HomeMy WebLinkAboutBLD1989-00040 • (3uT. NC,'ERMIT APPLIC ON
Jefferson County Building Department•P .O . Box "1220•Port Townsend. WA 98368
r •LOCATION
SPECIFIC LOCATION SITE ADDRESS 65 S4(S� �� /Ae 6�d/2,6at
POSTAL DISTRICT ) y i /SUBDIVISION
LEGAL DESCRIPTION LOT BLOCK DIVISION TAX NUMBER
001 -2. ,I '? PARCEL NUMBER />1- DF/Uttl4Y V. Y/.. 671 / a SECTION 5..E., la
PLANNING AREA SECTION 3U TOWNSHIP ,0 NORTH RANGE / UV WM
BUILDING INFORMATION
BUILDING TYPE TYPE OF IMPROVEMENT SQUARE FOOTAGE
[SINGLE FAMILY [. ''NEW BUILDING MAIN FLOOR /398
❑ MOOILE HOME 0 ADDITION 2ND FLOOR '-FOC'
O MODULAR HOME ❑ ALTERATION BASEMENT
[6ETACHED)ATTACHED 0 REPAIR CARPORT
GARAGE 0 REPLACEMENT GARAGE 7 Zc
[]'"WOODSTOVE ❑ WRECKING/DEMOLITION ICOMMERCIAL
❑ MULTI - FAMILY ❑ RELOCATION/MOVING INDUSTRIAL
NUMBER OF UNITS
MOBILE HOMES /) @ $3 5 `7L/C .�-^'❑ COMMERCIAL SIZE /
O INDUSTRIAL
YEAR @ $ 1 6 To�c
❑ HOTEL/MOTEL/DORMITORY MAKE -70h S 0 a $8 72
NUMBER OF UNITS %
O OTHER SPECIFY ESTIMATED COST OF @ $8
IMPROVEMENTS SELECTED
MARKET VALUE
UBC OCCUPANCY G U�1�7 $ ( -.`oC
SELECTED CHARA TE TOTAL RJ TJ CS OF BUILDING
PRINCIPLE TYPE OF FRAME PRINCIPLE TYPE OF HEATING FUEL
Cr-WOOD FRAME [ELECTRICITY 0 COLLECTIVE SOLAR
O MANUFACTURED CaWOODSTOVE [PASSIVE SOLAR
O STRUCTURAL STEEL 0 GAS 0 COAL
O REINFORCED CONCRETE ❑ OIL ❑ OTHER - SPECIFY
O MASONRY ( WALL BEARING ) DIMENSIONS /'/).
El OTHER - NUMBER OF STORIES C7C,, , TOTAL LAND AREA
DEPARTMENTAL REVIEW' 6,)
----g-
H LT EPARTMENT TYPE OF SEWAGE D I SPOSAL NUMBER OF PROI OSED BEDROOMS_
❑ PUBL 1 C OR PRIVATE NUMBER OF EXISTING BEDROOMS
l VI ND 1 V 1 DUAL ( SEPT 1 C ) NUMBER OF PROF'OGED BATH> G__..
APPROVED DATE ❑ INDIVIDUAL WELL NUMBER OF EXISTING BATHROOM
PUD TYP '.,OF WATER SUPPLY
PUBLIC ( NAME OF WATER SUPPLY) �� -1 •
APPROVED DATE ❑ PRIVATE ( NAME OF WATER SUPPLY
PLANNING DEPT . WITHIN SHORELINE JURISDICTION
0 YES NAME OF ADJACENT WATER BODY
(_T3'N 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 0 YES 0 NO
IDENTIFICATION
NAME Q ,f MAILING ADDRESS wM ZIP TEL NO
OWNER 4BAGBA2d 5-9/G.0
libelleeP.O.P.o. i3ok I3�(o
LAuf24 F_ T- `fib. 5E0OV 0)A 98368 3135--4F67
CONT &.:(.i,q - SN tux s
¢Z Pecs Per 365-7/5‘,
TATE LICENSE NO NT ; � rub g�3v�
1PcorL�d�avro - L� F_St150Lr ...
ARCH
a..
r
THE OWNER OF THIS BUILDING AND THE UNDERSIGNED AGREE TO CONFORM TO ALL APPLICABLE LAWS.
SIG TURE OF APP (CANT AP¢'L CATIO ATE RECEIPT NUMBER CHECK NUMBER OR CASH
I
APP ED BY PERMIT FEES
A P P Ni . 9,)1' "w BASE FEE INSPECTION
� BLDGENERGY SURCHARGESURCHARGE ' CD
PLAN CHECK
' �-�.�� TOTAL
AfFtRSON GOUNTV -�`"
PLANNING&FLDG DEPT 9 1 1 NUMBER REFUND DATE I pA'j'E 1 SS D
BUILDING OFFICIAL /J(../y/yS /'
, T J„ZS, Ps* //V •
•
NcSa
Q �
QC
•
Z
N•
y0
M \
--LC) ,? ` i `I °,
w O
vas
_ o
za � I i‘46 ss� awn
tc,
1,
cr)
cti
//
q
a ( I/
° off
ti A o I
k
\
101
•
/1D
R- {
.TF:F'FW:RICIN C;C TT1Jm y RtTT T.T)T TIC-1 1PF.RMT m
Jefferson County Planning and Building Department
Courthouse, 3rd Floor
PO Box 1220
Port Townsend, WA 9R38R
206-3R5-9141
PERMIT # •BT,DR9-0040 DATE TSSUFD. :O8/0R/89
STTF ADDRESS : RR4 i CAPE (0RGF. RD
!PORT TOWNSF.NT), WA 98368
OWNER •RRTUCF. LATJRTE PHONE: 385-91 FO
MATT,TNG ADDR :PO BOX 1366 1
:PORT TOWNSF.ND WA 9R38R
CONTRACTOR . . :KFT.T,v/SHTET,DS PHONE.: 3R5-71 56
MATT,TNC ADDR :42 PROSPECT
!PORT TOWNSF.NT) WA 9838R
CONTR. T.TC #:KF.T.T.EST 1 50T.F FXPTRATTON DATE.: / /
PARCF.T. NO. . . : 001301O2R
LEGAL DF.SC. . :STR 30-30-01 WWM. TAX #
LOT . BLOCK
DFSCRTPTTON OF TMPROVFMF.NT: single family residence
( ) Footing/Setbacks (Shoreline Sethark) /Mohiip Home Blocking!
( ) Foundation :
( ) Underground P i umb i nc/Undernrnund Tnsu l a t i nn :
( ) Framincr/Plumbing/Chimney-
( ) Tnsulation :
( ) Sheetrock:
( )Sewage Disposal System Final :
( �� Final/Occupancy Approval ! —,,a crk 4/ -.2tj c4 4e'
'27‘
CALL 3R5-9141 24 HOURS TN ADVANCE TO SCHEDULE TNSPF.CTTONS .
Office Hours q a.m. to 5 p.m.
Inspector ' s Hours q - 10 a .m.
24 Hour Recorder for Tnsnections.