Loading...
HomeMy WebLinkAboutBLD1989-00597 •ILDING ; 'ERMIT APPLICATION Jefferson County Builoing DepartmentIP .O . Box 122 Port Townsend. WA 98368 LOCATION ' Ea SPECIFIC LO CATION SITE ADDRESS � , J I r) `�--� Gle nno. POSTAL DISTRICT \ /SUBDIVISION U LEGAL DESCRIPTION LOT BLOCK DIVISION_ TAX NUMBER* 1(10 Pp ciQ) 7)1 OO 4 ..PARCEL NUMBER ?t ( Q 1 / 4 SECTION SECTION ,� 1 TOWNSHIP NORTH RANGE] LA ) WM PLANNING AREA!_ J BUILDING INFORMATION BUILDING TYPE TYP OF IMPROVEMENT SQUARE FOOTAG ❑ SINGLE FAMILY NEW BUILDING MAIN FLOOR � � ADDITION 2ND FLOOR _ / ❑ MO�I 1 LE HOME ❑ 2` ❑ MODULAR HOME ❑ ALTERATION BASEMENT ❑ DETACHED/ATTACHED ❑ REPAIR CARPORT GARAGE ❑ REPLACEMENT GARAGE ❑ WOODSTOVE 0 WRECKING/DEMOLITION ' COMMERCIAL ❑ MULTI - FAMILY ❑ RELOCATION/MOVING INDUSTRIAL NUMBER OF UNITS MOBILE HOMES ❑ COMMERCIAL SIZE @. $35 ❑ INDUSTRIAL YEAR 4 41 $ 16 ❑ HOTEL/MOTEL/DORMITORY MAKE — $8 NUMBER OF UNITS $8 / / 1 `� [J/OTHE - SREC I FY ESTIMATED COST OF (�+yv7� CMJ IMPROVEMENTS TOTAL, FAIR MARKET VALUE UBC OCCUPANCY GROUP $ $ �•r-x./ SELECTED CHARACTERISTICS OF BUILDING P NCIP PE OF FRAME PRINCIPLE TYPE OF HEATING FUEL WOOD FRAME 0 LECTRICITY ❑ COLLECTIVE SOLA,' ❑ MANUFACTURED U WOODSTOVE 0 PASSIVE SOLAR ❑ STRUCTURAL STEEL 0 GAS ❑ COAL ❑ REINFORCED CONCRETE 0 OIL ❑ OTHER - SPECIFY ❑ MASONRY ( WALL BEARING ) DIMENSIONS ❑ OTHER - NUMBER OF STORIES TOTAL LAND AREA DEPARTMENTAL REVIEW HEALTH DEPARTMENT TYPE OF SEWAGE DISPOSAL NUMBER OF PROPOSED BEDROOMS (1) fC 0 PUBLIC OR PRIVATE NUMBER OF EXISTING BEDROOMS ❑ INDIVIDUAL ( SEPTIC ) NUMBER OF PROPOSED BATHROOM -Z---'- APPROVED DATE ❑ INDIVIDUAL WELL NUMBER OF EXISTING BATHROOM PUD TYPE OF WATER SUPPLY ❑ PUBLIC ( NAME OF WATER SUPPLY) APPROVED DATE ❑ PRIVATE ( NAME OF WATER SUPPLY) y, �__ ...00...m... PLANNING DEPT . WITHIN SHORELINE JURISDICTION O YES NAME OF ADJACENT WATER BODY I ❑ NO (, APPROVED DATE BANK HEIGHT SETBACK C) PUBLIC WORKS DEPT ROAD RIGHT-OF -WAY WIDTH NAME OF PUBLIC ROAD NAME OF PRIVATE ROAD APPROVED DATE ROAD ACCESS PERMIT REQUIRED 0 YES ❑ NO IDENTIFICATION —�� MAILING ADDRESS ZIP TEL NO r 1 J1N A M E ,91yin `�f ^ .^ _ OWNER 1 /I r r( �( ' , / I C\)Lb 14- / , / I ,_ - CONT ' 'STATE L rc'rP4SE -au i ARCH i THE 0 NER OF S GUI '�ING A THE UNDERSIGNED AGREE TO CONFORM TO ALL APPLICABLE LAWS. ) SI A URE OF P ICA APPLICATION E RE T NU CHECK NUMBER OR CASH :7 PER�IT FF ('Ll le) S-7 APPROVED BY ((''�� \ 3 . BASE FEE INSPECTION A* T__,:`' �J� BLDG SURCHARGE PLAN CHECK E �2 ,,1989 % ENERGY SURCHARGE $ 1 38 TOTAL JEffERSQN COUNTY 911 NUMBER REFUND DATE i DATE ISSU f PLANNING gg,RRi�nc c BUI Y bFFICIAL , . . , • ......, . __. ---1 , • , • •-____,..... L..,f..,-. ...,/ . ...._ ,..4 ......A 5vc) .„_...... ___ _....-.....--2.1" ... ....... . , '').,..... n •:...) c . T (2), .4.—• -I -------------__._ .... ._.. ..... ..------- , ......------------- . . . ...... • \ ------ ....-- \ , - ____---'-------- . . . . . • . , .. . . • . . . . . . • : • . . . . . . . . . , . . . . • . . • . . . . • . . . . . „.. „ • . . . . . . . . • . • . . . . . . . . .. •. .• . . .. . .. . . . . • . , ..... .....• . . . . .. . . . . . . .. . . .. • . . . . .. . .• . . . • . . ,. . , . • . . . , . . . . . . . . . . . . , . .. • . • . . . . , • . .. . . . . . . . . .. . ., . . ... . . . . . . , . . . . . . .. . . • . . . .. . . , • . . . . . . . . . . . .. . . . . , . • . . , . . • . .. . . . . . . .. • ..• . . • . .. . . . . . . . .. , . . , . . . , . . . . . . ., .. . .. . . . . . . . . . . . . . . . ., . . . .. .. . . . •. . . . .. , . . . . . . . , .. • • . .. . . . . . , . .. . . . . . . . • . • . . . . . . . . . . .: • . , . .., ... •• . , . . . , .. ., • • .. . . . . . . , .. „ . . . • : . . . . • .. . . . . • . . . . . • . . . . .. . . . , . . . . . .. . . .. . . . , .. . . , . .. . • ,. . . . .. , .. . . • • • • . . . . . . . . . . • . .. . . . ,. . .. . . . . . . . . . . . . . . .. . . . . • . . . . . . . . . . • . , .. . . . . . . . . . . • . . . . , .. . . . , . . ... . - . . . . . , . . . . . . . - . . . . . . . . . . . . . . . . , .. . . . • . , . .. . . . . • \ ,t z 1 istia ------E---- 7-3 Si.)E i ( 7 Pi ,,-- FfiRSON COUNTY y ONG 81 titi3G DR ' 39 r i 1 i CU kalfilt t.- S '"' 1 t,A.,1-- Nfrtck , e XrCIi OIN) a 1j , v'c----' P-)\ / ....z_ /2, /27.' 7--'r•Cet-o-k r----e, ,____Lir te,i ,44.- 3- 17 --'-e--'1I 7 1/41,/, 69 / .-.7 -----L„ _AL 1'7-Y PV ,-.. \\, ,