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HomeMy WebLinkAboutBLD1989-00024 9 BUILD 'ERMIT APPLICATION >eP .O . Box 1220IPorttownsend' WA 98368 � efferson County Building Department f n LOCATION � �� SPECIFIC LOCATION' SITE ADDRESS � �_ 7 �°� 1401& POSTAL DISTRICT �„r,--- /SUBDIVISION `i' LEGAL DESCRIPTI N LOT 7.= BLOOC�K DIVISION 6 TAX NUMBER \ PARCEL NU,M < C� J 4 SECTION PLANNING AREA SECTION TOWNSHIP NORTH RANGE WM BUILDING INFORMATION BUILDING TYPE TYPE OF IMPROVEMENT SQUARE FOOTAGE ❑ SINGLE FAMILY EJ-'NEW BUILDING MAIN FLOOR ❑ MO1711LE HOME 0 ADDITION 2ND FLOOR OME ❑ ALTERATION BASEMENT DETACHED 'ATTACHED 0 REPAIR CARPORT y GARAGE' 0 REPLACEMENT GARAGE ❑ WOODSTOVE 0 WRECKING/DEMOLITION ( COMMERCIAL �,,... ❑ MULTI - FAMILY ❑ RELOCATION/MOVING INDUSTRIAL NUMBER OF UNITS MOBILE HOMES ❑ COMMERCIAL SIZE 0@ $3 5 O INDUSTRIAL YEAR !] @ $ 16 ❑ HOTEL/MOTEL/DORMITORY MAKE @ $8 NUMBER OF UNITS ❑ OTHER - SPECIFY ESTIMATED COST OF 0 2 $8 IMPROVEMENTS TOTAL FAIR MARKET VALUE UBC OCCUPANCY GROUP $ $ SELECTED CHARACTERISTICS OF BUILDING PRINCIPLE TYPE OF-- FRAME PRINCIPLE TYPE OF HEATING FUEL a WOOD FRAME 0 ELECTRICITY 0 COLLECTIVE SOLAR ❑ MANUFACTURED 0 WOODSTOVE 0 PASSIVE SOtAiR ❑ STRUCTURAL STEEL 0 GAS .0-COAL ❑ REINFORCED CONCRETE 0 OIL - -''^ j❑ OTHER SPECIFY O MASONRY ( WALL BEAR 1 NG ) -=" "DIMENSIONS 4--)`E ?� ft ❑ OTHER NUMBER OF STORIES TOTAL LAND AREA DEPARTMENTAL REVIEW HEALTH DEPARTMENT TYPE OF SEWAGE DISPOSAL NUMBER OF PROPOSED BEDROOMS 0 PUBLIC OR PRIVATE NUMBER OF EXISTING BEDROOMS , ®' INDIVIDUAL ( SEPTIC ) NUMBER OF PROPOSED BATHROOM APPROVED DATE ❑ INDIVIDUAL WELL NUMBER OF EXISTING BATHROOM, PUD TYPE OF WATER SUPPLY ❑ PUBLIC -( NAME OF WATER SUPPLY) APPROVED DATE 0/ PRIVATE ( NAME OF WATER SUPPLY :" ' . Ch - ?per %n{m(_m4,1 PLANNING DEPT . WITHIN SHORELINE JURISDICTION O YES NAME OF ADJACENT WATER BODY D NO APPROVED DATE BANK HEIGHT SETBACK PUBLIC WORKS DEPT ROAD RIGHT-OF -WAY WIDTH .._... NAME OF PUBLIC ROAD Lly I-- C ;gal <.b `f NAME OF PRIVATE ROAD (J APPROVED DATE ROAD ACCESS PERMIT REQUIRED ❑ YES ❑ NO IDENTIFICATION NAME MAILING ADDRESS Z I P T E L NO OWNER / L A / Ida/#b e 1 -- I �- - ,� � COf�i�lfd>` T. �:uC1 ���i✓> ,GG)1 s? 9/7 CONT <c,a,-7e et.,,,, STA'1 L L I CENSE NO e9.&)f I- ARCH _.. THE OWNER OF THIS BUILDING AND THE UNDERSIGNED AGREE TO CONFORM TO ALL APPLICABLE LAWS. S WIATURE O�L I CA SIT APPLICATION DATE RECEIPT. NUMBER CHECK NUMB,ER,.,.OR CASH APPROVED BY PERMIT FEES \ 1 BASE FEE INSPECTION LDG SURCHARGE PLAN CHECK APR 1 4 ENERGY SURCHARGE s 7s� SOTOTAL JEFFERSON COUNTY 9 I I NUMBER REFUND DATE DAT I D pi_!n;p11Nf, 3l G D E! BUILDING WAIAL .1 , / 7 4 • C7CITITNT'T':-,7 P`F:RFv1T m Jefferson County Planning and Ruilding Department Courthouse; 3rd Finor PO Rnx 1220 Port Townsend : WA 9R3 R 206-3R5-9 i 4 i PFRMTT # •RT.DR9-0O24 DATF. T SSUF.D. : O4/i 4/€ 9 S T TF. ADDRESS : 1 i O FAO T,F V T F.W T,N :PORT LUDLOW, WA 98365 OWNFR • DANT F.T, RROTHFRTON PHONF : MATT,TNO ADDR : 2n i NORTH RF.ACH DR PORT LUDLOW WA 98365 CONTRACTOR. . :NO CONTRACTOR PHONF: MATLTNO ADDR : CONTR . LTC St: F.XP T RATTON DATF PARCFT. NO. . . : 9354O0019 T,FGAT, DF.SC . . : STR OR-27-01 F.WM, TAX TOOT 9 , BLOCK • RRTDOEHAVF.N DFSCRTPTTON OF TMPROVFMFNT: detached garage i Font incr/Sethacks (Shoreline Sethack) /Mohi ie Home Riockincg: i Foundation : • i Underground P l umh i ng/Undernround Tnsu i at i nn i i Fram iri umh i ng/ h i mnev: l ) Insulation : i Sheetrock : i Sewage Disposal System Final : 1 Final /Ocotnancv Annrovai • `7 ._...__.5_it_ ._ ____ __._. CAT,T, 385-a 1 4 i 24 HOURS TN AD V ANCF. TO SCHFDULF. TNSPFCT T ONS. Office Hours 9 a . m. to 5 p.m. Tnsnectoris Hours q - 10 a .m. 24 Hnur Recorder for Inspections. i ha ue.�- `I 5/6 , 3 ''/8 Y ROOF RAFTER DIMENSION DIAGRAM Sces.L E �4aL� SIZE L� -v 12 LO L14'-o'I v n �J tA _ y — ~ r 11 If '^ 2-2"slo^ hIEADEtz ^� 3i1 3I-oVr" IYr" Ito'- q'/411 pANeL "o'I 2u'-o'l fit LOFT FLO( Sc-o 2 PLAN Vil gq _Oi I J N W — 7 14, L� 4 ,� a 1 I �J 4- Zii,4i, Fob m I = � NEnGER SJ bPOi!T Q sTL, coL, G1/2 Js: W = I 7 a. o IL d a/ a c+ W 0 j i � q'-o" c '1''0° OVEkI-VEAD �I r ' SE'G'jiold6L px�� �l/ Z • Z"< Iz': 01 VzUI&PcR L wJBL °C1 FIRST FLOOR Sea. Lra 3 T I'-4 q'-4AL LAN NT RAY," �yZp F16L µ pucL 'J' "LAN 6 61 P- 2024 SHEET 4 = I,�_. TOTAL 5