HomeMy WebLinkAboutBLD1988-00432 BUILDING PERMIT APPLICATION '
Jefferson County Building 0rtment• County Courthouse •Port Townsel leash.98368 • 385-9141
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I. LOCATION: geographic name S W SIDE O� 2 RO]A.D�/ l )�J� 3 S
NE $ J ( u ( 9 S W FROM INTERSECTION OF ROAD AND 3AD
other specific location or landmark: 7hf (i Q-2')?_ fit./ '�Z�'Q'
LEGAL,4CRIPTION: S
le2A Lot Block Subdivision
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 resi.-ntial
'\" ❑Alteration number of units or commercial needs of those • ployed
K ❑Hotel,Motel, Dormitory at either the U.S.Navy's Trent or
❑Repair,replacement
number of units Indian Island Facilities?
❑Wrecking Mobile Home
/�
rl,. ❑Moving (relocation) ❑Other-Specify ❑YES LINO
l f ❑Foundation only
USE
OWNERSHIP
ull-time Residence
❑Private (individual,corporation, 0 Second Home: Recreation Cabin,etc.
nonprofit institution,etc.)
❑Public (Federal,State or local gov't.) UBC OCCUPANCY GROUP: /10--::13 CD Second Home: Future conversion to
permanent residence
COST (Omit cents.
Nonresidential- Describe in detail proposed use of buildings,e.g.,food
• Cost of improvement $ r 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 beingn changed,enter proposed use.
b. Plumbing ` �1 �//d_co
c. Heating aiFconditioning t'IC:f")'.-
_ i (17 (�l�/
d. .,2ther (elevator,etc.) Cj f-1
TOTAL COST OF IMPROVEMENT $
III.SELECTED CHARACTERISTICS OF BUILDING -
Q1 PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL DIMENSIONS I
.Q (wall bearin ► ❑ rb •Number of Stories
❑Masonry 9 Public or P ' ate- --� •Total square feet of floor area,
.k---" ❑Wood Frame indivi (septic tank2c.) all floors,based on exterior
❑Structural steel dimensions
❑Reinforced concrete TYPE OF WATER SUPPLY •Total land area,sq.ft.
❑Public or private company
c / ,`` ther-Specify Ci � ❑Individual (well,cistern) NUMBER OF OFF-STREET
(((///111 PARKING SPACES
Enclosed
PRINCIPAL TYPE O HEATING FUEL TYPE OF FIREPLACE
❑Gas Outdoors
❑Oil RESIDENTIAL BUILDINGS ONLY
Electricity Number of bedrooms
✓✓✓❑Coal TYPE OF MECHANICAL
❑Other-Specify
Number of Full
bathrooms
Partial
IV. IDENTIFICATION •
-
Nam Mailing Address-Number,street,city and State ZIP code Tel.No.
_
1. C.-Lk c,L S 3 i V�% Y fs0 if 7 7 7
Owner
r� a /r^7---
2.
Contractor State License No.
a rt,
\ 3.
- -- Architect
J j
J The owner of this building and the undersigned agree to conform to all applicable laws.
��SLgnatu f applicant Address — licatio date
-.,,,, ,fie •f7G- ' _.....-- W/7(
PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
APPROVED BY (, h / j
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JCFA' I. raFIE L»TH DEPARTMENT
APPI'I�rt E+ :•: gEFic_M ,FEE I UE DATE RECEIPT NUMBER
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AUG 1 1 19 3. s'c7 3c.i
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$UILDINI {f�QNTV C7 • a
PLANNING&BLDG DEPT
The Printery-Port Townsend
APPROVED
AHERBON COUNTY
PLANNING&GIOG OUT
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