HomeMy WebLinkAboutBLD1990-00499 UUJLDING , 't-10,111 NNI'L. CAfION
,Jefferson County Building DepartmentsP .O . Box 1220'Port Townsend. WA 98368
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LOCATION L/,27--- / Li.D o �}
SPECIFIC LOCATION SITE ADDRESS o2O6 �/V 1/1/30 r- ,e/ L/L . n
6-y POSTAL DISTRICT /SUBDIVISION /1�yrv1AU\ . cl)ci9
z LEGAL DESCRIPTION LOT ,504(5/ BLOCK� DIVISION TAX NUMBER/
PARCEL NUMB R /"74 9tYO 4 7//,,3 0 1 / 4 SECTION
PLANNING AREA SECTION C t TOWNSHIP NORTH RANGE 01 ..E WM
BUILDING INFORMATION
BUILDING TYPE TYPE OF IMPROVEMENT SQUARE FOOTAGE
SINGLE FAMILY 0 NEW BUILDING D / MAIN FLOOR
❑ MODILE HOME 0 ADDITION 00 JG 2ND FLOOR
❑ MODU AR HOME 0 ALTERATION 51 �p€C17' BASEMENT
-fig DETACHE /ATTACHED 0 REPAIR /,Y°6L�L CARPORT
GARAG 0 REPLACEMENT DN ` GARAGE
WOODSTOVE 0 WRECKING/DEMOLITION COMMERCIAL
O MULTI - FAMILY 0 RELOCATION/MOVING INDUSTRIAL
NUMBER OF UNITS
❑ COMMERCIAL MOBILE HOMES
0 INDUSTRIAL SIZE a $40
0 HOTEL/MOTEL/DORMITORY YEAR $20
NUMBER OF UNITS MAKE q� $I
❑ OTHER - SPECIFY ESTIMATED COST OF 0 a@ $10
IMPROVEMENTS TOTAL FAIR MARKET VALUE
UBC OCCUPANCY GROUP $ $
SELECTED CHARACTERISTICS OF BUILDING
PRINCIPLE TYPE OF FRAME PRINCIPLE TYPE OF HEATING FUEL
WOOD FRAME ELECTRICITY 0 COLLECTIVE SOLAR
❑ MANUFACTURED 0 WOODSTOVE 0 PASSIVE SOLAR
O STRUCTURAL STEEL 0 GAS ❑ COAL
❑ REINFORCED CONCRETE 0 OIL 0 OTHER - SPECIFY
' 0 MASONRY ( WALL BEARING ) fit' DIMENSIONS /6112
fi00 1-
❑ OTHER - NUMBER OF STORIES TOTAL LAND AREA
DEPARTMENTAL REVIEW
HEALTH DEPARTMENT I TYPE OF SEWAGE DISPOSAL NUMBER OF PROPOSED BEDROOMS
O PUBLIC OR PRIVATE 1 NUMBER OF EXISTING BEDROOMS
n I ��D; DUAL ( S` 'T I j ;`..:::.:►rz'-.0 Cr Ps:CP�SE^ 31'.THRf CM
APPROVED DATE
0 INDIVIDUAL WELL ! NUMBER OF EXISTING BATHROOMa•••r
PUD TYPE OF WATER SUPPLY
O PUBLIC ( NAME OF WATER SUPPLY
APPROVED DATE ❑ PRIVATE ( NAME OF WATER SUPPLY
PLANNING DEPT . WITHIN SHORELINE JURISDICTION
❑ YES NAME OF ADJACENT WATER BODY
O NO
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
NAME MAILING ADDRESS ZIP TEL NO
OWNER
SRL)m 4- t__ ,3 4'7 0 /1 ( ,570YtfZ ,3f c ,e_
_ pi orm-E_Pt A (,9. P.X.2.5=)
CONT
' gI'A'rE LICENSI. NO
ARCH
THE OWNER OF THIS BUILDING AND THE UNDERSIGNED AGREE TO CONFORM TO ALL APPLICABLE LAWS;
SIGNATURE OF APPLICANT APPLICATION DATE ( RECEIPT NUMBER CHECK NUMBER OR CASH
; / 1? / , 7 /2- 9() I I a6t<fU rti.AD /0.2,-
APPR ED BY PERMIT FEES
BASE FEE INSPECTION
BLDG SURCHARGE PLAN CHECK
ENERGY SURCHARGE
TOTAL
911 NUMBER REFUND DATE DATE ISSUED
BUILDING OFFICIAL
t•
j F f L i�,E (0' . ,/vS 4 �' f� 1"O r' r .�Z3
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Jefferson. County Planning and Building Department
Courthouse, 3rd Floor
PO Box 1220
Port Townsend, WA 98368
206-385-9141
PERMIT # •BLD90-0499 DATE RECEIVED. :07/16/90
SITE ADDRESS: 206 OLYMPUS BLVD
:PORT LUDLOW, WA 98365
OWNER -RAY BRUMMELL PHONE:
MAILING ADDR: 5670 MOONSTONE REACH
:DRIVE
:CAMBRIA CA 93428
CONTRACTOR. . :NO CONTRACTOR PHONE:
MAILING ADDR:
CONTR. LTC #: EXPIRATION DATE:
ARCHITECT/ . . : PHONE:
DESIGNER •
MAILING ADDR:
PARCEL NO 7978900029 HEALTH:
LEGAL DESC. . :STR 04-28-01 EWM, TAX # BY: DATE:
LOT , BLOCK SHORELINES:
BY: DATE:
DESCRIPTION OF IMPROVEMENT: woodstove inspection
BUILDING TYPE •RES BEDROOMS--- BATHROOMS-- MAIN FL. . . : 0 sf
TYPE OF IMPROVEMENT:ALT EXIST. : 0 EXIST. : 0 2ND FL • 0 sf
GARAGE/CARPORT •D PROP. . : 0 PROP. . : 0 3RD FL • 0 sf
WOODSTOVE -Y TOTAL. : 0 TOTAL. : 0 BASEMENT. . : 0 sf.
UBC OCCUPANCY GROUP:R3 SEWAGE DISP. . : CARPORT. . . : 0 sf
TYPE OF CONST • WATER SUPPLY. : GARAGE • 0 sf
UNITS . : 1 STORIES :O HEAT TYPES. :EEB/ / DECKS • 0 sf
DIMENSIONS: MOBILE HOME COMMERCIAL: 0 sf
FRAME TYPE:WOOD MAKE: YR: INDUSTRIAL: 0 sf
EST COST. $ : 0 SIZE: BANK HT. . . :0 ft
PROJ GRP. . : 69] SH SETBACK:O ft
Owner. /agent A P1 R® V FEES
Signature: type amount by date recpt
PRMT $ 25 .00 MM 07/16/90 47378
Date: JUL 1 6 1990 B.C. $ 4 . 50 MM 07/16/90 47378
Issued By: Jefferson County nnin
Date: & Building Department
29 . 50 TOTAL
APPR.
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