HomeMy WebLinkAboutBLD1989-00047 BODING 'ERMIT APPLICATION
Jefferson County Building DepartmentoP .O . Box 1220OI-Trt Townsend, WA 9836;;
LOCATION
SPECIFIC LOCATION SITE ADDRESS (4:Z l/r✓ F , 1 f3 d-6 ) ( ), ��71
POSTAL DISTRICT N y/SUBDIVISION ii�� ��
LEGAL DESCRIPTION LOT BLOCK r� DIVISION TAX NUMBER,2.5
PARCEL NUMBER 02 t �3 3 ( C.F 1 / 4 SECTION
PLANNING AREA SECTION 3'3 TOWNSHIP e-3 Q NORTH RANGE ( F, WM
BUILDING INFORMATION
" !,DING TYPE TYPE OF IMPROVEMENT SQUARE FOOTAGE
- SINGLE FAMILY › NEW BUILDING MAIN FLOOR �_ . ...
A.J .MOfI LE HOME 0 ADDITION 2ND FLOOR
❑ MODULAR HOME ❑ ALTERATION BASEMENT
❑ DETACHED/ATTACHED ❑ REPAIR CARPORT
GARAGE ❑ REPLACEMENT GARAGE;511OP
❑ WOODSTOVE ❑ WRECKING/DEMOLITION COMMERCIAL
❑ MULTI - FAMILY ❑ RELOCATION/MOVING INDUSTRIAL
NUMBER OF UNITS
❑ COMMERCIAL MOBILE HOMES
SIZE .---- ' 4+.3 a - -v-y--
❑ INDUSTRIAL
YEAR fj ,
❑ HOTEL/MOTEL/DORMITORY MAKE �•, //a � ai $g6 -.0
NUMBER OF UNITS 4.-- ' J
OTHER SPECIFY 8
\( EST 1 MATED COST OF
.� ( ``(' k7t: r I IMPROVEMENTS TOTAL Fn .a hdARF$E,T, �Y„ALUE
UBC OCC�PANCY O-H`
SELECTED CHARACTERISTICS OF BUILDING /oX� i
PRINCIPLE TYPE OF FRAME PRINCIPLE TYPE OF HEATING FUEL
WOOD FRAMEELECTRICITY ❑ COLLECTIVE SOLAR
❑ MANUFACTURED WOODSTOVE ❑ PASSIVE SOLAR
❑ STRUCTURAL STEEL ❑ GAS ❑ COAL
❑ REINFORCED CONCRETE ❑ OIL 0 OTHER - SPECIFY
❑ MASONRY ( WALL BEARING ) DIMENSIONS
❑ OTHER - NUMBER OF STORIES_ TOTAL LAND AREA
DEPARTME AL REVIEW
HEALTH D PARTMENT TYPE OF SEWAGE DISPOSAL NUMBER OF PROPOSED BEDROOMS `
❑ PUBLIC OR PR1VATENUMBER OF EXISTING BEDROOMS
❑ INDIViDUAL ( SEPTIC ) NUMBER OF PROPOSED BATHROOM 1....„
APP Z:AT7
❑ INDIVIDUAL WELL NUMBER OF EXISTING BATHROOM
7
PUD TYPE OF WATER SUPPLY
❑ PUBLIC ( NAME OF WATER SUPPLY)
APPROVED DATE ❑ PRIVATE ( NAME OF WATER SUPPLY
PLANNING DEPT . W THIN SHORELINE JURISDICTION
YES NAME OF ADJA ENT rYATEIODY
t1 T J Ls>--�ca --
❑ 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 ❑ YES ❑ NO
IDENTIFICATION
r
NAME MAILING ADDRESS ZIP TEL NO
OWNER
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CONT �"�P,1-
S'!ATE L1CkNSE NO i c_____..x.y....2____;)
ARCH
r
THE OWNER OF THIS BUIL ING AND THE UNDERSIGNED AGREE TO CONFORM TO ALL APPLICABLE LAWS.
L APPICANTS
rl:ar7NO APPLICATION DATE RECE1PT0NUMBER CHECK NUMBER OR CASH
APP • BY PER 1 FEES
A P V _ C/ 1 BASE FEE INSPECTION
JU �V BLDG SURCHARGE PLAN CHECK
1
ENERGY SURCHARGE c,, f f ��
.tea d `JEFFERSON COUNTY c TOTAL
[7 -_.,—
PLANNING&SLOG DEPT
9 7 1 NUMBERMNUMBERREFUND DATE 1 AT I S r,•
BUILDING OFFICIAL �. (,,
.TF.F1r'F.RSC7N C;CM"N'T'iT RtJT T".T)T NC, R1 TVTT 'T'
Jefferson County Planning and Building Department
Courthouse; 3rd Floor
PO Box 1220
Port Townsend; WA 953R5 1
206-385-9141
PFRM T T # •RT.ffi9-0047 T)ATF TSSUFD. -Of /23/89
STTF ADDRFSS : 2860 F MARROWSTONF. RD
NORDT.AND . WA 98355
OWNFR •MTKF THORNTT,F.V PHONF
MATT,T NC AffR , 2A60 F MARROWSTONF Rn
NORDT,AND WA 9835B
CONTRACTOR. . :NO CONTRACTOR PHONE :
MATT.TNO AffR
CONTR . LTC #: F.XPTRATTON DATE.
PARCFT, NO. . . -021332015
LEGAL DFSC. . ' STR 33-30-01 FWM. TAX #
LOT BLOCK
T)F.SCRTPTTON OF TMPROVFMFNT —
( ) Footing/Setbacks (Shoreline Setback) /Mohiie Home Blocking!
( ) Foundation
( ) Underground Plumbing/Underground Tnsu i at i on -
( ) Framing/Plumbing/Chimney-
( ) Tnsulation :
( ) Sheetrock :
( ) Sewage Disposal System Final !
( )C.i..4frn'T70ccunancy Annrova l • .. sc...e 9 e0/1-1.41g2
CALL 355-9 1 41 24 HOURS TN ADVANCE TO SCHFT)TIT.F. TNSPFCTTONS.
Office Hours 9 a . m. to 5 p. m.
Tnsnector ' s Hours 9 - 10 a .m.
24 Hour Recorder for inspections.
Include the following items on your plot plan:
o Property boundaries 0 Weils
o Names of adjacent streets ❑ Septic tank
P ,
❑ Driveways and parking spaces ❑ Drainfield (enter NN if unkno
wn)
o Surface water(ponds,creeks, etc). o North Arrow
❑ Buildings(residence, sheds, garages, etc)
PLOT PLAN •
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• 1612 Hastings Ave. W.
Port Townsend, WA 98368
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