HomeMy WebLinkAboutBLD1989-00005 iiiILDING :ERMIT APPLICATIONi
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Jefferson County Builag Department*P .O . Box 122 'ort Townsend. WA 98368
1 LOCATION , a....Lw_e__ ....,
SPECIFIC LOCATION SITE ADDRESS
POSTAL DISTRICT /S UBDIVISIION
LEGAL DESCRIPTION LOT 140 BLOCK //^�;;D��IVISION 8 TAX NUMBER
/K PARCEL NUMBER�� ,3�? C & 017 1 / 4 SECTION
PLANNING AREA
SECTION q TOWNSHIP NORTH RANG E _ WM
BUILDING INFORMATION
7/ DING TYPE TYP OF IMPROVEMENT SQUARE FOOTAGE/yam
SINGLE FAMILY NEW BUILDING MAIN FLOOR
❑ MOBILE HOME ❑ ADDITION 2ND FLOOR (r.'
❑ MODULAR HOME 0 ALTERATION BASEMENT
❑ DETACHED/ATTACHED 0 REPAIR CAR' '
GARAGE 0 REPLACEMENT 48r)
❑ WOODSTOVE 0 WRECKING/DEMOLITION COMMERCIAL
❑ MULTI - FAMILY 0 RELOCATION/MOVING INDUSTRIAL
NUMBER OF UNITS MOBILE HOMES ¢
❑ COMMERCIAL SIZE ESJ)II� p� $3 5 �D
O INDUSTRIAL YEAR �� / V @ $ 16 k iQ
O HOTEL/MOTEL/DORMITORY MAKE W @ $8
NUMBER OF UNITS LA� $8 A, '44O
O OTHER SPECIFY ESTIMATED COST OF
IMPROVEMENTS TOT A.1,R/ MARKET VALUE
UBC OCCUPANCY GROUP $ $ / "--'C(J
SELECTED CHARACTERISTICS OF BUILDING
PR NCIPLE TYPE OF FRAME PRINCIPLE TYPE9F HEATING FUEL
WOOD FRAME [tom ELECTR 1 CZ''TY ❑ COLLECTIVE SOLAR
❑ MANUFACTURED ❑ WOODSTOVE ❑ PASSIVE SOLAR
❑ STRUCTURAL STEEL ❑ GAS ❑ COAL
❑ REINFORCED CONCRETE 0 OIL 0 OTHER - SPECIFY
❑ MASONRY ( WALL BEARING ) DIMENSIONS
❑ OTHER - NUMBER OF STORIES TOTAL LAND AREA
DEPARTMENTAL REVIEW
HEALTH DEPARTMENT TYPE OF SEWAGE D I SPOSAL NUMBER OF PROPOSED BEDROOM.-J
0�PUBL I C OR PR I VAT NUMBER OF EXISTING BEDROOMS
g- 1 ND I V I DUAL ( SEPTIC ) NUMBER OF PROPOSED BATHROOM
APPROVED DATE ❑ I ND I V I DUAL WELL NUMBER OF EXISTING BATHROOM,
PUD TYPE OF WATER SUPPLY
❑ PUBLIC ( NAME OF WATER SUPPLY)
APPROVED DATE 0 PRIVATE ( NAME OF WATER SUPPLY)`.... - W__ ,. sue
PLANNING DEPT . WITHIN SHORELINE JURISDICTION
O YES NAME OF ADJACENT WATER BODY
❑ NO
APPROVED DATE BANK HEIGHT SETBACK
PUBLIC WORKS DEPT ROAD RIGHT-OF -WAY WIDTH
NAME OF PUBLIC ROAD
NAME OF PRIVATE ROAD
APPROVED DATE ROAD ACCESS PERMIT REQUIRED ❑ YES ❑ NO
IDENTIFICATION ,I
NAME
/ ' ��^ �J��//� 9�"/} YMA I L I N/G ADD ESS ZIP TEL NO/1, "/y-
OWNER � / f � 'p "r \ 1 4 0� L , Iic ./3I
l/ y ‘apmac- _A- 991,-� 3
CONT 7
,t)b. .
ARCH
I
- - -,
THE OWNER OF THIS BUILDING AND THE UNDERSIGNED AGREE TO CONFORM TO ALL APPLICABLE LAWS,
SIGNATURE OF APPLICANT AP�/7..
TE R j� 'U.,.�yR CHCR OR CASH
4/1.0414t. *
Is
APPROD a P es'$
A P P El?
ICJ BASE FEE INSPECTION
-. 3 S Q BLDG SURCHARGE PLAN CHECK
FEB22198 �� �
I6 ENERGY SURCHARGE l � � TOTAL
JEFFEHSGN COUNTY /^
PLANNING&BLDG DEPT O REFUND DATE DAT I SSU-Ws,
91 1 NUMBER � ��� vei
BUILDING OFFICIAL �
w
I.
.7 F_-i~.TR t-IrTJ C3C)TIN'-i'v .F TT i i.T)i i\ic
Jefferson County Planning and Ru i l as i ng Department
Courthouse, 3rc3 Floor
PO boX 1220
Port Townsend . WA gRSRA
206-355-9 1 4 I
PRRMTT # • rsT,fRq-OOO5 T)ATI". 'I SSITRT). : 02 %2 z�r
STT'F. A DRESS ' Iq1 ROBIN T,N
:PORT r tmT,OW. WA 98365
OWNRR •TOM W MFARA PRONF. • 36S-574
MAILING AT)T)R • 1 709 IV 1 6OTH
SFAT"'T,R WA c A i 33
CONTRACTOR . . :NO CONTRACTOR PHO)Nr'
MAT T,i NO AIIT)R
CONTR . LTC #: 'EXPIRATION i)ATF.
PARCFT, NO. . . - 9359CCOJ i 6
T,FOAT, i)F.SC . ' S-i R 09-2 7-o 1 FWM . TAX 7
LOT 16 . RT,CCK
T)FSCRTPT TON OF TMPROVFMFNT' single family residence
3 Font inn/SetnacKs (Shoreline SetC)ac:K) lMohi iP Home locking
1 Foundation .
i Underground P i umh i ng i iindergrnz)nd Insulation • •
1 ) t+ramincyriP lumC}ingiCnimney:
i Insulation .
) Sheetrock :
! SP.Wal7e Disposal System Final :
( i Final /Oocidnanc:v Approval : 02
CAi,T. 355-91 4 i 24 HOURS TN Af)VANCF TO SCHF.T)UT,F TNSPFCTTCNS .
Office Hours y a .m. to 5 p.m.
Tnsnento.rts Hours q - 10 a . m.
24 Four Recorder for inspections.
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