HomeMy WebLinkAboutBLD1989-00092 LOLDING 't'ERMIT APPLICATION
1 .! ,' -
Jefferson County Building DepartmentIrT .O . Box 1220' ort Townsend. WA 98368
LOCAT I ON_
SPECIFIC LOCAT ION A SITE ADDRESS / /-3ea4;e:-/- t //‘,/" XV'
LEGAL DESCRIPTION\t/ PLOOSTTAL D I STR I CT Ci?;i144N.EiVI/SUBD I V l''S ION
BLOCK DIVISION TAX NUMBER
f PARCEL NUMBER, ,C10 t 144 1) 1 / a SECTION
PLANNING AREA )( SECT ION / sfiE TOWNSHIP NORTH RANGE I ( ) WM
BUILDING I NFoRMAT I ON
BUILDING TYPE TYPJ OF IMPROVEMENT QUARE FOOTAGE
C) SINGLE FAMILY kiTIEW BUILDING M IN FLOOR
G3 MOBILE HOME 0 ADDITION 2N FLOOR
O MODULAR HOME 0 ALTERATION BASE ENT
0 DETACHED/ATTACHED 0 REPAIR CARPO
GARAGE
rweREPE.!',CEMENT i GARAGE
0 WOODSTOVE 0 WRECKING/DEMOLITION COMMERC i A
O MULTI - FAMILY 0 RELOCAT I ON/mov 1 NG INDUSTRIAL —
NUMBER OF UN I Ts -----
MOB I LE HOMES
0 COMMERCIAL S I Z F. I 6-7r, 0 @ $35
O INDUSTRIAL
YEAR L:-/ _0 @ $ 1 6 _\\,,
O HOTEL/MOTEL/DORMITORY
MAKE 0 @ $8
NUMBER OF UN I TS — • --- _
O OTHER - SPEC I FY ,O @ $B
' EsT I MATED COST 0
TOTAL FAIR MARKET VA- UE
UBC OCCUPANCY GROU172:5_,. $ $ --
SELECTED CHARACTERISTICS OF BUILDING
PRINCIPLE PRINCIPLE TYPE OF FRAME TYPE OF HEATING FUEL
O WOOD FRAME 0 ELECTRICITY 0 COLLECTIVE SOLAR X
ET MANUFACTURED 0 'EDOBSTOVE 0 PASSIVE SOLAR
Li STRUCTURAL STRUCTURAL STEEL GAS 0 COAL
O REINFORCED CONCRETE 0 OIL n OTHER - SPECIFY
O MASONRY ( WALL BEARING ) DIMENSIONS
ite., Y
O OTHER - NUMBER OF STOR I ES TOTAL LAND AREA ----:er
DEPARTMENTAL REVIEW • - . — _
HE LTH DEpARTmENT TYPE OF SEWAGE DISPOSAL NUMBER OF PROF09 rD,-- BEDROOMS
// -?_ g 7 0 PUBLIC OR FR I VATE
V(1 ND I V I DUAL. ( SEPT I C 1 NUMBER OF EXISTING BEDROOMS
7,4!..7,irru? OF PROPOSED BATHROOM APPROVED DATE
n INDIVIDUAL WELL NUMBER OF EXISTING BATHROO_SoL.4
,.......-... r
PUD • TYPE OF WATER SUPPLY
APPROVED DATE 0 PUBLIC ( NAME OF WATER SUPPLY) (1_,../r/
0 PR I vATE ( NAME OF WATER SUPILLI
PLANNING DEPT . WITHIN SHORELINE JURISDICTION
0 YES NAME or ADJACENT WATER BODY
si I
....
. .
APPROVED DATE ARK HE I GUT SETBACK
PUBLIC WORKS DEPT ROAD R I GHT-OF -WAY WIDTH
NAME OF PUBLIC ROAD
•II NAME OF PP I vATF. ROAD
APPROVED DATE poAD ACCESS PERMIT REQUIRED 0 YES 0 NO
- — -
IDENTIFICATION
NAME FILING ADDRESS ........_ ZI:, TEL
,
•<-?1,:+:71_r ' /c (4,
— ,
— *
CONT
— -sr-FA TY,-17TE17.771.117.—B o T-
1
_ 1
ARCH
THE THE OWNER OF THIS BUILDING AND THE UNDERSIGNED AGREE TO CONFORM TO ALL APPLICABLE LAWS.
,,, — , —---, .-.---------
SIG TU APPLI, ANT APPIATIOI DATE RECEIPT utuyisEn CHECK NUMBER OR CASH
/ /C.) / / c/
a 9 9 9
APP'RO ED BY
\ PERMIT FEES
n.)
