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HomeMy WebLinkAboutBLD1989-00096 BUILDING , 'ERMIT APPLICATION Jefferson County Biding Department'iP .O . Box •O.Port Townsend. WA 98368 /1! LOCATION • � ��� SPECIFIC LOCATION SITE ADDRESS I` ��� � , ,� /SUB POSTAL .PISTRIGT— '`/ VISION LEGAL DESCRIPTION LOT ( Cr BLOCK DIV! $I9 TAX NUMBER PARCEL NUMB R 4/ ,I SECTION PLANNING AREA SECTION ' TOWNSHIP ' NORTH RANGE WM BUILDING INFORMATION BUILDING TYPE TYPE OF IMPROVEMENT SQUARE FOOTAG � - ❑ SINGLE FAMILY fEW BUILDING MAIN FLOOR ,';�- ❑ MOBILE HOME ❑ DDITION 2ND FLOOR �-( b ❑ MODULAR HOME ❑ ALTERATION BASEMENT ❑ DETACHED/ATTACHED 0 REPAIR CARPORT GARAGE ❑ REPLACEMENT GARAGE ❑ WOODSTOVE ❑ WRECKING/DEMOLITION COMMERCIAL ❑ MULTI - FAMILY 0 RELOCATION/MOVING INDUSTRIAL NUMBER OF UNITS ❑ COMMERCIAL MOBILE HOMES r . ,C- ❑ INDUSTRIAL SIZE // $35 ��x"/ ` � ❑ HOTEL/MOTEL/DORMITORY YEAR �I� q� $ 16 ��Cl NUMBER OF UNITS MAKE 0 $e O #iER SPEC 1 FY ' ESTIMATED COST OF r 0 @ $8 'LrA....,J IMPROVEMENTS UBC OCCUPANCY GROUP $ $O la-1,FAI F7 MARKET VALUE`f SELECTED CHARACTERISTICS OF BUILDING 'NPF1NCIPLE TYPE OF FRAME PRINCIPLE TYPE OF HEATING FUEL 191) WOOD FRAME LECTRICITY 0 COLLECTIVE SOLAR ❑MANUFACTURED _ WOODSTOVE ❑ PASSIVE SOLAR ❑ STRUCTURAL STEEL ❑ .S 0 COAL ❑ REINFORCED CONCRETE 0 OIL ❑ OTHER - SPECIFY ❑ MASONRY ( WALL BEARING ) DIMENSIONS 1 ❑ OTHER NUMBER OF STORIES `''r--- TOTAL LAND AREA DEPARTMENTAL REVIEW HEALTH DEPARTMENT TYPE OF SEWAGE D 1 SP I ;y1UMBER OF PROPOSED BEDROOMS c L 3/.-3gY a. PUBL I C OR PR I VAT • g Li�IUMBER OF EXISTING BEDROOMMS l ►• I ND I V I DUAL ( SEPT 1 NUMBER OF PROPOSED BATHROOM APPROVED DATE `- i I ND I V I DUAL WELL NUMBER OF EXISTING BATHROOM war PUD TYPE OF WATER SUPPLY ❑ PUBLIC ( NAME OF WATER SUPPLY) APPROVED DATE ❑ PRIVATE ( NAME OF WATER SUPPLY �0.asi PLANNING DEPT . WITHIN SHORELINE JURISDICTION ❑ 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 i/ /!i) 1��y —�1 NAME WA NG ADDRESS ZIP TEL NO OWNER 1 _re>( --6 1 ct l & CONT ( ) 7S-'- S`r-ATt.-LI- .E1NSE NO I 5 ARCH P THE OWNER OF THIS BUILDING AND THE UNDERSIGNED AGREE TO CONFORM TO ALL APPLICABLE} LAY' \�1_GN URE QF PP ICANT 7/LI ATE ' RECEIPT N.W.MBER J CHECINUMBE �.SH Cli AP`1 BY PERMIT FE S A 'l''''r 5 3 Ca- BASE FEE INS,=TION CHECK MAR 199 , / 3 `�t BLDG SURCHARGE PI IF.FF€RSON COUNTY [ c C ENERGY SURCHARGE d 3c- (_ TOTAL N ANNING &DWG DEN P I SS UED 911 NUMBER REFUND DATE BUILDING OFFICIAL 11. —: • . .. ._ / / 7 Q) ,* to/ F c _T F:F'F F R S C)TiT C CI T T T,J'T'V' F t J T T.T3 T i'vT C "F:F?M T T Jefferson County Planning and Building Department Courthouse, 3rd Floor PO Box 1220 Port Townsend, WA 96368 2O6-365-9141 PF.RMTT # -RT,f89-OO9Fi DATE TSSi1F.fl_ : O3/OFi/69 STTF. AnnRF.SS: 71 RAVVTFW AVE :RRTNNON. WA 9E1320 OWNER -KF.VTN FFT,TX PHONE : MATLTNC A1)T)R : 71 RAYVTF.W :RRTNNON WA 96320 CONTRACTOR . . :NO CONTRACTOR PHONE: MATT,TNC AT)T)R : CONTR . T,TC #: FXPTRATTON DATE : PARCF.T, NO. . . : 9R0700-612 T,F.c,AT, T)F.SC. _ : STR 2 1 -25-02 WWM. TAX # T,OT 19 ; BLOCK 6 ; OT.VMPTC CANAL DESCRIPTION OF TMPROVF.MF.NT: single family residence ( ) Footing/Setbacks (Shoreline Sethack) /Mobile Home Blocking: 3/365)27 ( ) Foundation : ©lC �!�" y/41$1 ( ) Underground P l umh i nn/ttnderoround Insulation : ( , Framing/Plumhincr/Ch mney: 45 441 ( ) Tnsulatinn : ( ) Sheetrock : ( ) Sewage. Disposal System Final : ( ) Final/Occupancy Approval : CALL 365-91 41 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 Tnspections. 1/2_47 ., " tom c s - , UR.`_ ,-44 �; � 6�,� � Lei { 3 {