HomeMy WebLinkAboutBLD1989-00013 BODING PERMIT APPLICATION
Jefferson County Building Department*P .O .rBox 1220*Pot Townsend. WA 98368
•
(LOCATION
.1-i....... %-,--i-- 2-...-----4,-- _ P
SPECIFIC LOCATION SITE ADDRESS 1 -li -_
POSTAL DISTRICT /SUBDIVISION
LEGAL DESCRIPTION LOT BLOCK DIVISION TAX NUMBER `(
PARCEL. NUMBER.O 1 / 4 SECTION t� //,�
SECTION / TOWNSHIP NORTH RANGE d(4) WM
BUILDING INFORMATION
BUILDING TYPE TYPE OF IMPROVEMENT SQUARE FOOTAGE 4/
J L INGLE FAMILY NEW BUILDING MAIN FLOOR //
✓❑ MOBILE HOME ❑ DDITION 2ND FLOOR e
• MODULAR HOME ❑ ALTERATION BASEMENT Ja.7 c
❑ DETACHED/ATTACHED ❑ REPAIR CARPORT
GARAGE ❑ REPLACEMENT GARAGE
❑ WOODSTOVE ❑ WRECKING/DEMOLITION COMMERCIAL
❑ MULTI - FAMILY ❑ RELOCATION/MOVING INDUSTRIAL
NUMBER OF UNITS (�
❑ COMMERCIAL MOBILE HOMES 1 ac7 ;'h 2 $3 5 l S-��IOIJ
❑ INDUSTRIAL SIZE ( 'vv��Jj h^�
❑ HOTEL/MOTEL/DORMITORY YEAR Ia��Q'" q� $ 16 �t/ ! ��j
NUMBER OF UNITS MAKE 0 $$
❑ OTHER SPECIFY ESTIMATED COST OF p� $8
IMPROVEMENTS
UBC OCCUPANCY GROUP (($T0%kI((/ F((�J]]''
} 2cfMARKET VALUE
SELECTED CHARACTERISTICS OF BUILDING
PRINCIPLE TYPE OF FRAME PRINCIPLE TYPE OF HEATING FUEL
WOOD FRAME ❑ ELECTRICITY 0 COLLECTIVE SOLAR
❑ MANUFACTURED *i7DSTOVE ❑ PASSIVE SOLAR
❑ STRUCTURAL STEEL ❑ COAL
❑ REINFORCED CONCRETE 0 OIL 0 OTHER - SPECIFY
❑ MASONRY ( WALL BEARING ) DIMENSIONS
n ❑ OTHER - NUMBER OF STORIESc� TOTAL LAND AREAS��
DEPARTMENTAL REVIEW
H ALTH EPARTMENT TYPE OF SEWAGE DISPOSAL NUMBER OF PROPOSED BEDROOMS er
�C -7 ❑ PUBLIC OR PRIVATE NUMBER OF EXISTING BEDROOMS
ND I V I DUAL ( SEPTIC ) NUMBER OF PROPOSED BATHROOM
APPROVED DA E INDIVIDUAL WELL NUMBER OF EXISTING BATHROOM
mansiow
J , 12D TYPE OF WATER SUPPLY
L /�J}— ❑ PUBLIC ( NAME OF WATER SUPPLY
APPROVED DATE ❑ PRIVATE ( NAME OF WATER SUPPLY)
PLANNING DEPT . WITHIN SHORELINE JURISDICTION �—
❑ YES NAME OF ADJACENT WATER BODY
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 0 YES ❑ NO
IDENTIFICATION
NAME MAILING ADDRESS ZIP TEL �NO/
OWNER 3 / 3 !, '���''c /�,-c12 1\ ft 7�7
.'-'st s P,)
CONT
i -STATE LTC_E'L SE NO I ,
ARCH
f
THE, OWNER OF THIS BUILDING AND THE UNDERSIGNED AGREE TO CONFORM TO ALL APPLICABLE LAWS;
6NA U E OF PPLICANT APPLI ATIO ATE RECEIPT NUMBER CHECK NUMBER OR CASH
le l coil� � 3.5L7s Ca ' � 75
APPR Y PERMIT/FEES ES
N'• ( Q'?'t�J D BASE FEE INSPECTION
Y� . -SZ) BLDG SURCHARGE PLAN CHECK
R 1959 ` ENERGY SURCHARGE S TOT
AL
JNNING ON GGU NTY G O` fREUNO DATEPL 917 NUMBER
BUILDING OFFICIAL /L q(C___ LG�
V7
•s
_T F F'F'F TR F;C YP4 C I C YF T r4 T V R,T T T T.T)T TT C� F 1F.i io.T T 'T'
Jefferson County Planning and Building Department
Courthouse; 3rd Floor
PO Box 1220
Port Townsend, WA 98368
206-385-91 41
PERMIT # •RT,T)89-001 3 DATE TSSTTF.T). :03/01 /90
SITE AD )RESS: 1 61 CRATG RT)
( ARDTNF.R . WA 98334
OWNER •STEVE TOPES PHONE
MAILING AT)fR • 323 1 SHERTDAN STREET
•PORT TOWNSF.NT) WA 98368
CONTRACTOR. . :NO CONTRACTOR PHONE.!
MAILING AT)T)R
CONTR. LTC #: EXPIRATION T)ATF.
PARCET, NO. . . : 902042005
LEGAT, DF.SC. . -STR WM, TAX #
LOT RT,OCTZ
DESCRIPTION OF IMPROVEMENT!
( ) Footing/Setbacks (Shoreline SPthack) /Mnhi1P HnmP R1oc:king!
( ) Foundation -
( ) Underground P i umb i ncr/TTndercrround Insulation :
( ) Framing/Plumbing/Chimney!
rg,sA/V ptvA4s
( ) Insulation ! Yin 4.,Z24 / - 0 J
( ) Sheetrock Zd 177—
,EL IA) 6a—7 1
( ) Sewage Disposal System Final :
( • . /121 O
CALL 385-9141 24 FOURS TN ADVANCE TO SCHEDULE INSPECTIONS.
Office Hours 9 a .m. to 5 p. m.
a
Inspector ' s Hours 9 - 10 a .m.
24 Hour Recorder for Tnsnpctions.