HomeMy WebLinkAboutBLD1988-00436 BUILDING PERMIT APPLICATI I
Jefferson County Built Department•County Courthouse •Port To. .nd, Wash.98368 • 385-9141
N E 1
I. LOCATION: geographic name S W SIDE OF ROAD FEET
S W FROM INTERSECTION OF ROAD AND j' ( ( O 0Ct.l(r ROAD
other specific location or landmark: 6 a /4
LEGAL DE CRIPTION:
�,{� Lot Block Su i 'fn
ki
J3 aYI Tax Number %Section Section Township Range
K II. TYPE N COST OF BUILDING -
TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY
❑ ew building 2<ingle Family ❑New County Resident
��I Addition //❑�\Multi-Family Is this structure to serve the residential
V❑(Alteration number of units or commercial needs of those employed
❑Repair,replacement El Hotel,Motel, Dormitory at either the U.S.Navy's Trident or
number of units Indian Island Facilities?
❑Wrecking ❑Mobile Home
❑Moving (relocation)
❑Other—Specify ❑YES ❑NO
❑Foundation only
USE
OWNERSHIP
❑Full-time Residence
❑Private (individual,corporation, ❑Second Home: Recreation Cabin,etc.
nonprofit institution,etc.)
!
❑Public (Federal,State or local gov't.) UBC OCCUPANCY GROUP: ` '"f--- ❑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 exis_tin. • ilding is being changed,enter' proposed use.
b. Plumbing 3O (to • rico �/ Co p,
}. ✓ g, conditioning 1 YJxa`i Q. Ico 2✓0/ lf/ 1 t/ q
" • - c. Heating,air +� n_ /
d. Other (elevator,etc.) °3' rj 2i2A71 Off'`e/ ' 0 O 0
• TOTAL COST OF IMPROVEMENT $ r`Co 1( /�''''f13 ( f01�
III.SELECTED CHARACTERISTICS OF BUILDING - Qf 9`6 Fri �(
PRINCIPAL TYPE OF FRAME TYPE OF SEW ISPOSAL DIPSO3
Masonry (wall bearing) •Number of Stories C/1�
❑ 9 ❑Public or Private
•Total square feet of floor area,
00d Frame >ndividu (septic tan ,etc.) all floors,based on exterior
❑Structural steel dimensions
❑Reinforced concrete TYPE OF WATER SUPPLY •Total land area,sq.ft 2 �r
❑Other—Specify ❑Public or private company 3,3 J
i'✓lndividu.�istern) Pr-
NUMBER OF OFF-STREET
PARKING SPACES
Enclosed
PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE
❑Gas Outdoors
��❑//Oil RESIDENTIAL BUILDINGS ONLY I tt'li� A+�
,12J..Electricity Number of bedrooms a d d i,'es
❑Coal TYPE OF MECHANICAL
LNOt Speci
Number of {Full ��
Q bathrooms
Partial
IV. IDENTIFICA ION- (3)6X
�f� •
Name iling Addrress—Numb ,str et,city and State ZIP code Tel. No.
1. V\ ND 9ES7
Owner f "47 t-f
1
"32.444 tractor �11� StYtel ice No. �1 e� M.s7 -90 73
c tare- (�(�wEG /� I� C� A-t2
3. _
Architect
The owner of this building and the undersigned agree to conform to all applicable laws.
////gnatu> 7PPlicant,,ç/7 AddressApplica oy
P NNING AREA IRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
APPROVED BYYbe / 1
//
JEFF SON COUNTY HEALTH DEPARTMENT
Alt 0:03 /4 PERMIT FEE IS UE DATE RECEIPT NUMBER
�3y
<,. ‘
MAA' 3 1988 3 ,5� _ ( �
BUI J�NgG OFFICIAL ''7, SD
` t
a�""t ER ON MAN
/
b��G KEPT The Printery—Port Townsend f
•
SHORELINE SETBACK EVALUATION
APPLICANT: )421e
ADDRESS: /3 a O 0
TELEPHONE: (home) (business )
PROPERTY DESCRIPTION
PROPERTY SITE NUMBER: Ll 3 OIdQ4 iaasi
LEGAL:
Owner : aG�+,� �r /'
Address: T 273 _old Odic.. 142, 1
Tax Parcel Number: 902// 7 C!/3
Real Property Description: f. X / cya�j 01.4. 4/ Z
Semi®k 11 J 7''2'l ) ) t&t
ADJACENT WATER BODY: C,.'1v . 73612
EVALUATION
BLUFF HEIGHT: / 5 f SOURCE: / �`/ '°`i 73/C<i A.-)
BLUFF STABILITY: SOURCE:
❑ STANDARD SETBACK: feet
This minimum setback shall be measured from the ordinary high water
mark to the most waterward edge of the proposed structure .
( BLUFF SETBACK: /OU feet
This minimum setback shall be measured from the bank' s edge to the
most waterward edge of the proposed structure .
11
❑ AVERAGE SETBACK : feet
This minimum setback shaLL be measured from the bank ' s edge to the
most waterward edge of the proposed structure. This setback is
based on the foLLowing caLcuLations of adjacent residential
structures .
Right House (facing waterward) :
• Setback from bank or ordinary high water : feet
• Distance to the proposed structure: feet
Left House (facing waterward ) :
• Setback from bank or ordinary high water : feet
• Distance to the proposed structure: feet
❑ SUBDIVISION SETBACK : feet
This minimum setback shaLL be measured from:
This setback was estabLished by the approvaL and fiLing of the pLat .
VARIANCE
REQUEST:
❑ APPROVED ❑ DENIED DATE:
ACKNOWLEDGEMENT
The above evaluation was determined on information provided by the
appLicant. ShouLd any of this information be found inaccurate, the
setback requirement may be re-evaluated .
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