HomeMy WebLinkAboutBLD1989-00371 (3UILD4 ;+ERMIT APPLICATION
BuildingDepartment®P .O . Box 1220sPort Ownsend . WA 98368
Jefferson County
OC T o► IDS J �-J
SPECIFIC LOCATION SITE ADDRESS SUBDIVISION
POSTAL DISTRICT / •
LEGAL DESCRIPTION LOTD 1 V 1 ON,�TAX NUMBER A
"
BLO = I "/ �1 / 4 SECTION
PARCEL NUMBER 2 si: WM
PLANNING AREA -�
SECTION / TOWNSHIP / _ NORTH RANGE
BUILDING INFORMATION
B ILDING TYPE TYPE OF IMPROVEMENT SQUARE FOOTAGE /�/2
[
NEW BUILDING MAIN FLOOR
✓�S 1 NGLE FAMILY BASEMENT 2ND FLOOR "�`'
❑ MOE1 I LE HOME ❑ ADDITION __
❑ MODULAR HOME 0 ALTERATION CARPORT
❑ DETACHED/ATTACHED 0 REPAIR ..------
❑ REPLACEMENT GARAGE
GARAGE ._..._.__...
(/WOODSTOVE ❑ WRECKING/DEMOLITION COMMERCIAL �_
❑ MULTI -FAMILY
❑ RELOCATION/MOVING INDUSTRIAL
NUMBER OF UNITS MOBILE HOMES❑ COMMERCIAL S I YEAR � G,ZE F� a $35
❑ INDUSTRIAL ____ a $ 1 6
��,,//''
❑ HOTEL/MOTEL/DORMITORY MAKE ItJ $g
NUMBER OF UNITS��„ a $g
❑ OTHER - SPECIFY ESTIMATED COST OF
IMPROVEMENTS TOTA F R MARKET VALUE
UBC OCCUPANCY GROUPt+
SELECTED CHARACTERISTICS OF BUILDING
PRINCIPLE TYPE OF HEATING FUEL
NCI
p WOOD TYPE OF FRAME LECTRICITY 0 COLLECTIVE SOLAR
FRAME ❑ PASSIVE SOLAR
'44
OODSTOVE 0
MANUFACTURED COAL
❑ STRUCTURAL STEEL AS 0 0 OIL 0 ALS - SPECIFY
❑ REINFORCED CONCRETE
❑ MASONRY ( WALL BEARING ) DIMENSIONS
✓ r�
❑ OTHER 5 _ NUMBER OF STORIES TOTAL LAND AREA
DEPARTMENTAL REVIEW /
9
H ALT DEPARTMENT TYPE OF SEWAGE DISPOSAL mBER OF EXISTING mR OF S BEDROOMS
❑ UBLIC OR PRIVATE
PR62° �ND I V I DUAL ( SEPTIC ) NUNUMBER OF PROPOSED BATHROOM __
PPROVED DATE 0 INDIVIDUAL WELL NUMBER OF XISTING BATHROOM...or
PUD TYPE OF WATER SUPPLY( ,) 3l 7A 1.(1UY � I, Aff/�"
0 PUBLIC ( NAME OF WATER SUPP
..Q
- ,,
4,,,,,. _ APPROVED DATE ePRIVATE ( NAME OF WATER SUPPLY i
: PLANNING DEPT . WITHIN SHORELINE JURISDICTION
is 0 YES NAME OF ADJACENT WATER BODY
/NO SETBACK
•x APPROVED DATE BANK HEIGHT
'_> PUBLIC WORKS DEPT ROAD RIGHT-OF-WAY WIDTH / }
JI r/ ? }
NAME OF PUBLIC ROAD
NAME OF PRIVATE ROAD YES ❑ NO
(74 . APPROVED DATE ROAD ACCESS PERMIT REQUIRED ❑
IDENTIFICATION ZIP TEL NO
MAILING ADDRESS
NAME .....7,7--. r : ' -,' /!
OWNER
!C
CONT 5 P/ _.
'4'''+. R C H /A ld a%0, si ikilM0 / ?.K . (U r/
. LDING D THE UNDERSIGNED AGREE TO CONFORM TO ALL APPLICABLE LAWS.
