Loading...
HomeMy WebLinkAboutBLD1989-00447 IJU? DING '.RMIT APPLICATION ,bAc� 90(�// / 6 Jefferson County BuildinyDepartmentIP .O . (Box 12200 rt Townsend. WA 98368 • SPECIFIC LOCATION SITE ADDRESS .17 v rk2 r i d e La,ie - POSTAL D STRICT /SUBDIVISIO 5b . �] .. LEGAL DESCRIPTION LO BLOCK DIVISION TAX NU .IBER PARC NUMBER 1 / 4 SECTION PLANNING AREA SECT ION/�O�a©i WNSH I P )fr/ NORTH RANGE 7/: WM BUILDING INFORMATION BUILDING TYPE TYPE OF IMPROVEMENT SQUARE FOOTAGEp Q SINGLE FAMILY ANEW BUILDING MAIN FLOOR / l U �Q ❑ MOBILE HOME /❑ ADDITION ❑ MODULAR HOME 0 ALTERATION ❑ DETACHED/ATTACHED 0 REPAIR - R'Pa Dee4 c� 0 GARAGE 0 REPLACEMENT GARAGE 9 ❑ WOODSTOVE 0 WRECKING/DEMOLITION COMMERCIAL ❑ MULTI -FAMILY 0 RELOCATION/MOVING INDUSTRIAL `• l NUMBER OF UNITS /� / /� c 0 COMMERCIAL MOBILE HOMES ifig a� $3 5 ��lU 3�•5(J SIZE �•L (3 0 INDUSTRIAL YEAR �� ❑ HOTEL/MOTEL/DORMITORY $ 16 `�✓ NUMBER OF UNITS MAKE ,cale_2_50 @ $8 f OTHER - SPECIFY / 4•OD Nj ,50�0• $8 `7/• On y 0 ESTIMATED COST OF a1 / 7 IMPROVEMENTS TOTc FAIR A M T VALUE i.r;- UBC OCCUPANCY GROUP j 7 $ 5-,O SELECTED CHARACTERISTICS OF BUILDING PRINCIPLE TYPE OF FRAME PRINCIPLE TYPE OF HEATING FUEL k(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 ❑ MASONRY ( WALL BEARING ) DIMENSIONS ❑ OTHER - NUMBER OF STORIES k TOTAL LAND AREA DEPARTMENTAL REVIEW HEALTH DEPARTMENT TYPE OF SEWAGE DISPOSAL NUMBER OF PROPOSED BEDROOMS ,3 (D PUBLIC OR PRIVATE NUMBER OF EXISTING BEDROOMS- 0 I ND I V I DUAL ( SEPTIC ) NUMBER OF PROPOSED BATHROOM 2. APPROVED DATE 0 INDIVIDUAL WELL NUMBER OF EXISTING BATHROC- iitrir PUD TYPE OF WATER SUPPLY --.... [ PUBLIC '( NAME OF WATER SUPPLY 1----L N.) APPROVED DATE 0 PRIVATE ( NAME OF WATER SUPPLY A PLANNING DEPT . WITHIN SHORELINE JURISDICTION 0 YES NAME OF ADJACENT WATER BODY r,_.. NO !fi,Y 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 J�J NAME p �c�� /�'� MAILING MAILING �eAfD(DRESS (��'f ,/ ZIP T E L NO OWNER '7 t - Res D a rco,S 6 O // / �r`%oza .'�'"'� lacLey. e 4 "7� l j /. Lu DLO � l,J�- J I�365- 37%-/0/ CON T Po e_ ReSo(.(. 11' A I'E LICENSE ND r Cr / r / ,3Y ARCH 7 1 THE OWNER OF THIS BUILDING AND THE UNDERSIGNED AGREE TO CONFORM TO ALL APPLICABLE LAWS. SIGNA ,OF A APPLI ATI DATE RECEIPT NUMBER CHECK NUMBER OR CASH ~ r ?pi t I 1 ROVED BY PE MIT FEE 5Sf SZ�� BASE FEE INSPECTION A P P t4,S BLDG SURCHARGE PLAN CHECK / / 4 AUG Z ( 7 t V ENERGY SURCHARGE $ /z Ci? ) TOTAL 9 JEFFERSd N 9 1 1 NUMBER REFUND DATE I�i•I 1 SS PtAMNINMO ELM RG OFFICIAL ` �� 4 66 ti • qG t 192's I ` ,( 117-D thti�r�t:;•it . DbII �f t I ( ul( 1 26 • • Lo-r cPSis 1�a ii -RRNIRIDC- - /-/7P� ��r� L DdL JEFFERSON cater PLANNING&BLDG DEPT -+ \ Imo/\�'�� ///���� - \Lk-C3 9. .y +.. 4.-;-i �,� _ r'\ ¢r v ( /I' - "� ��// \ ____)ve,....(...._ I ZI\ a 1 ________, r l. C a\a z- Gam` " "4" L""; "►4.1 — j //92.:;J,..1,7_4-,Lv, . ,_____. 0 Wy-;-- At- -a,,,,,..4,-L,s_c, 7 "k`e J'7",--,4_.e_.-e , Z---eq / 4- --7 -`4-"P '‘e-YS (fr&I-17-- AN'Uj C.,,) A)/ f/e-,T a is ,, 777-2-0-0 L Ye- "' -' - __s ,u UIL.Q L 17/z,i-e--,-- c_r__,,,,,....„ -e,i7,,,>, I 7 51q4 -67w----,r,J1-4 CO'i " ,I 6. --,d ii, ./4„) ..... .-----&-5-7za c.k c„e; .,../a 12' 2,,( 67 ci 6 --H,_ _______Lx,:z,? (A.,\.<-,--?..e.„) .) -,t7t c._. ZJ t-....__ nit c$C c4 L cQ t., 17 i;(76 nAPt- --I---L) til -------- ( 1J