HomeMy WebLinkAboutBLD1989-00067 •
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Jefferson County Planning and Ru i i c3 i nca Department
Courthouse, 3rd Floor
Pit Box 1220
Port Townsend , WA 98368
706-385-9 i 41
PHRMT'T # • RT,ilR9-OOf 7 DATE T SSTTFr). • 08!3i1/A9
SITE AT)i1RESS • 52 7TH AVE
PORT HAr1T.i)CK . WA 98339
OWNN.F •CHERYL i.ARCON PHONE : 3R5-4g02
MATT.TNC AililFr : Pn Box 795
PORT HAi1T.i1CK WA 98339
CONTRACTOR . . -Nil CONTRACTOR PHONE :
MA T T T NG A I r l R S
CONTR . T.T C #• FXP T RATTON r1ATF.
PARCF.T. NO. . . : 9n 1 800- i}5
LEGAL TWSC . . : STR 34-30-0 i WWM. TAX #
LOT BLOCK TRONT)AT,R
T)FSCRTPT T ON OF TMPROVF.MFNT • single family addition
i Footing/Setbacks (Shoreline Setback) /Mobile Home Rinckina
) Foundation :
; Tinc1ergrnunc3 Piumhing/TTndernrounc3 Tnsulatinn -
i Framing/Piumhinr/Chimney-
{ ) Insulation :
i She.etrock :
( ) Sewage Disposal System Final :
J Flna cc'uaancv Annrcer --
T""a!?:/
CALT. 325-91 41 24 HOURS TN ADVANCE TO SCHF.Tii3T,R TNSPFCTTONS . •
Office Hours 9 a . m. to 5 p.m.
Inspector ' s Hours 9 - in a . m.
24 Hour Recorder for inspections.
LAVING , ERMIT APPLICATION
Jefferson County Building Department0P .O . Box 122OePort Townsend, WA 98368 .
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SPECIFIC LOCATION SITE ADDRESS 67-. 'r----.,,.-7 ,,,"-e--e-4—i-\
POSTAL DISTRICT /SUBDIVISION _L-/-7
LEGAL DESCRIPTION LOTSZ22x LOC
6 DIVISION TAX NUMBER
. _ 4( PARCEL NUMBE 0 / A SECTION
PLANNING AREA SECTION 0SHIP NORTH RANGE_ WM
BUILDING INFORMATION
_ -
BUILDING TYPE TYPE OF IMPROVEMENT SQUARE FOOTAGE
tlt
1p MOBILE HOME ADDITION elpg
r,-- .SINGLE FAMILY N B/-*----F
\--- 0 EW UILDING ,
( (:;?) Xq MAIN FLOOR
2ND FLOOR 4
O MODULAR HOME 0 A .TERATION BASEMENT
O DETACHED/ATTACHED , 0 REPAIR CARPORT
GARAGE 0 REPLACEMENT GARAGE
O WOODSTOVE 0 WRECKING/DEMOLITION COMMERCIAL
O MULTI - FAMILY 0 RELOCATION/MOVING INDUSTRIAL
NUMBER OF UNITS ,,,---
MOBILE HOMES ,, ,,,,,,,,'' j a $35
D COMMERCIAL
SIZE
O INDUSTRIAL
YEAR -- --("" i ci) $ 1 6
O HOTEL/MOTEL/DORMITORY
MAKE - q 0
NUMBER OF UNITS -
O OTHER - SPECIFY M EDCO 0 2 $8
ESTIST OF
IM OVEMENTS T R MARKET VALUE
UBC OCCUPANCY Gno ' $
SELECTED CHARACTERISTICS OF BUILDING
i P NCIPLE TYPE OF FRAME PRINCIPLE TYPE OF HEATING FUEL
a 000 FRAME ( ELECTRICITY 0 COLLECTIVE SOLAR
i0 MANUFACTURED 0 WOODSTOVE 0 PASSIVE SOLAR
0 STRUCTURAL STEEL 0 GAS 0 COAL
O REINFORCED CONCRETE 0 OIL 0 OTHER - SPECIFY
----
O MASONRY ( WALL BEARING )
DIMENSIONS
0 OTHER - , _ , 1 NUMBER OF STORIES TOTAL LAND AREA
DEPARTMENTAL REVIEW
HEALTH DEPARTMENT TYPE OF SEWAGE DISPOSAL NUMBER OF FROPOSED BEDROOMS ......6..
gi-459 , c 0 PUB L I C OR PR I VAT E NUMBER OF EXISTING BEDROOMS ifiv-7'
„....4 A,(
c"..)4_!NDIVIDUAL PEPTIC ) NUMBER OF PROMYSED BATHROOM
. -
APPROVED DATE ' 0 INDIVIDUAL WELL — NUMBER OF EXISTING BATHROOM
PUD T PE OF WATER SUPPLY
PUBLIC ( NAME( NAME OF WATER SUPPLY)
APPROVED DATE 0 PRIVATE ( NAME OF WATER SUPPLY)
--- .
PLANNING DEPT .
fj l'rk WITHIN SHORELINE JURISDICTION
O YES NAME OF ADJACENT WATER BODY
O NO
APPROVED DATE BANK HEIGHT SETBACK
PUBLIt) VORKS 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
---- -
N ME MAILING ADDRESS ZIP TEL NO
OWNER --.
— -9' ,t, • , 1
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4' B.-TA I L TTETTIrIZTT'gr,- 7 ZY--i
ARCH
THE OWNER OF THIS BUILDING AND THE UNDERSIGNED AGREE TO CONFORM TO ALL APPLICABLE LAWS:
,,SAAL, pm OF AP ICANT AP I 10 Au, ,1 NER BET _ CHE NUMB R OR CASH
41. ru c g, Q.t,v . _1: i .1,-V (,0
,
APPR ., P R I T FEES 1.7 cc 2/131_4_7 :---- /
AP
BASE FEE INSPECTION
D
- Lei(''- C) BLDG SURCHARGE t--7 62, 50 PLAN CHECK
AUG 6 1989 ENERGY SURCHARGE
TOTAL
-
JEFFERSON COUNTY
PLANNING&BLDG DEPT 9 I I NUMBER REFUND DATE
BUILDING OFFICIAL
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elf 40_, 17/. /13 711:761 '