BASE FEE INSPECTION
A P P . ".. \')'k\ . -'" 5'6 _ BLDG SURCHARGE PLAN CHECK
-
t4 4
.... '
_ ENERGY SUCH F-
_
ARG 122E50
TOTAL
ifKOWNUWWI l' SUED
9 1 1 NUMBER REFUND DATE DAT . '
BUILDING OFFICIAL __ // 2- .41
L_ 0
10 HO /0/0/8?
OFFICE OF THE ASSESSOR, JEFFERSON COUNTY
MOBILE HOME QUESTIONNAIRE
RP Account 41
PP Account It
DATE
**********************************************************************************
Please read the entire form and provide as much information as possible. This will
help us identify the unit correctly and avoid double assessments. It will also aid
in placing a correct value on your property.
*******************************
REASON FOR INQUIRY:
Field visit Excise tax JSuilding Moving
by deputy affidavit permit permit
Dealer report Application Delinquent State transfer
by sale for title taxes report
*******************************
MOBILE HOMEiOWNERSHIP/OCCUPANT DATA
Name(s) fWe // / /(6, 'f' )4
Street or Box
iS(� / i �dr lr_' /
City Ctd( 19cP State/Zip (/t/it
Home phone ac zi Work phone
Best time to call 012 e►/- 4:00 —
(specify home or work)
NOTE: If you rent the mobile home give name, address, and telephone number of
owner here
*****************
MOBILE HOME DATA: _
/ � —�
Length (exclude hitch) Model Year 7.� --
Width
Make Model
Serial number
*****************
MOBILE HOME LOCATION - IN PARK
Park name ,l t7< /Seer erl i `/ lee/
Space if Date placed in park
(PLEASE COMPLETE REVERSE SIDE)
MOBILE ,OME LO(ATION - NOT IN A PARK
Do you cwn (or are buying) land on which mobile home is located or do you
rent tha land? (CIRCLE) OWN
BUYING RENT
Assessor's Rea,±. Property account (parcel) number (The 9 digit number on the tax
statement or valuation notice) .
What is the street address of this land?
Street /v7 /✓` 1�`t�!'l �°f�
City C"
If you rent the land what is the name and mailing address of the land owner?
Name Al c ..
Street or Box
City
State/Zip
Telephone n n ber
***********
MOBILE H)ME HISTORY
Date yoi, purchased 0 " / e �
Purchase: price
rto
How did this mobile home get to its present location: 4
Mo,,7ed into Jefferson County from �� //���/uQ/� �
(County or State)
Delivered by dealer (name) /4'L
Moved from another Jefferson County .location? YES o , NO. If yes, please give
previous address/location.
Didn't move - pruchased in place. .Yes or N0 .
Naae of previous owner
Address
City State/Zip
If lnoved, was advance tax paid? YES or NO. If yes, to which County
Doethe' mobile home replace a previous mobile home at this new location? YES or NO
If ;:his is a replacement, to whom and where did the previous mobile home go?
Thank you for your assistance. If you need help or information about the assessment
of ycur mobile home call the Assessor's Office at 385-9105. Questions about taxes
call the Treasurer's Office at 385-9150.
(NOTE: If mobile home is new to this county a valuation notice will be mailed to
you when it's valued and added to the assessment roll.)
'2lease .send completed form to: JEFFERSON COUNTY ASSESSOR OFFICE
PO Box 1220
PORT TOWNSEND, WA 98368
! .
•si
S/
,_Th......
., <--
' / /y-..'
. f - /5 .
C3
4-....ad ,, - t...:$ •
v ,,,3. •o,"
5 ":11
I .0' 4
/ vl_< '
-• h
/, .
..j.•*‘.
t- •••::7-.,---- 1------ ---7- _,....:14_
,- ,r, , >r•
,., —
‘•`...-
' '. )
.
•
/C 7/"- ''. t'
,/,/v 7I e A... ..71 _..7:..c A/e__; ,...,, 1
01 ' . •
1,-• -- 4 ' '.>1 1m ;41-',7,t...,5 4, ""4-.•:'It e-A94.,:- j-71 •••/•-iil '-• C1/4 .5.-. t
eN/ Y723/. T,/ . , 't. •--. .,
' "A 4,16 4.,...i.A. /474-/C, d•I
\ ,
\ A-.' .0,ed.- .4.1Pfa_;;;,` ,,i„r),4"- . ',,i15•-'7,,,,,'_ k
- ,
I0 c A le.._..9 ,
471 • -
•r c , i i .0 '-'"
S.. • _ -4,.., • law I
% 2 A
,,,)1 •74 t, J.
/
, . /•,,eod,•
../ k ,
/9- ; \I
• N _5-;,-,,,,,,a U,-e.:A./
‘b., ' •
. . 4. 4
4 ". 7--/ *-74•;-6---4—
• k
'N 7/
i ri ....eAs i"Al''''i°•?e,e,--
-..c.2
, e • NI ' NZ---- °.' i
.
4---2-54-
I M ••••-•••.44-.•7 7.-....,../ 4
i .-:-..,,,, ,..•4,_,,,4-t•a4t'l:•-. , ...
