HomeMy WebLinkAboutBLD1989-00049 gILDING , 'ERMIT APPLICATION
Jefferson County Builog Department•P .O . Box 122'ort Townsend. WA 98368
LOCATION S v /4 ,1%//ii A 43-e'D
SPECIFIC LOCATION SITE ADDRESS /
POSTAL DISTRICT- //L_ /SUBDIVISION (�
LEGAL DESCRIPTION LOT BLOCKK DIVISION TAX NUMBER A`-"
PARCEL NU?�/BE�ER P7�c,.( 003 f 1 / 4 SECTION /
SECTION ( /f TOWNSHIP1f5 • NORTH RANGE / . WM
BUILDING INFORMATION `�--�T
BUILDING TYPE TY E OF IMPROVEMENT SQUARE FOOTAGE di
SINGLE FAMILY NEW BUILDING MAIN FLOOR 3-26
7o MODILE HOME ADDITION 2ND FLOOR
❑ MODULAR HOME 0 ALTERATION BASEMENT
❑ DETACHED/ATTACHED 0 REPAIR CARPORT
GARAGE 0 REPLACEMENT GARAGE
❑ WOODSTOVE 0 WRECKING/DEMOLITION COMMERCIAL
❑ MULTI - FAMILY 0 RELOCATION/MOVING INDUSTRIAL
NUMBER OF UNITS
❑ COMMERCIAL MOBILE HOMES /
❑ INDUSTRIAL SIZE S�6 a1. $35 �U/ lUU
❑ HOTEL/MOTEL/DORMITORY YEAR $ 16
NUMBER OF UNITS MAKE $8
❑ OTHER - SPECIFY ESTIMATED COST OF 0 @ $8
IMPROVEMENTS TOTAL FAIR MARKET VALUE
UBC OCCUPANCY GROUP $ $
/G^3
SELECTED CHARACTERISTICS OF BUILDING
PRINCIPLE TYPE OF FRAME PRINCIPLE TYPE OF HEATING FUEL
WOOD FRAME W ELECTRICITY 0 COLLECTIVE SOLAR
MANUFACTURED Q WOODSTOVE 0 PASSIVE SOLAR
❑ STRUCTURAL STEEL 0 GAS 0 COAL
❑ REINFORCED CONCRETE 0 OIL 0 OTHER - SPECIFY
❑ MASONRY ( WALL BEARING ) DIMENSIONS /J
❑ OTHER - C
NUMBER OF STORIES 7 TOTAL LAND AREA CDEPARTMENTAL REVIEW 3u,4 /a_c, JeS/rHEALTH DEPARTMENT TYPOF SEWAGE D SPOSAL NUMBER OF PROPOSED BEDROOMS
/ 1 r 2./3 I68 0 PUBL I C OR PRIVATE NUMBER OF EXISTING BEDROOMS
1 ND I V I DUAL ( SEPTIC ) NUMBER OF PROPOSED BATHROOM
APPROVED DATE ❑ I ND I V I DUAL WELL NUMBER OF EXISTING BATHROOM
wiessaI
PUD TYPE OF WATER SUPPLY
0 PUBLIC ( NAME OF WATER SUPPLY) �' // 1
�PPROVED DATE 0 PRIVATE ( NAME OF WATER SUPPLY (i(J r-d/
PLANNING DEPT . ___—WITHIN SHORELINE JURISDICTION
0 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
PROVED DATE ROAD ACCESS PERMIT REQUIRED 0 YES 0 NO
IDENTIFICATION
NAME MAILING ADDRESS ZIP TEL NO
OWNER n
�re7fi jEccryM0�Q Ps() l1/G/69
1/ c /�a{4D P/l_ IFP..3Cos 732
CONT 0(J3r1
STATt LICENSC NO 1
ARCH
•
THE OWNER OF THIS BUILDING AND THE UNDERSIGNED AGREE TO CONFORM TO ALL APPLICABLE LAWS;
Si NAURE OF - - ICENT APPLIC IO DATE RECEIPT NUMBER CHECK NUMBER OR CASH
�I '/ D A. r 4. A m onV (2- za�88 3GQ 5 .) _�c.'
APPROV), -iiiik PERMIT FEES
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r� '' -•
,,,,,m �` - BASE FEE -- I NSPECT I ON
A v ,�t `� J BLDG SURCHARGE PLAN CHECK
Jo N 1 ' 19B9 -"\ l S dJ ENERGY SURCHARGE $ 'z 3
TOTAL
JEFFERSON COUNTY —
M r,p Ai^ &SIDG OFPT 9 1 1 NUMBER J REFUND DATE /[(/�/ /J�
-ATE, 1 SSUED
BUILDING OFFICIAL
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Jefferson County Planning and Building Department
Courthouse, 3rd Floor
PO Box 1220
Port Townsend, WA 98388
20E -AR5-q i 41
PERMIT # •RT,DRq-0O4q DATE ISSUED. :06iiq!Sq
SITE ADDRESS : 850 NO NAMF. RD
PORT LTJDT.OW. WA 9R385
OWNER • SCOTT RTCHMONT) PHONE: 732-4157
MAILING ADDR : 850 NO NAME RD
PORT T,UDT,OW WA gA365
CONTRACTOR . . -NO CONTRACTOR PHONE :
MATT.TN(, ADDR :
CONTR . LTC #: EXPIRATION DATE!
PARCET, NO. . . - R21 OFi3O21
LEGAT. DESC . . :STR WM. TAX #
LOT BLOCK
DESCRIPTION OF TMPROVF.MENT- single family residence
( ) Footing/Setbacks (Shoreline Sethack) /Mobile Home Blockina:
( ) Foundation :
( ) TJndernround Plumbing/Underground Insulation !
( ) Framing/Plumbing/Chimney:
( ) Insulation :
( ) Sheetror.k
( ) Sewage Disposal System Final :
( ) Final /Occupancy Approval :
CALL :385-g141 24 HOURS TN ADVANCE TO SCHEDULE INSPECTIONS.
Office Hours 9 a .m. to 5 p.m.
Inspector ' s Hours q - 10 a .m.
24 Hour Recorder for Inspections.
APPR
JEFFERSON COUNTY
Pt ANNIOiS&SLOG DEPT
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