HomeMy WebLinkAboutBLD1989-00061 r
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.7FF°�'i~ F? C)T3 C;(7TIT3'1" " WITT T-.i)T T\TC r+. : FvTTi i
Jefferson County Planning and Building Department
Courthouse, 3rd Floor
PO Box 1220
Port Townsend, WA 98368
206-:355-9141
PFRMTT # • RT,T)A9-OO6 1 DATF. TSSTJF.D. ! O7/1 9/A9
STTF ADDRESS: SOUTH CHANDLRR CT
PORT T,TJDT,OW. WA 98365
OWNF.R POPF. RFSOTJRCES PHONE ! 437-2101
MAT T,TNC-; ADDR• 6OM PARADTSF. RAY RD
STJTTF. #4
PORT T,Iifl ,OW WA 98365
CONTRACTOR. . ! SAME. AS OWNER PHONE.
MAILING ADDR -
•
CONTR. T,TC #: POPFR 1 2389 FXPTRAT T ON T)ATF: / /
PARCFT, NO. . . ,i , 7f1'1 V (D01 001 ^ ' QD2 ?, co 3- C. (2.) '"-D
T,F,r,AT, DFSC. . ! STR 1 7-2B-O 1 F.WM . TAX #
LOT 10 , BLOCK
DRSCRTPTTON OF TMPROVFMENT- multi-family unit 4-plex S , A )? C ),
( ) Footing/Sethacks (Shoreline Sethack) /Mohiie Home Rlockincp
. A_4„...„,,
e/DA/
( ) Foundation ! -
P,'--
( ) Underground Plumhincr/TJnderarnund insulation !
i c., 1 Fram i nor/P]mh i ng/Ch i mney
ki
insulation ' ,,,, ,_ v5/2.2_19-1 /. _ �y
( ) Sheetrock! 1 Z ,
( ) Sewage Disposal System Final -
( ) Final/Occupancy Annr valc
CAT,T, 385-91 4 1 24 HOURS TN ADVANCE TO Sc HFfhTT,F TNSPF.CT' S-. �.4 _ ) 0
Office Hours 9 a .m. to 5 p.m.
inspector ' s Hours 9 - 10 a .m.
24 Hour Recorder for Inspections.
13UI•ING 'ERMIT APPLICATION PLIIW f -8
Jefferson County Building Department1P :O : Box 1220.Port Townsend. WA 98368
LOCATION C� /� ri x�T� �j-) 1
SPECIFIC LOCATION SITE ADDRESS 50u t lwt-' I , Coo t `f/L P- . -' -
POST AL/ppDISTRICT /SUBDIVISION 'l AV1e netRWR I/ �� '
' _
LEGAL DESCRIPTION LOT4/ O BLOCK rDIVISION TAX NUMBER �
PARCEL NUMBER SoZ// /7- 04/ 1 / 4 SECTION
PLANNING AREA SECTION /7 TOWNSHIP pV? NORTH RANGE / E. WM
BUILDING INFORMATION
BUILDING TYPE TYPE OF IMPROVEMENT SQUARE FOOTAGE/ 7 /_
❑ SINGLE FAMILY )4 NEW BUILDING MAIN FLOOR 3Y
C�e3 -40E;
❑ MOBILE HOME 0 ADDITION 2ND FLOOR o29.42/- 9(
❑ MODULAR HOME 0 ALTERATION BASEMENT ,-
❑ DETACHED/ATTACHED 0 REPAIR CARPORT
GARAGE 0 REPLACEMENT GARAGE /gaa - A2, _
❑ WOODSTOVE ❑ WRECKING/DEMOLITION COMMERCIAL
MULTI - FAMILY ,/ ❑ RELOCATION/MOVING INDUSTRIAL
NUMBER OF UNITS L� MOBILE HOMES n /1 �7
❑ COMMERCIAL SIZE 3d034j pl $3 5 ICS 1 a . 75
❑ INDUSTRIAL YEAR c ,.4�cc�� @ $ 1 6 y7�39/360
❑ HOTEL/MOTEL/DORMITORY MAKE 111 41 $8
NUMBER OF UNITS cn�s
❑ OTHER - SPECIFY EST 1 MATED COST OF /yaa @ $8 //j 376
tr IMPROVEMENTS TO f Fi I�2�MAR 7 VALUE
UBC OCCUPANCY GROUP 4"�" . $ 3 ,y "
SELECTED CHARACTERISTICS OF BUILDING
PRINCIPLE TYPE OF FRAME PRINCIPLE TYPE OF HEATING FUEL
* WOOD FRAME A! ELECTRICITY 0 COLLECTIVE SOLAR
❑ MANUFACTURED 0 WOODSTOVE 0 PASSIVE SOLAR
❑ STRUCTURAL STEEL 0 GAS 0 COAL Z -o VARe
ElREINFORCED CONCRETE ❑ OIL y OTHER - SPECIFY ./FAQ d...
❑ MASONRY ( WALL BEARING ) DIMENSIONS
❑ OTHER - NUMBER OF STORIES TOTAL LAND AREA
DEPARTMENTAL REVIEW
HEALTH DEPARTMENT TYPE OF SEWAGE DISPOSAL NUMBER OF PROPOSED BEDROOMS g
N PUBLIC OR PRIVATE NUMBER OF EXISTING BEDROOMS
❑ INDIVIDUAL ( SEPTIC ) NUMBER OF PROPOSED BATHROOM
APPROVED DATE
❑ INDIVIDUAL WELL NUMBER OF EXISTING BATHROOM�
PUD TYPE OF WATER SUPPLY / _M1p
X) PUBLIC ' ( NAME OF WATER SUPPLY) LuD�cv t,9 f�
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 ❑ YES ❑ NO
IDENTIFICATION
NAMEp�(7/��` `\ (/� �]MAA�I�L� I�NNGG ADDRESS
� �/ ZIP TEL NO
OWNER 1 \esoarceS ( pas-yjL � � )�VK KA,. '/A y,/ ,����C/
Lai -v gAJ(OS
CONT S71Me —
Wft I 7 j97S �3 '.d.,
ARCH
THE OWNER OF THIS BUILDING AND THE UNDERSIGNED AGREE TO CONFORM TO ALL APPLICABLE LAWS. _
'S I GNAT '+DF . 1 APPL II AST >ON DATE RECE I/PT NUMBER CHECK M
NUMBER OR CAS
,,Z .-? )(,,, .-.4ti(r , CtS?)
''SAP VED BY P I,�T FEES
A v EE C ](��; BASE FEE INSPECTION
A,
a S LDG SURCHARGE PLAN CHECK
JFF " r `�' ,UC
ENERGY SURCHARGE d : ( J ) TOTAL
FERSON�COUNTY j' , $PfANNING&BLOC e ylJ
9I I NUMBER REFUND DATE I D/ESSUED
BUILDING OFFICIAL \CA., c6C1 "