•
t i
t.:
...,....4 ,
LI ' ,
Ay"....e..../
ki )
No ,
4 0 •:' .
,...
. .
[. i
I
,•:,
....-f. • I .
1
. ,
. I
. I
. •
I •<,
. ,
I t
N
I
- 1.
i I
;i •3\ .
1,-
.7-
1 \v'
w .
I >1
. • I • .
. . • . ,
•.,if‘: '&: ',--
: I .
,•. , -4
.. , „
I1 " ' ' ' '. .. ' 2,:!. 'Y i'&' :1''..7 '.1: ...... '.:...;:, :'-'. "H-,;`..4,--'•`;',:::!:174, ?.
, . ''-i•<;• ' • ••:':':': ' I : -: ' '':•;-'2, ..:''.. ...- '• •-•,.' •;--, ''''' ••••:.;.: :•••••'..':•':1-:-. ,J., ".1:.:','•••••,i,':•''.' •:q.:.: ',''°''''< '''':,f:Af(';,'?...‘;','''.4$,:'''..!;'::,.:%.'''',;•-•,;‘ T..:
:A''VA.4,%.i •,•:;','•:;:. '':..'.. . . ' ' . ''', . , . ,. r,.., ,.. Mii ? ,'!'(.2.':';',',.Iti,, ,..,:..;1,.: i:',.;:,,iqrS4'.'04.4.:, :;4,i,4,41Z;.:r.^.`,,,4•AV.,-.%;CL;;;',A,,:.' '
'.141i..-:..... ;.:Y.-..:;f: ; -,.•;:.,:''', ' ' '"' ''' L',•!..,2,-.,`,::,;-t,' ''''',-.V,:::-.' ',' ,;:',;,,."f; •,,..;.. ..1.',... *.:
4:.. 411, /,',......"`., ', ..: ' 4-''.' ,), ,- '4, • -2,;.",„.iiVe ';••!i://e4f..•'-' ','f ".-,2,;(1.;;',•.-',,/,, .;,•,..';.;',1SerAt,,,i,!:‘-).-,,i'...:-::'-2714A,-; ', '::,•'.;',-..'Pi:',Mt.‘,",r,"il,,-.•.;;,;i4iNg 'I-1-•;gtl•alfle,::. :4•.;gi
Nlit I
,.,s -•••. .-A.Ne-z."-- -...-;v.,..:, --•". ,c.)-e."4.0 e*""*.• ..-.7.. 7 .., ,.. ...-4 '' ''',..?--.-•'---••':' ••- ''-'g..'•-,:.••'-' _"• ...'--;,;&!-4:-•.1-."--.-' ::,',1•:`,4•'....cv..-i,‘..''' •'•••••',P:s4..n,k,,,,,zz,"!7,.;,N• v,,.4,-'`, '. .,:.7,,-,,,
,.•
.TFFFF.R.5 C)1V C':C)TITV'TY 1FVUTT T.T)T 1\TC3 FFRMT 'T
Jefferson County Planning and Building Department
Courthouse, 3rd Floor
PO Box 1220
Port Townsend , WA 9R36R
206-3R5-9141
PERMIT # •RT.T)R9-OO92 DATE TSSTJRD. ! 1 1 /02/R9
STTR ADDRESS : 141 BEAVER VAT,T,FY RD
•CHTMACTJM, WA 9R325
OWNER •RORF.RT FT,AHERTY PHONE• 3R5-OR21
MATT,TNc ADDR - 1561 TRONDAT,F RD
PORT HADT,OCK WA 98339
CONTRACTOR. . -NO CONTRACTOR PHONE!
MATT,TNO ADDR
CONTR. LTC #! RXPTRATTON DATE!
PARCF.T, NO. . . -9O 1 1 4 i -O2O
LEGAT, DESC. . ! STR 14-29-01 WWM, TAX # 70
LOT , BLOCK
DFSCRTPT T ON OF TMPROVF.MFNT. MORTT,F, HOME TNSTAT,T,ATTON
Footing/Setbacks (Shoreline Setback) /Mobile Home Blocking
( ) Foundation -
( ) Underground Plumbing/Underground Tnsulation .
( ) Framing/Plumbing/Chimney.
( ) Insulation !
( ) Sheetrock.
( ) Sewage Disposal System Final !
( ) Final /Occupancy Approval !
CAT,T, 385-91 41 24 HOURS TN ADVANCE TO SCHEDULE TNSPF.CTTONS .
Office Hours q a.m. to 5 p.m.
Tnspectnr ' s Hours q - 10 a .m.
24 Hour Recorder for Inspections.
A P
ft
NOV
JEERSONC UNTY
PLANNING&BLDG DEPT
/43/70 r
t0-6-trea- Ft/17"d
P;v2;4-4 s-
P4-&-c-j-cle
V & iar-z.
ed e
I 2 /
011- /
/ —
1) - z)-74-'7