HomeMy WebLinkAboutBLD1989-00033! .. .
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[3UI :NG ERr1iT APPLICATION
Jefferson County Building Departmentsr .O . Box 1220*P110 Townsend . WA 98368
LOCATION �C,-�tr:of l/l
SPECIFIC LOCATION SITE ADDRESS 1
POSTAL DISTRICT_/SUBDIVISIOI
LEGAL DESCRIPTION LOT BLOCK DIVISION TAX NUMBER-
'") PARCEL NUMBER ('")f)/ d7 - c'I 1 / a SECTION
PLANNING AREA :, �J
SECTION -7 TOWNSHIP, 2j() NORTH RANGE /I/O WM
BUI ING INFORMATION
BU LDING TYPE TYP OF IMPROVEMENT SQUARE FOOTAGE%�
SINGLE FAMILY NEW BUILDING MAIN FLOOR
53
❑ MOBILE HOME 0 ADDITION 2ND FLOOR / 1 7
❑ MODULAR HOME ❑ ALTERATION BASEMENT lC - -�-----
CARPORT
❑ DETACHED/ATTACHED 0 REPAIR
GARAGE 0 REPLACEMENT GARAGE 8
❑ WOODSTOVE 0 WRECKING/DEMOLITION ( COMMERCIAL
❑ MULTI - FAMILY 0 RELOCATION/MOVING INDUSTRIAL
NUMBER OF UNITS MOBILE HOMES /r,Q�
❑ COMMERCIAL S I ZE /-y�� Cl� $3 5 tttL//l./
❑ INDUSTRIAL YEAR J@ $ t 6 J P c;3oo
❑ HOTEL/MOTEL/DORMITORY MAKE VI @ 14 /6 a
NUMBER OF UNITS �'
❑ OTHER SPECIFY ESTIMATED COST OF $8 6
IMPROVEMENTS TOTAL FAIR MARKET VALUE
UBC OCCUPANCY GROUP 3 $ $ vs,--'/
SELECTED CHARACTERISTICS OF BUILDING
PRIN IPLE TYPE OF HEATING FUEL
PRI IPLF_ TYPE OF FRAME
WOOD FRAME LECTRICITY 0 COLLECTIVE SOLAR
❑ MANUFACTURED 0 WOODSTOVE ❑ PASSIVE SOLAR
❑ STRUCTURAL STEEL 0 GAS 0 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 DISPOSAL NUMBER OF PROPOSED BEDROOMS ,--
5��� ❑ P 1 C OR PRIVATE NUMBER OF EXISTING BEDROOMS
1 D I V I DUAL ( SEPTIC ) NUMBER OF PROPOSED BATHROOM''
APPROVED DATE P INDIVIDUAL WELL NUMBER OF EXISTING BATHROOM
PUD TYPE OF WATER SUPPLY
O PUBLIC ( NAME OF WATER SUPPLY)
APPROVED DATE 0 PRIVATE ( NAME OF WATER SUPPLY , .
PLANNING DEPT . WITHIN SHORELINE JURISDICTION
❑ YES NAME OF ADJACENT WATER BODY
O
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
-��"^ MAILING ADDRESS _ Z I P TEL E L NO
11NAME�/,D l /�����"�!I /� rYJ 1 1)'•�'
OWNER / //4,1 /l r 3& aa,C Y3 41e_,/ < ) 130-0
k
CONT ,
SrATE LIEENSL NO
ARCH t
HE OWNER OF THIS BUILDING AND THE UNDERSIGNED AGREE TO CONFORM TO ALL APPLICABLE LAWS.
Tt.+ TL,T1 pF° APPLICANT APPLICA O ATE 1 R EIP R I CHECK NU ER OR CASH
APP- D cif\Y i('t PERMIT F S
A P 0 (t22I • ��BASE FEE I NSPECT 1 ON
WY 11 -CJ BLDG SURCHARGE PLAN CHECK
/�• OOENERGY SURCHARGE $t & / ) ' "TOTAL
JEFFERSON COUNTY •P VVV
PLANNING&BLDG DEPT 911 NUMBER REFUND DATE 1 DA E SSUED
BUILDING OFFICIAL
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'W T'.7-c �C-3 iv t.7 i 7 'e- i:► 1- i.i) i TV it r. r=c Fvi i s
Jefferson County Pinning and Building T3enartment
Courthouse . 3rd Floor
Pi) Box 1220
Port Townsend . WA y8.s65
206-385-9141
PF.RMTT # • RT,Rq-OO.z3 DATE. T SSTTF.T). • O5IO2/Rg
SITE ADDRESS • 350 i HASTTNGS AVE W
" PORT TOWNSENT) . WA gF3FF
OWNER • PH T T, HARVEY PHONE.• 85-i .s20
MAILING AilfR • :SRO i FASTING AVE W
:PORT TOWNSF.NI) WA y5.36R
CONTRACTOR. . •NO CONTRACTOR PHONE •
MATT,TNcG ADDR :
•
CONTR. LTC #- F.XPTRATTON DATF. •
PARC;ET, NO. . . • OO i O720 i i
LEGAL DESC. . • STR O7-3O-0 i WWM. TAX
TOT FLOCK •
RSCRTPTTON OF IMPROVEMENT: single family residence
i Footing/Sethacks (Shoreline Sethack) /Mnhile Home Rinckincr•
i Foundation :
i i Underground PiumhingiTTndercground Insulation :
T FramingrPiumhing Chimney•
- � P fir� vc i 1_ i_.1--t-)�ii_ 1
( f „,Tnsulation - �j � s/ . ✓� j
i / 1 fi tr • if
9-p
; Sew ge Disposal System Final :
F i na 1 i Occupancy Annrova i • /, (4[.
CALL . 85-y i 4 i 24 HOURS TN ADVANCE. TO SCHF,DTTT,F. T NSPM.CTTONS.
Office Hours q a .m. to 5 p.m.
inspector ' s Hours q - 0 a .m.
24 Hour Recorder for inspections.
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