( q p� -
Owner � ) f`7��10 ��(�� '
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Contractor State License No. I
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.,,,,j Architect
� ) The owner of this building and the undersigned agree to conform to all applicable laws.
Signature of applicant Address Application date
` P, 6('/ S G, t2 f `�e/tVir W4 O5/23 /88
PLANNING AREA RE DISTRICT SCHOOL DISTRICT WATER DISTRICT
APPROVED BY / .5A,•'aa,h-5,4Q ,*---
JEFFERS° COUNTY HEALTH DEPARTMENT
APPROVAD.B • PERMIT FEE ISSUE A E
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RECEIPT NUMBER
V \ICJ\ �O3Lea..)
BUILDING OFFI zIALi988 8 'vC
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PLANNING$BtDG OE- The Printery—Port Townsend ,--
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