11111111.11111111111 -;- r r e , - 1:7;11. I ' .7-r1-- ME
HE OWNER OF THIS CHECK ('lLMB CASH
:104902111Plier
� APPLICATION DATE RECE 1 PT NUMBER '/--j�/l/.J//1 J,�l[
r.,
4C/4!).e a)--[
`r APPROI'ED ` PE MIT FEES
( 0 �-1-0BASE FEE INSPECTION
A P P R E.Q PLAN CHECK
BLDG SURCHARGE
MAR 19 � �`'' J D _---
ENERGY SURCHARGE TOTAL
,� f CO REFUND DATE DAT I w J NNIN SO(�1.006(JE G(Ji 9 1 1 NUMBER
PlANi;+ING&8lDG DEPT
BUILDING OFFICIAL _
s-/i• ai drop -o K, HOKSC 7 drdih fif/I cil'/n IV' d/L `5 35��
i 4, 0 •
•
P,r
N It_
� r �,
/
0 ,-.) i
/147. \___,.......) tAt
t°, vv
597 .
`^t0 a I/� �c ;�n�'
•DYd'y P,t lei /
, i1-- 1 \
t
k .
(Y): r 7:--- ----:-
Nls .- ..„._,,(. , ,,, ,
He,/, ----,„,,,.\\\ -(''‘
s �
'6 --LD '"------ \a°'''''-°:)1( . __. ) k- ___ L5_0,_______:/ /
\\ \\\._. , _ --
ro
Iv PVS'e- o P¢ From Sikeef ‹g
130 Pf -1Frorn neared proprill An,vL6 f "
t .
Cledve1 Ldni -Deride) by i ,' C1® J Ilne
G:enervil f P Id71 'i"o 5o4e/A diiai revsfo-Noose,
t=vo`n 4 pus e., Id PS sio ..i i-o ti.)es74-dna'AA)cr11A
dawn fo Yid on tdest"dnd down /nfQ .
frees YD 1Ae nor/A. Slope is 04 o.0/417e,Y —. _L____
.5"y or 3 per /nd ;
Spa/€ //o „1C, / ,
T _
IIIIIIIMMii■ .2.'j
iEMINN _ , .� ■ii
i irill _
■iiiii 'M11111111111111ri■i
IIIRIMIIII IIIIIII �� INN
iiiiii /111111 .� 4�� III
iiiiii�l �111111 iii
i1111441111111•111111111111/11111111111111111111111111111111 ME
iiiii►rIIIM_ EMI ' N
11111111E1111111 / :. . 1m -■ ii
i IMEIMINIENNWAILIPM1111111111111111111111M111111
i//l4mmii'i.�. 1��. EN milmil
1 I , NFAIMIIIIIIIIIIIIIMIIIIIIIIIIIIIIIIIIEIIIIIIII .
■i 11111111lii ■
1 1 111111111111111111111Res rae Al, A Amsimmomataam
- immummENEMMEMMOMMNI Qj 111111111B111. I i
1 . 111111111111=111111.4116161111M111111111111111MIIMINEIDEPIT. 1
' ' 11111111 ! iii
4 ' ■ ' ► 11111111111111111111111111111
1111111111111111111111.1111111111111111111111111111111111111111 MIK
11111111111111 • IIIIIiiiN ii//
MIME i __ __ iii
' • ► NM k. i� �o)(' S` r.i!�' 811ii�`'�i/4
- 11111111111111111111111 Y®x I iNii w'/ _
iiiii � EIMMIIIMIE1111111111111111
..1 > o i■ �IRW/i
iiiiii__ _-UIIH//i
iii■� 111111i►iii111% 1
1 ► 11111111111111
1 it �,�
iiii ■WA
iiiii a ii ''ir
iiiiii __ r/i M=
iiiiii ® I■i!//ii
- ._ .._-1_ _ -- - / 1
_
APPROVED
-JEFFEBSON COUNTY
&SLOG OEN
I
s /Ls cxt
ad 0 e-A-NM4-4 qCS °4s.
et- ,
( /6? ( t (‘)(14-k4 0—a C+—LA,4 (3
l/ /�7 S e Sig ,,,�
( _
7, ,..,„4-
77,
�� W
!/ b l l
Li7°�z" () �^ /7'L'r'�,
o