HomeMy WebLinkAboutBLD1989-00116 (3ADDING 'ERMIT APPLICATION 411
Jefferson County Building Department0P .0 . Box 1220.Port Townsend. WA 98368
1/111
LOCATION
SPECIFIC LOCATION SITE ADDRESS
iqio 4/Y Ci.Li-z)P-403L.4)
POSTAL DISTRICT fjt /SUBDIVVISION
LEGAL DESCRIPTION LOT BLOCK DIVISION TAX NUMBER
PARCEL NUMB R! )J -,a Da7C J t / 4 SECTION
PLANNING AREA SECTION TOWNSHIP 3C) NORTH RANGE ///3 WM
BUILDING INFORMATION
BUILDING TYPE TYPE OF IMPROVEMENT SQUARE FOOTAGE //''0�
( SINGLE FAMILY W BUILDING MAIN FLOOR it-
\--, ❑ D
MOBILE HOME p1TION 2ND FLOOR I
❑ MODULAR HOME ALTER-AT-VON BASEMENT
❑ DETACHED/ATTACHED REPAIR CARPORT
GARAGE 0 REPLACEMENT GARAGE Inl'7n
❑ WOODSTOVE 0 WRECKING/DEMOLITION I COMMERCIAL
❑ MULTI - FAMILY 0 RELOCATION/MOVING INDUSTRIAL
NUMBER OF UNITS MOBILE HOMES /�
❑ COMMERCIAL SIZE @ $3 5 3//S 0O
❑ INDUSTRIAL YEAR @ $ 16
❑ HOTEL/MOTEL/DORMITORY MAKE /Q � � 4�� $8 ' 07)
,
/NUMBER-OF UNITS v
^ ,( GATHER P 1 FY \ ESTIMATED COST OF 0 @ $8
Vi4�t�Ge 75 00 I MPROVEMEN S TOTr L A I RKET VALUE
UBC OCCUPANCY GROUP 3 $ �,� �a� $^ w / _�---
SELECTED CHARACTERISTICS OF BUILDING
PR NCIPLE TYPE�RAME
PRI CIPLE TYPE OF HEATING FUEL
WOOD FRAME ELECTRICITY 0 COLLECTIVE SOLAR
❑ MANUFACTURED 0 WOODSTOVE 0 PASSIVE SOLAR
❑ STRUCTURAL STEEL 0 GAS 0 COAL
❑ REINFORCED CONCRETE 0 OIL 0 OTHER - SPECIFY
❑
@' RI SONRY ( WALL B A G ) DIMENSIONS
OTHER - /9l°JA NUMBER OF STORIES TOTAL LAND AREA
DEPARTMENTAL REVIEW
HE LT DEPARTMENT TYPE OF SEWAGE DISPOSAL NUMBER OF PROPOSED BEDROOMS /
(.� �❑ P�U�L 1 C OR PRIVATE NUMBER OF EXISTING BEDROOMS
/ �}�JD 1 V 1 DUAL ( SEPTIC ) NUMBER OF PROPOSED BATHROOM
'APPROVED DATE NUMBER OF EXISTING BATHROOM
�, . NDIVIDUAL WELL
PUD TYPE OF WATER SUPPLY
O PUBLIC -( NAME OF WATER SUPPLY. -
APPROVED DATE ,RIVATE ( NAME OF WATER SUPPLY
way.
PLANNING DEPT . WITHIN SHORELINE JURISDICTION
O 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 0 YES 0 NO
IDENTIFICATION
,/ /NAME �y/� ��//' / //� `/yyyMAILING
���A I L I NG(f��/A,/DDRESS RZIP J��J TEL NO
OWNER y �6 /�llvl, I�iV il// /� (9)--f `--�"'- ` &
J r Oct_
s
CONT L„/ 1( 'Q � We ��
15t)_,_;:zir.fr
ARCH /11
1 P ,
THE OWNER OF THIS BUILDING AND THE UNDERSIGNED AGREE TO CONFORM TO ALL APPLICABLE LAWS.
SLUREO�F pAPPLICANT
fPPL I CANT A 1 CAT I�r�l� TE ' RECEIPT NUM�ER ' CHECK OR CASH
c ' \1 l`t r- ��} x f(}Jam) 3C5/J�7 /�1�1 ^17
AP O ED BY PERM IT7r FRS
\ L`8 W
FEE INSPECTION
A P p ', \,,, , -
--/ E-")v BLDG SURCHARGE PLAN CHECK
A 5 198 / , 00 ENERGY SURCHARGE $ 2� D� TAL
JF.FFERSON COUNTY 9 1 1 NUMBER REFUND DATE I DA 1 S v,
PLANNINr
BUIL.�7 pktirFICIAL �C�' eir
t4 Jo: -(. .� ! 189
Al-
Jefferson County Planning and Building Department
Courthouse , 3rd Floor
Son :220
Port Townsend, WA 98368
206-385-9141
PERMIT # '3LD89-0:16 DATE ISSUE. : 04, 05 '
S TE A✓ OIJTO?17'
:DOT TOrW?\: _ND WA 98 68
OWNER FRANCTS/M LER. PH^v\_E .
A'RPORT O1 TOFR RD
: DC y -, W'_\ Sr'N WA 93 68
CONTRACTOR. . : L:TTLE LITTLE PHOYE : 385-5606
MAILING ADDR: 3535 MCNEILL
:PORT TOWNSEND WA 98368
CONTR. L:O # : _1TTLL0 5705 E:1?TRAT10x DATE :
LOAN LENDER. :
MATL_'_\ C ADDR:
PARCEL
EGA , DESC . . : STR 28-30-01 WWM, TAX #
LCT ?�OCr-
INPa OVEMENT : additon L. f.... ems .._ _.__ s c o .tea .�-j ses_._...__..
- oct ng;'Setoac_�.s ( Shoreline Setback) Mob4l e.
( )
/ ) T_..
\
/ Sewage Di spo�"^ -
\ Tina, Occupancy Approval :
0
CALL 385-914: 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS .
Office Hours 9 a. m. to 5 p .m.
Inspector ' s Hours 9 - _0 a.m.
24 Hour Recorder for inspections .
I
i (=, 3 .
ate) - cry
ff-- O
s. N — �D `
/ V) .
-1
(st.<-1.
/ , . o•e-•
Q X \ 1
DJ2 1 (.,,',. •, 3/a1 - 5 .., 1\Q,N1`�
wE� o—% S \ „,
• I
l
' � C ?
cJ 2 •i 0 " ,r f U�LL
30
2-`. tel- 4 p (.,e,tII,c
i .pip.
6" ui A3 tf 642,4-,'7,-L
`
^ ^
/
|
----- l ----------- -------'-
`
ov, ~PI
10 J�q
|
| '
k� .
r
.
'
'
^ . '
~°
�
-
k
^
�
••
44.
_ , .
d W._
•
•
•
•
•
f
t A _-
•
,..
. .
•
_ .•� - •
-
•
IC,-as:::-- 97 ` tA_s A.5.- C:--11 - .)-4XS
0/76
!
,moo t3 ec,k_ i Zo
C;rf— --, 4`-r_ er- C , 7._- _,77_,,,it. ) 4cx.,
__,.._._
titao /g
4 "( //,L)
3 S/—(«
y4c,te,s/� . `
clz� AG
/ 4,7
- Cam,
-C1± r/`C)J,ac S
de•` � �
''-' 7 50 71/437- .-.-"---------"-'"--------_. '.__.,._..L___...._......? '`.1'
c 'AV DAB 746 ` r
1" , f) '� ' --c y o
\ s c