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HomeMy WebLinkAboutBLD1989-00085I BUIDING ERMIT APPLICATION 111 Jefferson County Building DepartmenteP .O . . Box 1220*Port41Townsendr WA 98368 pit•ormial• 1 LOCATIO 1 ".' 111, . ' 40.: di VI rifila • SPECIFIC LOCATION SITE ADDRESS...s, POSTAL DISTRICT Air _ /SUBDIVI . ION LEGAL DESCRIPTION LOT BLOCK DI ISION TAX NUMBER _ /2) N )._Qs_PARCEL DER 7--.2 - _ 4 SECTION PLANNING AREA. SECION TOWNSHIP NORTH RANGE WM BUILDING INFORMATION BUILDING TYPE TYPE OF IMPROVEMENT ! SQUARE FOOTAG .-... --- tg), SINGLE FAMILY KNEW BUILDING MAIN FLOOR , ( ) O MOBILE HOME 0 ADDITION 2ND FLOOR ,---? (-/ Q O MODULAR HOME 0 ALTERATION BASEMENT --- O DETACHED/ATTACHED 0 REPAIR CARPORT _ GARAGE 0 REPLACEMENT iGARAGE O WOODSTOVE 0 WRECKING/DEMOLITION ' COMMERCIAL O MULTI - FAMILY 0 RELOCATION/MOVING INDUSTRIAL NUMBER OF UN I TS _ MOBILE HOMES , ,----* O COMMERCIAL SIZE . O INDUSTRIAL YEAR 0 @ $ 16 O HOTEL/MOTEL/DORMITORY MAKE ' C-'0 0 6) .F 8 ND 0 NUMBER OF UNITS . --— O OTHER - SPECIFY 0 @ $8 EsTimATED COST OF R IMPvEmENTS TOTA..k FAIR VALUE UBc OCCUPANCY GROU ; 47 $ d ',) I /C- ,U SELECTED CHARACTERISTICS OF BUILDING PRINCIPLE TYPE OF FRAME PRINCIPLE TYPE OF HEATING FUEL tj WOOD FRAME 0 E .CTRICITY 0 COLLECTIVE SOLAR O MANUFACTURED WOODSTOVE 0 PASSIVE SOLAR O STRUCTURAL STEEL y GAS 0 COAL O REINFORCED CONCRETE i 0 OIL 0 OTHER - SPECIFY 0 MASONRY ( WALL BEARING ) DImENSIONS 0 OTHER - NUMBER OF STORIES 2 . TOTAL LAND AREA DEPARTMENTAL REVIEW HEATH D pARTmENT TYPE OF SEWAGE DISPOSiN1, , 3EROFPROpOsED BEDROOMS & VI ,,:, PUBLIC OR PRIVATE NUMBER OF EXISTING BEDROOM 01 1 I ND I VI DUAL ( SEPT I C ).1.- --. ' NUMBER OF FROPOS ED BATHROOM. APPROVED DATE moil/! DUAL WELL NUMBER OF EXISTING BATHROOM -r . ,-- AF, P TYPE OF WATER SUPPLY O PUBLIC ( NAME OF WATER surrLYJ — VE DATE N PRIVATE ( NAME OF WATER SUPPLY — — _ ,,,v,,,,,rcr,x,1,1, 137Mnia.,o.r........,....44" PLANN NG DEPT . 'I. WITHIN SHORELINE JURISDICTION O YES NAME OF ADJACENT WATER BODY NO APPROVED APPROVED DATE BANK HEIGHT SETBACK - — PU LC 'KS DEPT ROAD RIGHT-OF -WAY WIDTH NAME OF PUBLIC ROAD --- NAME OF PRIVATE ROAD _ — APPROVED DATE ROAD ACCESS PERM I T REQUIRED Li YES 0 NO — — — — IDENTIFICATION . ---- ----- — — NAME MAILING ADDRESS ZIP TEL NO * -...-......,.. ........-..,. 5WNER E • V,, /'il:0 Y 'A 6 fl.'e;1'%/:/,'/ /-i ei, ,':' ;V/el' * ..... * ........ -..,,......- .... CONT . ,7A ; e—Tles717-17,1 i — ARCH ------ THE OWNER OF THIS BUILDING AND THE UNDERSIGNED AGREE TO CONFORM TO ALL APPLICABLE LAWS. .........-. *** **•.^.''*"- --,, E OF A P P P,A-61--T----- * j An 1 • y - - E REC .I PT NUM ER CHECK NUMBER OR CASH •-/7/ .... . ?/ 4.' 16 All ,.....