HomeMy WebLinkAboutBLD1989-00039 Jefferson County Building Department.P O Box 122Q .ort Townsend . WA 9836 :;
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SPECIFIC LOCATION SITE ADDRESS / 0. l / I ,L,_,.. ))
POSTAL DISTRICT PI /SUBDIVISION
LEGAL DESCRIPTION LOT BLOCK DIVISION TAX NUMBER
PARCEL NUMBER 66 ` Y)-/ 0.5 1 1 / 4 SECTION
PLANNING AREA SECTION ! TOWNSHIP , NORTH RANGE WM
BUIL ING INFORMATION
BU LDING TYPE TY OF IMPROVEMENT SQUARE FOOTAGE
SINGLE FAMILY NEW BUILDING MAIN FLOOR
❑ MOBILE HOME ❑ ADDITION 2ND FLOOR
❑ MODULAR HOME ❑ ALTERATION BASEMENT
❑ DETACHED/ATTACHED ❑ REPAIR CARPORT
GARAGE ❑ REPLACEMENT GARAGE G
❑ WOODSTOVE ❑ WRECKING/DEMOLITION COMMERCIAL
❑ MULTI - FAMILY ❑ RELOCATION/MOVING INDUSTRIAL
NUMBER OF UNITS
MOBILE HOMES ry
❑ COMMERCIAL //-@ I�$3 5 /03 G. 0
SIZE
❑ INDUSTRIAL YEAR ' J/7�
❑ HOTEL/MOTEL/DORMITORYMAKE i/2 _cA @ ,x' //,.›2
NUMBER OF UNITS ``❑ OTHER - SPECIFY ESTIM D COST OF 0 @ $8
IMP: •VEMENTS ITOTAL FALR MARKET V,A E
UBC OCCUPANCY GRt3 p 3 $ $ r j/' ()_�/ �j/ Lf )
SELECTED CHARACTERISTICS OF BUILDING (/JJ
PR CIPLE TYPE OF FRAME PRI PLE TYPE OF HEATING FUEL
WOOD FRAME ELECTRICITY ❑ COLLECTIVE SOLAR
❑ MANUFACTURED ❑ WOODSTOVE ❑ PASSIVE SOLAR
❑ STRUCTURAL STEEL 0 GAS ❑ COAL
❑ REINFORCED CONCRETE 0 OIL ❑ OTHER - SPECIFY
❑ MASONRY ( WALL BEARING ) DIMENSIONS j`\
o
❑ OTHER - NUMBER OF STORIES / TOTAL LAND A!!EA .�.'''S�
DEPARTMENTAL REVIEW
HEALTHDEPA TM T TYPE OF SEWAGE DISPOSAL NUMBER OF PROPOSED BEDROOMSp4--/
Q ❑ XBL C OR PRIVATE NUMBER OF EXISTING BEDROOMS
tl L"�/I V i D UAL ( S E PT 1 C ) NUMBER OF PROPOSED BATHROOM /
APPRO ED DATE INDIVIDUAL WELL NUMBER OF EXISTING BATHROOM
PUD TYPE OF WATER SUPPLY
❑ PUBLIC ( NAME OF WATER SUPPLY)
APPROVED DATE ❑ PRIVATE ( NAME OF WATER SUPPLY
PLANNING DEPT . WITHIN SHORELINE JURISDICTION
O 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 ❑ YES ❑ NO
IDENTIFICATION
NAME/�,;y�� S�y-� j'� y/��,MAILING
�.ArI L I NG ADDRESSi/ JZIP�j`�,�f TEL NO
OWNER AJl'Ci J.d-W>� c J" 1 1 'lC j R""s r� ! ` �./
C SL 7 NI q
CONT
S'TATE LICENSE. NO -
ARCH
THE OWNER OF THIS BUILDING AND THE UNDERSIGNED AGREE TO CONFORM TO ALL APPLICABLE LAWS.
Sl IA LRE OF APPLIC?N APPL CATIO E RECEIPT NU ER CHECK NUMBER OR CASH
-7%7( > (_demo 6 / 1 � r 78/
P ROV, BY P RMIT FEES
a BASE FEE INSPECTION
�� BLDG SURCHARGE PLAN CHECK
JUN2 989 ENERGY SURCHARGE $ ��J"
TOTAL
JfftEfi i& LD6 D i REFUND DATE y�ATE ISSUED
PLANNJNfi&8LD&DEPT 9 1 1 NUMBER /`/-4/�^//
BUILDING OFFICIAL { la (/"
_TF:F'WF:RF C7N C C)tIT IT'V 13TTT T.T)T 1JC; T:›F:T�'ilviT `T'
Jefferson County Planning and Building DepartmentCourthouse, 3rd Floor J
PO Box 1220
Port Townsend, WA 96366
2O6-365-9141
PERMTT # •RT,rS9-0039 DATE TSSiiRT). !O6/26/Ti9
STTE AT)T)RF.SS ! 391 ARARTAN T.N
!PORT TOWNSEND, WA 98368
OWNER - SHARON PF.NT)RAS PHONE! 395-31 1 6
MAILING AT)T)R ! 391 ARARTAN LN
!PORT TOWNSENT) WA 96368
CONTRACTOR. . !OWNER PHONE.-
MATLTNO AT)T)R !
CONTR. LTC #! EXPTRATTON T)ATF.- / /
PARCF.T, NO. . . !OO1 O71 O31
T.EGAT, T)FSC. . !STR 07-30-01 WWM. TAX dt
LOT , BLOCK
T)ESCRTPTTON OF TMPROVEMF.NT! single family residence
( ) Footing/Setbacks (Shoreline Setback) /Mobile Home Blocking-
( ) Foundation -
i ) Underground Plumbing/Underground Insulation :
( ) Framing/Plumbing/Chimney!
( ) Insulation !
( ) Sheetrock:
( ) Sewage Disposal System Final :
( ) Final /Occ unancy Approval !
CALL 355-91 41 24 HOURS TN ADVANCE TO SCHEDULE. TNSPF.CTTONS .
Office Hours 9 a .m. to 5 n.m.
Inspector ' s Hours 9 - 10 a .m.
24 Hour Recorder for inspections.