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HomeMy WebLinkAboutBLD1989-00034r : --. ilk 4 BUILD , 'ERMIT APPLICATION Jefferson County Building Department•P .O . Box 1220.Port Townsend . WA 98368 r LOCATION \yy4v0- -- POSTAL SPECIFIC LOCATION SITE ADDRESS/ DISTRICT /SUBDIVISION �'� LEGAL DESCRIPTION LOT . BLOCK DIVISION 3 TAX NUMBERU PARCEL NUMBER 1 / 4 SECTION PLANNING AREA SECTION/ TOWNSHIP 2D NORTH RANGE WM • BUILDING INFORMATION BU ING TYPE TYP OF IMPROVEMENT SQUARE FOOTAGE Th m SINGLE FAMILY NEW BUILDING MAIN FLOOR `�,( ❑ MOBILE HOME 0 ADDITION 2ND FLOOR // ,• ❑ MODULAR HOME 0 ALTERATION BASEMENT ✓ t. ❑ DETACHED/ATTACHED 0 REPAIR CARPORT GARAGE 0 REPLACEMENT GARAGE �e ❑ WOODSTOVE 0 WRECKING/DEMOLITION COMMERCIAL ❑ MULTI - FAMILY 0 RELOCATION/MOVING INDUSTRIAL NUMBER OF UNITS MOBILE HOMES ❑ COMMERCIAL SIZE /444L0 a $35 4/��� ❑ INDUSTRIAL YEAR q� $ 16 ❑ HOTEL/MOTEL/DORMITORY MAKE 45'C /L- @ $S NUMBER OF UNITS ❑ OTHER - SPECIFY ESTIMATED COST OF &V 0 @ $B C '" /-X, IMPROVEMENTS TOTA AIR MARKET VALUE UBC OCCUPANCY GROUP $ 1() SELECTED CHARACTERISTICS OF BUILDING PR CIPLE TYPE OF FRAME PRIN PLE TYPE OF HEATING FUEL WOOD FRAME ELECTRICITY 0 COLLECTIVE SOLAR ❑ MANUFACTURED 0 WOODSTOVE 0 PASSIVE SOLAR ❑ STRUCTURAL STEEL 0 GAS 0 COAL ❑ REINFORCED CONCRETE 0 OIL 0 OTHER - SPECIFY ❑ MASONRY ( WALL BEARING ) DIMENSIONS .�f❑ OTHER NUMBER OF STORIES / , TOTAL LAND AREA{ • pi-- DEPARTMENTAL REVIEW H5ALT DEPARTMENT TYPE OF SEWAGE DISPOSAL NUMBER OF PROPOSED BEDROOMS -) / ' ❑ P IC OR PRIVATE NUMBER OF EXISTING BATHROOMBEDROOMS / �/ INDIVIDUAL ( SEPTIC ) NUMBER OF PROPOSED / , A PROVED DATE ❑ INDIVIDUAL WELL _ NUMBER OF EXISTING BATHROOM PUD TYPE OF WATER SUPPLY ❑ P LIC ( NAME OF WATER SUPPLY ,T APPROVED DATE PRIVATE ( NAME OF WATER SUPPLY 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 0 YES 0 NO IDENTIFICATION -- NAME MAILING ADDRESS ZIP T E L NO OWNER /yVmO /e ` ( -/ - ��3 , CONT -W- STATE LICENSI NO 1 ARCH t /// THE OWNER OF THIS BUILDING AND THE UNDERSIGNED AGREE TO CONFORM TO ALL APPLICABLE LAWS. S IS. 1/}TUR �{-AP,f'GI` rNT 1 % AT�NDATE I RE I_PT Ni1MBER CHECK NUMBER OR CASH sIIJ� t(�C�/i// / 5 ��l}—r-)r UJ� r `mil/'/� //'�I / CC SAPPRO1 B PERMIT FSZ13 / 3W /� I /, L'/(7n ����� f� BASE FEE ((((CC//// ! I NSl/P/EEC(T ION A P V I, '� BLDG SURCHARGE PLAN CHECK� AY 2 1989 //G�...J ENERGY SURCHARGE — � C�Ti J AL JEFFEM f,QUNp / 0 `— 9 1 1 NUMBER REFUND DATE r DAT ISSUED PLANNING k tugy BUILDING''C7tbftEfC1AL A r+.r c"'+ .. r=c F-7; t)iv (()T i iv" `v' 1-s T a T T.i)T 1V� 1::)Ti: c'vi T `T' Jefferson County Planning and Ru i i ri i ng Department Courthouse, .srd Floor PO Box 1220 Port Townsend , WA 98368 2O6-3A5-q 1 41 PERMIT # •RT.D8q-0034 DATE TSSUED. -05/22/Sc SITE ADDRESS - 7 1 SAN JUAN DR : PORT TOWNSEND, WA g8368 OWNER - STEVEN ANTHONYPHONE ! 883-582zs MAILING ADDR : PO BOX 1 5 1 5 PORT TOWNSEND WA 98368 I ONTRACTOR. . :NO C0NTKACTOK PHONE. MAILING ADDR : CONTR. LTC 4.! EXPIRATION DATE. - PARC:F.T. 1'VO. . . - y3A4OJOf'9 1 0 --- LEGAL DRSC. . - STR i3-30-02 WWM, TAX # LOT 10 STOCK CAPE GEORCE n T V .'S DESCRIPTION OF IMPROVEMENT: single family residence ( ) FootinaiSetnacks (Shoreline Sethack) /Mohile Home Rlockino f ) Foundation ! i tinderaround P lumhing/iinderarrnind Insulation ! ) Framing/P iumhingr/Chimney. i ) Insulation ! ) Sheetrock ) Sewage Disposal System Final : abi/4,0 ) Final /Occupancy Approval : �— - — /05p/ CALT. 555-g141 24 HOURS TN ADVANCE TO SCHEDULE INSPECTIONS . Office Hours a a .m. to 5 p. m. inspector ' s Hours y - 10 a .m. 24 Hour Recorder for inspections. • - — — 4. JQ/ �� %0 O(, - ..___i ' C � 4 { i : E i i 7 I ,P \o it OQ ? � 5 SL3 I • - , i I I �. ._ .- —; Y - w ~7 t ._ ,-_ __ _'_ __ OFF• I r *c ` -+ -_. : ,