The URL can be used to link to this page

Home My WebLink AboutBLD1989-00445 1 .r f3UFING,I ERNI,T APPLICATION Jefferson County Building Departrnen`tP . O . Box 1220*PTt Townsend. WA 98368 LOCATJON _5% / /La re11cW r+k �e--•QGPttY7 SPECIFIC LOCATION SITE ADDRESS .,3yf . yr-AI &/r.7 r is h POSTAL DISTRICT /SUBDIVISION LEGAL DESCRIPTION LOT BLOCK DIVISION TAX NUMBER -�L:PARCEL NUMBER 1 / 4 SECTION PLANNING AREA SECTION TOWNSHIP NORTH RANGE WM BUILDING INFORMATION BUILDING TYPE TYPE OF IMPROVEMENT SQUARE FOOTAGE ❑ SINGLE FAMILY 16 NEW BUILDING MAIN FLOOR q 6 0 ❑ MOBILE HOME ❑ ADDITION 2ND FLOOR O MODULAR HOME 0 ALTERATION BASEMENT ❑ DETACHED/ATTACHED ❑ REPAIR CARPORT GARAGE 0 REPLACEMENT ' GARAGE O WOODSTOVE ❑ WRECKING/DEMOLITION COMMERCIAL O MULTI - FAMILY 0 RELOCATION/MOVING INDUSTRIAL .',,,, NUMBER OF UNITS N,; ` ❑ COMMERCIAL MOBILE HOMES „, , -/ k,��! ❑ INDUSTRIAL SIZE �/� a $35 0 ❑ HQTEL/MOTEL/DORMITORY YEAR a $ 16 , OTEL/ OF UNITS MAKE VI @ $8 7(.)(C� C,) cs (�" OTHER - SPECIFY 0 @ $8 .! ESTIMA D COST OF Swot .- IR Er.tEr{TS ,.m - ldF' TOTAL I FA-} �^ MARKET VALUE UBC OCCUPANCY GROUP M . $ 595 $ �C` SELECTED CHARACTERISTICS OF BUILDING `*°an PRINCIPLE TYPE OF FRAME PRINCIPLE TYPE OF HEATING FUEL ,, WOOD FRAME 0 ELECTRICITY ❑ COLLECTIVE SOLAR ❑ MANUFACTURED ❑ WOODSTOVE ❑ PASSIVE SOLAR �' 0 STRUCTURAL STEEL 0 GAS ❑ COAL ❑ REINFORCED CONCRETE ❑ OIL 0 OTHER - SPECIFY -_ O MASONRY ( WALL BEARING ) DIMENSIONSayXYV ❑ OTHER - NUMBER OF STORIES / TOTAL LAND AREA DEPARTMENTAL REVIEW HEALTH DEPARTMENT TYPE OF SEWAGE DISPOSAL NUMBER OF PROPOSED BEDR l�tatS J }7 9 _/s 0 PUBLIC OR PRIVATE NUMBER OF EXIST EDROOMS �JC 1 R INDIVIDUAL ( SEPTIC ) NUMBER 0- OPOSED BATHROOM APPROVED DATE s INDIVIDUAL WELL .R OF EXISTING BATHROOM PUD TYPE OF WATER SUPPLY O PUBLIC ( NAME OF WATER SUPPLY) APPROVED DATE 1 PRIVATE ( NAME OF WATER SUPPLY PLANNING DEPT . WITHIN SHORELINE JURISDICTION O YES NAME OF ADJACENT WATER BODY ':] NO APPROVED DATE BANK HEIGHT SETBACK PUBLIC WORKS DEFT 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 MAILING ADDRESS ZIP TEL NO OWNER eel 1/ ./ //t r^d _ '// .>CC>j NI!),CLoci ✓'i-h 7 Sys 4!i./✓1 CONT ! er/'?l9 b:'! 71 14JA 1L C ,auwe ge9o3/ �`y'�/ SiAIL ARCH YHE OWt-IEN CF THIS EU I LC!NC AND THE UNDERSIGNED AGREE TO CONFORM TO ALL APPL I CAPLE LAWS. At A E F ' CAN APPLICATION DATE R C 1 T E;ER CHECK N 7>3ER OR CASH A PROP, E3 PER IT FEES BASE FEE INSPECTION SO S �' L ��, - __u_ BLDG SURCHARGE - _ J PLAN CHECK .'FERSDAi ;i NTY ENERGY SURCHARGE - "� PM.QAtAPING&BLDG DEPT $ �(_0 "'" TOTAL • ,_ fl 1 I NUMBER REFUND DATE I 1](� CEI S/J BUILDING OFFICIAL ( //�;J7 E- 00 �MIIMIIIIIIIII Tom_ Coanhr y ` Suite B • 16521 Hilay 99 • Lynnwood, WA 98037-3161 illaSTEEL BUILDINGS Everett Line: (206) 2584171 Toll Free: 1-800-824-9552 lanimminim IIIAdministrative Headquarters: (206) 743-1555 DIVISION OF DIVISION Contractor's Lic. #: PERMABI 179JR Quality: Our Future Depends On ItTM Site Plan PLEASE CHECK: LProperty dimensions ©Septic and drainfield ®Access to proposed building LfExisting buildings -IISewer lines C�Lot size ®Proposed building (Setbacks of proposed and tiEievation of property ❑Easements existing buildings ❑Bodies of water Main road with name 9Floorplan Job name: r'4 / 8� ' � c�'r A. Job Site Address: e--/( l%om)-1.5 (,.rc rk_ Legal Description 015 `I Lev°` fr., 1 b0 Prop shy/Sjoi pt, S ' zy{,S1 set)fl�' ` C'''1"-1 ' 46ue-/ C 2,a 0 t) I/ •"/ {�?ir/SGvGr 7L, 20 b Owner has verified and approved the location of accessories, orientation of the building to the north, and verifies that all items specified in paragraph B of the contract are shown on this drawing and vice versa. Customer signature: ommmmmmmimmoioffice(while) production(canary) production(pink) customer(goldenrod) ^_7989 PerniaEi�!t Icrr�ctnes �i89 i ll JEFFERSON COUNTY PLANNING&SLOG DEP' 1 -12"-$. 04- 14$4(4..