HomeMy WebLinkAboutBLD1989-00094 1 111OLDING f''ERMIT APPILICATION
. •
Jefferson County Building Department-P .O . Box 1220Wort Townsend, WA 98368 •
1 — LOCATION N
.,... ,
SPECIFIC LOCATION SITE ADDRESS _
POSTAL DISTRICZBDIVISION
LEGAL DESCRIPTION LOT FLOCI5 ,GWION TAX NUMBE6;;1--)
PARCEL Nu,MpER 71N //17 1 / 4 SECTION
PLANNING AREA /
SECTION / TOWNSHIP , '7 NORTH RAr4GEJJj1 WM
BUILDING INFORMATION
____
BUILDING TYPE 1TYP OF IMPROVEMENT SQUARE FOOTAGE
O NGLE FAMILY
N
2ND FLOOR
MOBILE HOME NEW BUILDING
0 ADDITION MAIN FLOOR
---
O MODULAR HOME 0 ALTERATION 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
O COMMERCIAL S I t E iltir7O 0 a $35
O INDUSTRIAL YEAR . 0 4 $ 16
O HoTEL/moTEL/DoRmIT ——
MAKE $8
NUMBER OF UNITS I . , --- .
O OTHER - SPECIFY 0 @ $8
E 4ATED COST OF
imrnovEr— . T L,TA FAIR MARKET VALUE
UBC OCCUPANCY GRO -,'; $
SELECTED CHARACTERISTICS OF BUILDING
PRINCIPLE TYPE OF HEATING FUEL
PRINCIPLE TYPE OF FRAME "
0 WOOD FRAME &C---KtECTRICITY 0 COLLECTIVE SOLAR •
PI/MANUFACTURED 0 WOODSTOVE 0 PASSIVE SOLAR
O STRUCTURAL STEEL 0 GAS 0 COAL
O REINFORCED CONCRETE 0 OIL 0 OTHER - SPECIFY
O MASONRY ( WALL BEARING ) _
DIMENSIONS C-1
0 OTHER - _ _ NUMBER OF STORIES TOTAL LAND AREA -___-,
— ------ .
DEPARTMENTAL REVIEW
HEALTH D Ilef TMVIT TYPE OF SEWAGE D I SF OSA L NUMBER OF PROPOSED BEDROOMS -.
ills g al , 0 P L I C CM PM I VAT E NUMBER OF EXIST IfG BEDROOMS
1
INDIVIDUAL ( P.EPTIC ) . NUMBER OF PROPOSED BATHROOM
APPROVED DATE Li INDIVIDUAL WELL ...i NUMBER OF EXISTING BATHROOM
PUD TYPE OF WATER SUPPLY
. WKUBLIC ( FAME OF WATER SUPPLY)._ ---
APPROVED DATE 0 PRIVATE ( NAME OF WATER SUPPLY)
PLANNING DEPT . WITHIN SHORELINE JURISDICTION
0 YES NA749.. OF ADJACENT WATER BODY
-- ----
g '0
APPROVED DATE BANK HE
SETBACK
PUBLIC WORKS 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
.
NAME , tIAILING AD.ReSS ZIP TEL NO
i.....
Ira or
AA/10)? i I OP di 17gregArli I liFyi ingja 7
a mg WA.4_, " _ .
_______
coNT "
--------- — - . . — —
ARCH — -
THE OWNER OF THIS BUILDIPIG AND THE, UNDERSIGNED AGREE TO couFonm TO ALL APPLICABLE :
-- -,- ------------
S I GNA 'Re OF APPLCANT 7 L CATION DATE iRECE I PT NUMBER CI-ICK NUMBER R CASH „,/
APPROVD .Y PERMIT FEES
AP i, .
BASE FEE __—, INSPECTION
BLDG SUrla LARGE PLAN CHECK
I 11P 4:
;
ENERGY SURCHARGE -
M `--)
Off ER soAl,..,m„, YY . — TOTAL
AUk:''4
'DWG DEPT i n 9 I I NUMBER REFUND DATE DAT IS
, BU I LD I NG OFFICIAL /1 2_
,
--- '
.T i 1y 1 '.R S C)TT C:C)T I T4 9 V' 1 T T T T.T)T TT C� )1 lvi T T•
Jefferson County Planning and Building Department
Courthouse, 3rd Floor
PO Box 122O
Port Townsend, WA 9R36R
206-3R5-9141
PERMIT # •BT,DR9-0094 DATE TSStJED. - 1 1 /02/R9
SITE ADDRESS : 1105 CHTMACtJM RD
PORT HADT.00K. WA 98339
OWNER -TONV R*DENHETMER PHONE! 385-7523
MAILING ADDR !PO BOX 898
1
!PORT HADT,OCK WA 98339
CONTRACTOR . . -NO CONTRACTOR PHONE.:
MATT,INO ADDR !
CONTR. LTC #- EXPIRATION DATE!
PARCEL NO. . . ! 9O1 1 1 4-OOR
LEGAT, DESC. . -STR 11 -29-01 WWM; TAX # 52
LOT : BLOCK
DESCRIPTION OF IMPROVEMENT! MOBILE HOME INSTALLATION
( ) Footing/Setbacks (Shoreline Sethack) /Mohile Home Blocking!
( ) Foundation -
( ) Underground Plumbing/Underground Insulation
( ) Framing/Pdumhing/Chimney-
) Tnsulationr
( ) Sheetrock
) Sewage Disposal System Final !
( ) Final /Occ nancy Approval -
//UAL ///2.6 /mil/
CAT,T, 385-9141 24 HOURS TN ADVANCE TO SCHEDULE INSPECTIONS .
Office Hours 9 a.m. to 5 p.m.
Inspector ' s Hours 9 - 10 a .m.
24 Hour Recorder for Inspections.
- .
IP° I
cuv!sr
bier v s iz,..• A#54:
B ' • /
't: :)./ •
I c)
1 /
i Cr I•
.... /...... /
,-) .1%
i6/074- / k
7 ‘
...,
,
.„--- i
J 0 i
1 i r
....„
„....., ,
f I,
1 .t
: 1 k
, (, ;
; , ,. ,..,
, ,
i *, 1
'4 1 r
,
,
,
1 ‘
\ \
i , \
i \ ,
.
\ \
I
1
'. \
t
\
1i' 't '
\ \
'T
\k.,...,.. ,..._...
........... r
/761 MI' C
i"."'