HomeMy WebLinkAboutBLD1989-00560 BUILDer .e.'ERnIT APPLICATION
Jefferson County Building DepartmentrT .O . Box 1220'zPort7Wownsend, WA 98368
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LOCATION
SPECIFIC LOCATION SITE ADDRESS _KT
POSTAL DI STR I CT /SUBDIVIS N AP-f-2T.
LEGAL DESCRIPTION LOT 16) BLOCI." Di VI BION TAX NUMBER--
_ PARCEL, NUMBF,R (?...? n) 1 / 4 SECTION
PLANNING AREA SECTION. _TOWNSHIP NORTH RANGE
BU I LD I NG 1 NFORMAT I ON
BUILDING TYPE ' TYPE OF IMPROVEMENT SQUARE FOOTAGE
r S I NG LE FAMILY NEW BUILDING MAIN FLOOR .
(\A 0 °DILE HOME 0 ADDITION ZNO FLOOR _
O MODULAR HOME 0 ALTERATION BASEMENT
,---
0 DETACHED/ATTACHED 0 REPAIR CARPORT
N
GARAGE Li REPLACEMENT 1GARAGE --- --77—
0 WOODSTOVE 0 WRECKING/RLMOLITION ' commEnctAL
N_ 0 MULTI - FAMILY 0 RELOCATION/MOVING INDUSTRIAL
(.----, at #.5-44b.35
NUMBER OF UNITS-- MOBILE HOMES . ,:-.. /
O COMMERCIAL 1110 - gp ,
•
SIZE _
'.' 0 INDUSTRIAL
$
0 HOTEL/MOTEL/DORMITORY
MAKE
NUMBER OF UNITS _
- ---—_,
O OTHER - SPECIFY ..0 @ $8
ESTIMATED COST OF
IMPROVEMENTS ____ad_ TOTA FA R MARKET VALUE
UBC OCCUPANCY GROU
- $ $
SELECTED CHARACTERISTICS OF BUILDING 5q, z t3
. —
PRINCIPLE TYPE OF FRAME PRINCIPLE TYPE OF HEATING FUEL
XWOOD FRAME
ELECTRICITY 0 COLLECTIVE SOLAR
0 MANUFACTURED 0 WOODSTOVE 0 PASSIVE SOLAR
O STRUCTURAL STEEL 0 GAS 0 COAL
O REINFORCED CONCRETE 1 0 OIL 0 OTHER - SPECIFY
El MASONRY ( WALL BEARING ) DIMENSIONS
0 OTHER - NUMBER OF STORIES / TOTAL LAND AREA
, —
DEPARTMENTAL REVIEW •
(ss:) H ALTH DEPARTMENT TYPE OF SEWAGE DISPOSAL NUMBER OF
\ 9 0.-
4'" /----EUB I., I C OR PRIVATE: NUMBER OF EXISTING BEDROOMS
0 INDIVIDUAL ( SEPT I C ) NUMBER OF PROPOSED BATHROOM,--- ,,,
\c) PPROVED DATE
0 INDIVIDUAL WELL NUMBER OF EXISTING BATHROOM
----------, .
PUD cTYPE OF WATER. SUPPLY
UBLIC ( NAME OF WATER SUPPLY)
APPROVED DATE (._
(----- 1411TVATE ( NAME OF WATER SUPPLY,I.,e, (._ r
PLANNING DEPT . WITHIN SHORELINE JURISDICTION
0 YES NAME OF ADJACENT WATER BODY
...,
...._. APPROVED DATE :NI( HEIGHT SETBACK
--------- __
. _ , ---- , ----
FUI)9. QRKS DEPT ROAD RIGHT-OF -WAY WIDTH ._
IC) NAME OF PUBLIC ROAD --
NAME OF PRIVATE ROAD
:- .
‹. ..<2 APPROVED DATE ROAD ACCESS PERMIT REQUIRED 0 YES 0 NO
- - — -- ----
IDENTIFICATION
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14 A m% ,Th r.7 A I L. I r 4 G A 0 D R S S ZIP ' T E L H 0
----
OWNER ,0",_? p)c,re.s2.„ ___‘____z- ,...._ .,,
d -&----i a,ts ‘,.., i:__ 9 23
--
275/3tS
CONT r P 0 Oa\
C
M Li,V777-s770-i/--,i eu fiscal 1 e L
ARCH
1.------ . _
, —-—-<TBE OWNER OF THIS BUILDING AND THE UNDERSIGNED AGnma TO couronm TO ALL APPLICABLE LAWS:
---, --.... , , -,-.---,--------........--
V3,31RE OF APPLICANT 4 APPL C ON DATE ! RECEIPT 7,1, TR CHECK NUMBER OR CASH
APPROV D Y . rER 41 T ',,E.-F4S to l) 1 j3-7 2136/7- froLatvc)
APpR CAD Vzil,STi." _ —
FEE I rispE 10N
SEp
---D BLDG SURCHARGE . .---- PLAN CHECK
_
‘ mg ...._
...ja,„(iRENERGY SURCHARGE '
r •S JEFFERstm co TOTAL
PLANNING& WM -
BLOG DE.p7
/0. 1 (A.7)9 1 I ra..1m7FR F1E'''ur"":1 DA E E I -14E
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BUILDING OFFICIAL
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SE 'A/ 1989
JEFFERSON COUNTY
PLANNING&BLOS OW
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