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HomeMy WebLinkAboutBLD1989-00488 Mill-NG '0.:'ERMIT APPLICATION Jefferson County Building DepartmentP -0 -* Box 1220sPort Townsend, WA 98368 — — _____LpcATIoN - - SPECIFIC LOCATION SITE ADDRESS ' 7! "-1-(e C) le ,LAW , POSTAL DISTRIC14 /SUBDIVISION LEGAL DESCRIPTION LOT BLOCK ruvisipp TAX NUMBER___ PARCEL NUMBER (-C) c1-1 cd,•2pPI / 4 SECTION PLANNING AREA o SECTION 7 TOWNSHIP .3() NORTH RANGE. -7-7-7-- WM BUILDING INFORMATION __ )31714/LDING TYPE TYPE OF sMPROVEMENT SQUARE FOOTAG SINGLE FAMILY ETNEW BUILDING MAIN FLOOR .\, 0 MOBILE HOME 0 ADDITION 2ND FLOOR c\t, 0 MODULAR HOME 0 ALTERATION BASEMENT r"-- 0 DETACHED/ATTACHED 0 REPAIR CARPORT GARAGE 0 REPLACEMENT iGARAGE .......„ -NI 0 WOODSTOVE 0 WRECKING/DEMOLITION ' COMMERCIAL E----- 0 MULTI - FAMILY 0 RELOCATION/MOvING INDUSTRIAL .---, NUMBER OF UNITS-- MOBILE HOMES 0 COMMERCIAL SIZE 0 INDUSTRIAL . . . . _I @ I 6 oo_ 0 HOTEL/MOTEL/DORMITORY YEAR $ NUMBER OF UNITS _ „-- _ 0 OTHER - SPECIFY 0 @ $8 ESTIMAT D COST OF • IMPR EMENTS MARKET VALUE UBC OCCUPANCy GROU // $ $ _ . SELECTED CHARACTER STICS OF BUILDING PRINCIPLE TYPE OF HEATING FUEL PRXNCIPLE TYPE OF FRAME • WOOD FRAME 0 ELECTRICITY E COLLECTIVE SOLAR O MANUFACTURED 0 W ODSTOVE 0 PASSIVE SOLAR O STRUCTURAL STEEL GAS 0 COAL O REINFORCED CONCRETE 0 OIL 0 OTHER - SPECIFY ________ .-K.) 0 MASONRY ( WALL BEARING ) DIMENSIONS 0 OTHER - NUMBER OF STORIES, _TOTAL LAND AREA C-\k, N.. .- DEPARTMENTAL REVIEW HEALTH DEPARTMENT TYPE OF SEWAGE DISROSAL, Nuo-- OF PROPOSED BEDRs• - q//cv-(57 ql-i O —' ' 0 /;;UBLIC OR PRIVATE NDIVIDUAL, ( SEPTIC ) NUmI3 ER OF EX I ST I NG BEDROOMS NUMBER OF PROPOSED BATH it* APPROVE DATE .... I ND I V I DuAL WELL NUMBER OF EXISTING BATHROOM PUD TYPE OF WATER SUPPLY 0 PUBLIC ( NAM.74 OF WATER SUPPLY C,5cD APPROVED DATE 0 PRIVATE ( r471/7", OF WATER SUPPLYj_ PLANNING DEFT . WITHIN SHORELINE JURISDICTION 0 YES NAME OF ADJACENT WATER BODY r NO _E .. -..o.. 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 E NO IDENTIFICATION NAME MAILING ADDRESS ZIP TEL NO .,-- OWNER ' t • •. me., at._ . . ..,........_ — - . /41 \ ,....,- ARCH — --- --_, THE OWNER OF THIS BUILDING AND THE uNDERSIGNED AGREE TO CONFORM TO ALL APPLICABLE LAWS. '''TURE ,F AP&ICANT 1APP ICATI 'N E tillIPT trDER CHCCK NeTER OR CASH ' .....e.......0..— "----03 o /q7) API,R•...E1:\.,:y . 7 P. RMIT -EES A i 0 Ilf LI , R DAsr,Gy F E E _ I NSpECT I ou .-"- - BLDG SURCHARGEGE PLAN CHECK J EfISIDIC 1 ONO 1 ___LS,... ENE SURCHAR $ /4. PLANNING&ROG DEPT TOTAL ill A it ..IC ' 6 I I NUME3ER REFUND DATE DATE ISSUED BUILDING OFFICIAL 1 • *ilk . . 9 Q, • j 1 I I I o I I 1 I j I ; I I I I i I I . I 1 I I -L----4---i --- - ---1-7 1 I 1 I I . —••••••I . I I .''I ...........-....... . I I i 1 •••••••••+..:"...It.....r'r... .....T , -' ..-1 11:1 I I I I i I I i • I I .. I ' 't.' 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