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Home My WebLink AboutBLD1989-00015 BUILDING PERMI I- APPLICATION . Jefferson County Building artment• County Courthouse •Port Townse Vash.98368 • 385-9141 N E I. LOCATION: geographic name S W SIDE OF ROAD FEET NE �V\'R G f-lamA n S W FROM INTERSECTION OF ROAD AND � �. o I 4 ".' - ROAD other specific location or landmark: /S''y PC____ LEGAL DESCRIPTION: CAV (i E Q Lot ,--Black Subdivisiop, e 35700 01 f Tax Number Y4 Sec ion S lion Township Rang II. TYPE AND COST OF BUILDING - TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY ew dilingle Family CI New County Resident El ition LJ Multi-Family Is this structure to serve the residential number of units ❑Alteration or commercial needs of those employed ❑Repair,replacement ❑Hotel,Motel, Dormitory at either the U.S.Navy's Trident or number of units Indian Island Facilities? ❑Wrecking ❑Mobile Home Uj Moving (relocation) ❑Other—Specify DYES L�NO ❑Foundation only //RR USE OWNERSHIP Private (individual,corporation, U Full-time Residence nonprofit institution,etc.) ,Second Home: Recreation Cabin,etc. ❑Public (Federal,State or local gov't.) UBC OCCUPANCY GROUP:-/0 3 ❑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 i •eing changed,enter` '! proposed use. b. Plumbing Is .. .`4A. ;t_ 35 — / O 1+ c. Heating,air conditioning �-- %� I d. Other (elevator,etc.) g d r cu Qy —y90 I » i a • TOTAL COST OF IMPROVEMENT $ ' `� / III.SELECTED CHARACTERISTICS OF BUILDING - V/ mot/ PRINCIPAL TYPE OF FRAME I TYPE OF SEWAGE DI P ENSIGNS Masonry (wall bearing) •Number of Stories ❑ 9 PPublic or Priv a •Total square feet of floor area, �ood Frame f174lndividuptic tank,etc.) all floors,based on exterior []Structural steel ---�•-' dimensions '1 ) '-, ❑Reinforced concrete TYPE OF WATER SUPPLY •Total land area,sq.ft. ublic or private company rl 1, C'0❑Other—Specify NUMBER OF OFF-STREET ❑Individual (well,cistern) PARKING SPACES Enclosed PAIN PAL TYPE OF HEATING FUEL TYPE OF FIREPLACE ;as �G^�. Outdoors Rlil ❑Oil RESIDENTIAL BUILDINGS ONLY Y Number of bedrooms • oal TYPE OF MECHANICAL. ):ki Full f they—Sp cif Number of bathrooms Partial IV. IDENTIFICATION - • Name Mailing Address—Number,street,city and State ZIP code Tel.No. v 1. 4v,:,. 9't,2� ': 776-— Owner b _ ) _V_ Contractor State License No. -- - i J. Architect 15,tft t-ii" l)E 1(A/CA S f The owner of this building and the undersigned agree to conform to all applicable laws. iligna of ap lican/t, Addr anon to 3'7)6 4-4 PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT` �i ) f APPROVED BY /2.0V7 am JEFFER:Afp TH DEPARTMENT _ APPROVED BY: ERMIT I. E IS UE DATE is 5 /(5 RECEIPT NUMBER v ,!APR27i$UILDING O F r OPd COUNTY I .,� Ir 3 5-3s�L.A &,BLDG DEPT The Printery —Port Townsend 1 V n aq y.. 1 1 0 8 4. r .s _TF'.rF'Fi-c C3TT C:C3Ii TNT°VV- 1= 17i i.i)TTTC 'P: r' NTi ffi Jefferson County Planning and Building, Department Courthouse, 3rd F i onr PO Rox 1220 Port Townsend; WA 9R3FiRR 2O6-385-9141 PERMIT # •RT,T)R9-001 5 DATE TSSUR . - O4/2ti/r39 STTE AT)T)RF.SS - 231 N REACH T)R - PORT T,TTDT,OW, WA 98365 OWNER •CTTRTTS THOMPSON PHONE: 771 -4846 MAILING AffR - 9220 CASCAT)F. DRIVE :EDMONDS WA 98020 CONTRACTOR. . -NO CONTRACTOR PHONE ! MAILTNG AilfR - • CONTR . LTC #: EXPIRATION DATE - PARCEL NO. . . -9357000i9 LEGAT, T)ESC. . -STR WM. TAX # T,OT 20 . RT,OCK • DESCRIPTION OF IMPROVEMENT! single family residence - 0,Z_2 ( ) Fonting/Setbacks (Shur ck) /Mnhiie Home Blocking: ( ) Foundation - ( ) Underground Plumbing/Underground insulation - ( ) rFraminrr/Piumhinn/Chimney- 01G ( ) insulation ! �72 /1 /S ( ) Sheetrock - /j(/ kj 15' f p' , ru �-- ( ) Sewage Disposal System Final : ( ) Final /Occupancy Approval : 11/ `2-0 if elle= 0 57 CAT.,T, 385-9141 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS . Office Hours 9 a .m. to 5 p.m. Tnsnectores Hours 9 - 10 a .m. 24 Hour Recorder for inspections. S SHORELINE SETBACK EVALUATION APPLICANT : (P, 6,/e7-2.1_ /V/C6 /% llliUl3'✓,5 cam/ ADDRESS: 9.30)(> 'il, ''fC'dc TELEPHONE: (home ) (0260 )775--1?':74 3f (business ) ` `0C/ 7 ��' '� )71--( 6 PROPERTY DESCRIPTION PROPERTY SITE NUMBER: ILO-7- v 2 / J '< LEGAL: Owner : dedivf / ' //tornJnzt/ Address : ( 4`j' 1/jz� Tax ParceL Number: ReaL Property DescrLptLon: 1.07- f)J /)/V 2 PLn 7 c7,F — 5R I ) &F///,' vet/ , RC-cc P_) C' E-/-2 YON e r — ADJACENT WATER BODY: cG e vML (-Tyr r c•-,v x)/1.6 L/1-6.c)ciy �-� EVALUATION BLUFF HEIGHT: ~ SOURCE: 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: feet This minimum setback shaLL be measured from the bank' s edge to the most waterward edge of the proposed structure . 411 410 ❑ 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:. di-' ,r14/ 4='1 -11k X APPROVED ❑ DENIED DATE: / ete l 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 . 627-/ter p anner) (date) rt i i i i I f I Z I I i o , N i i U ' 2 d I i I� I i I I i I I 60 /STAN ¢ Pull<H Crib_ ao' //fo / 2s / s N,-i�rH (5J4-"icrr/ /_)/;/I Z- W 0 N LE(-�i)L biI1151014 /� PLY--1 6r- Hftv") RCC—AB5 C F Te-FF- fcRs�`iv couNTY