-•, 3 1 v/ ---- , APPkr Ci)7 Pr_StliAr 1 U0 __ DASE FEE INSPECTION _ l(,,..),L.,iet--- ,---N, LoG SURCHARGE FLAN CHECK CT 1 2 TY \ JEFFERSON COUNTY — .-- s----, S EvErzGy SURCHARGE i TOTAL --(---) — PLANNING&BLDG DEPT 9 I I rwmy,E,R ii-mr tm io DATE-7- °ATP; I SS 1,,..0 _ BUILDING OFFICIAL • 70 /6 4 l' 4t1r% k 70 Pi — 7 c.>D-_ 41k. '11/4°17 PERMIT APPLICATION ' Jefferson County Building ii3UILDING rtment• County Courthouse •Port Townsel /ash.98368 • 385-9141 N E I. LOCATION: geographic name S W SIDE OF ROAD FEET NE S W FROM INTERSECTION OF ROAD AND (n&� 'r iga ROAD U)\l other specific location or landmark: 1 �t LEGAL DESCRIPTION: Pc rc -I 4 - Lot Block Subdivision CT,2 I 0 BI-! CO2- �2� Tax Number %,Section Sec ion Township Range II. TYPE AND COST OF BUILDING - TYPE OF IMPROVEMENT BUILDING TYPE MOBILITY yNew building ❑Single Family ❑New County Resident ❑Addition ❑Multi-Family Is this structure to serve the residential El Alteration number of units or commercial needs of those employed ❑Repair,replacement ElHotel,Motel, Dormitory at either the U.S.Navy's Trident or number of units Indian Island Facilities? ❑Wrecking ❑Mobile Home ❑Moving (relocation) Other-Specify ❑YES ❑NO ❑Foundation only USE OWNERSHIP ❑Full-time Residence ❑Private (individual,corporation, nonprofit institution,etc.) El Second Home: Recreation Cabin,etc. ❑Public (Federal,State or local gov't.) UBC OCCUPANCY GROUP: ❑Second Home: Future conversion to permanent residence COST (Omit cents) Nonresidential- Describe in detail proposed use of buildings,e.g.,food • Cost of improvement $ processing plant,machine shop,laundry building at hospital,elementary To be installed but not included school,secondary school,college,parochial school,parking garage for in the above cost department store,rental office building,office building at industrial plant. a. Electrical Elf use of existing building is being changed,enter proposed use. b. Plumbing c3 ao Q j'„ Q ` ,`(�/00 c. Heating,air conditioning 0 cl)@ 8 d. Other (elevator,etc.) AI 8 0 rlyl(/ • TOTAL COST OF IMPROVEMENT $ III.SELECTED CHARACTERISTICS OF BUILDING - PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL DIMENSIONS El Masonry (wall bearing) ❑Public or Private f1O+ in •Number of Stories �/ {- •Total square feet of floor area, Wood Frame 'qIndividuat(septic tanI t6.)p all floors,based on exterior 0 Structural steel �\ \__,_/ dimensions El Reinforced concrete TYPE OF WATER SUPPLY •Total land area,sq.ft ❑Other-Specify ElPublic or private company *Individua (well cistern) NUMBER OF OFF-STREET //777 } .1 PARKING SPACES Enclosed PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE ❑Gas Outdoors ❑Oil RESIDENTIAL BUILDINGS ONLY ❑Electrici Number of bedrooms ❑ TYPE OF MECHANICAL _Y Other-Specify Number of Full bathroom, - Partial IV. IDENTIFICATION - • Name Mailing Address- Number,street,city and State ZIP code Tel.No. i. Ch+men-h , (4)(re, N' y 2Ofr ) N ctB3\5& Owner 2. (5pi-P Contractor State License No. 3. Architect The owner of this building and the undersigned agree to conform to all applicable laws. ure of applican Address Application date „,e4....„73,,_ '/.191 -.-- Oci/02-/P)8 PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT APPROVED BY P' \ ,--. C--)‘C JE FEER �® iQTY' H\ ALTH DEPARTMENT APPROVE Y PERMIT FEE ISSUE DA E RECEIPT NUMBER s t9ee a, 0 O FF C gUgNTY t (50, ©pA �J 5 o2O I IBUILDINGOF tt-1ALB T 753 I5-O The Printery-Port Townsend Q ti 110 / 76/g42? 1PP c-- ,... , _.4,-- Acco,„).11.4) 71,-0,/ -?4,4 Le Aire % e - 4:57.£' /'v.:./✓i s .c c 4/ T'Z n p4oir s Ttj v c s ini \ „v, 0111Z''''',. O ,R; 5 , /z-' • 57-A/,Qs TO TOPSia y tit\;'::::; I I C�/SET - •yE�r -it �c�`H Cs7.44r( sio6" Aeo,..)R,,,¢- Yobs vE- I STAc1C f c1,;�,,yi j, /% Cc ,60r 4.; ./,-; 4,/ / / . ( i44O,e£' zid2G'c7 VC',/T WA ea_ • JS 0va 2':uS prillF- C#/ir7e.v2 " ' 1111 I/0 Or Sri/epv4/ /7-d/z-E-"7- ` ' cv •k - eDo L 0 Toro-rS Te�A�S-". S r f noxcfez::, ra.. , p: • \ • • . Hill \,. \ , 73/9 t--4,7,,z ' 9 i • •i - / , c\-- , ..-3.43--7..-,74,--,--,i- \ ---- i s \ J °-.:.ram \ . ; s>" .,(4\--,/,,,../.;--;":,--___,_----_-_.); ....,,0_ t¢}; { • j S TAIf25' 7%9r4er r .7) 'Pc.. r l EAT//66 A,,,,c-c/Gov�Qiivs a Av.• . F: PWF: R C7,TT E tTTTi\T a' . 1ii T T.i)T TvC; r- s . r�?ivi T 'ice Jefferson County Planning and Building Department Courthouse, .Rrd Floor PC Rnx 1 2 i7 Part Townsend, WA >Ins.inrs 2O -.SR5-`)i 41 PF.RMTT # - RT,n8q-o(nts5 DATE T SStiE1). : 1 O/1 2 /8y S T T F. AI11/RF» ' 2g40 FT,Ac T,F.R Rn :NOT T)T,ANiJ . WA y8.55rR OWNER -WAY F CHTMEN"TT PHONE : iVIA i i,T G ATII)R 7 T OX 20f :NC)Rff,ANT) WA y8358 CONTRACTOR . . :NOJ CONTRACTOR cOR PHONE: MAT T,T NC AT)T)R • CONTR . T,T C #: EXPIRATION ilATF. PARCFT, NC). . . : q 2 i OS4-00 T,FCAT, FSC . . : STR OR-29-01 EWM . TAX # LOT BLOCK i)ESCR TPTTON OF TMPROVFiv1EN T: single family residence i Fontina/Sethacks Shoreline Sethack) /Mnhi ie Home Sinckina i Foundation - ; tinceraround P i umh i ncrT/iindercclraund Insulation : i rFraming/Piumhina/chimney: Tnsniatinn - Sheetrnc : Sewage Disposal System Final - ( 1 Final /Occupancy Annrnvai : // 2-0 / CATJ, R5-y 1 4 1 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS . Office. Hours q a . m. to 5 p.m. 't n.snectnr l .s Hours q - 10 a . m. 24 Hour Recorder for Inspections. Aw p APy/{ovc8 4 /Y 0 3W TLD7- iL AIYI «�M�Nrs _- wozes,op _ iV oe A�z �g /V-g Sic 10 3 3 57' 9 LET ZD,