HomeMy WebLinkAboutBLD1991-00120 a •
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Jefferson County Planning and Building Department
Courthouse, 3rd Floor
PO Box 1220
Port Townsend, WA 9A368
206-385-9141
PERMIT # -RT,D91 -01 20 DATE Rr.0 IVF.D. : 0A/1 2/91
SITE ADDRESS - 1 75 EAGER HILT. RT)
PORT TOWNSEND, WA 98368
OWNER -HOWARD PAGER ?Row, 385-5269
MATT,TNc ADDR- 1 76 PAGER HILT, RD
PORT TOWNSF.ND WA 98368
CONTRACTOR. . :NO CONTRACTOR PHONE-
MAILING ADDR
CONTR . LTC #: EXPIRATION DATE:
ARC H T TFCT/ . . - PHONE!
DESIGNER
MAILING ADDR
PARCEL NO. . . -9021 :31002 HEAT,
LEGAL DRSC. . : SIR 15-29-02 WWM, TAX # RV: DATE:
LOT 3 , BLOCK DISCOVERY BAY VTT,T, SHORELINES !
BY: DATE
DESCRIPTION OF IMPROVEMENT! single family residence
RTTTT,DTN(, TYPE -RFS BEDROOMS--- BATHROOMS-- MAIN FT, . . . _ 2600 sf
TYPE OF IMPROVEMENT-NEW EXIST. : 0 EXIST. _ 0 2ND FT, 0 sf
GARAGE/CARPORT PROP. . _• 3 PROP. . • 2 3RD FT, • 0 sf
WOODSTOVE •Y TOTAL. : 3 TOTAL. : 2 RASEMF.NT. . _ 0 sf
URC OCCUPANCY GROTUP:RS SEWAGE DTSP. . : SEPTIC CARPORT. . . . 0 sf
TYPE OF CONST WATER SUPPLY -PRIVATE GARAGE 0 sf
UNITS . : 1 ST0RIES : 1 HEAT TYPES . -HTP/WOD/ DECKS 200 sf
DIMENSIONS ! MORTT,F. HOME COMMERCIAL: 0 sf
FRAMF. TYPE-WOOD MAKE! YR - INDUSTRIAL : 0 sf
EST COST. $ : 106000 STIR' RANK HT. . . :0 ft
PROJ (;RP. . - 739 SH SETBACK: O ft
Owner/accent FF.RS
Signature ! tune amount by date recut
�i► PPMT $ 660 . 50 AK 03/12/91 52750
Date l 1� PT,CK $ 99 . 0R AK 03/1 2/9 1
R.C . $ 4 . 50 AK 03/12/91
Issued By: 11 \ � ;� •t t•�`,-
Date : Jeffersnn Cnwty piennl Z1 C\
& Building Department
$ 764 . 0R TOTAL
it -1 P- 3/° ///
c�()r 71\T fl v FI t i T i,i) 'T C r'�- R:TR iNAT I -i-
Jefferson County Punning and Building Department
Courthouse, 3rd Pinny.
PO Box 1220
Port Townsend , WA vrs.znrs
20 -385-9141
PERMIT #. . . 7RT,T)9i (1i 2O DATEDATETSSiir.Ffl
. : O.ii29r9'
SITE A')T)RESS : ! 75 PAGER ."TT.T, RD .
: PORT TOWNSENDI. WA 9836A
OWN .R •HOWARS1 FACER PHONE- 385-5269
MATT.TNC ADfR : i 7Fs EAGER HILT. RD
PORT TOWNSEND WA 98368
CONTRACTOR. . .NO CONTRACTOR PRONE.
MATT.TNC AnnR
•
CONTR . LTC #' T'.XP T RAT T ON DATE :
PARCEL NO. . . - 9O2 i 3 1 OO2
T.F.GAT. T)FSC. . : STR 13-29-02 WWM. TAX #
LOT 3 , nT.Oc^K T)TSCOVF.RY RAV VTT,T.
T)r.Sc;rc € rTTON 0 ' IMPROVEMENT: single family residence OA17 )(I).
( i Fnntincr/Sethacks (Shoreline Sethack) M n le Home Blocking:
( ) Foundation
( 'ndernrnund P- l umh i nn i underground Tnsu l a t i on -
( } Framing, Pl nin Chimney. y/zI,&
,' s
( . mallalipot /JAINN R W
1 .SH .trncir /�.
) Sewage Disposal System Final :
( 1 i na l/Occupancy Annrnva € t =
CAT.T. 385-9141 24 HOURS TN ADVANCE. TO SC:HF.T)i1T.F. TNSPF.CTTONS .
Office Hours 9 a . m . to 7 n.m.
Tnsnectores Hours 9 - 10 a .m.
24 Hour Recorder for Inspections .
LDING 'ERMIT APPLICATION r''-
1
Jefferson County Building DepartmeMt•P .O . Box 1220•Port Townsend. WA 98368
LOCATION /�-�
SPECIFIC LOCATION SITE ADDRESS �/ c,
POSTAL DISTRICT." /SUBDIVISION
LEGAL DESCRIPTION LOT BLOCK DIVISION TAX NUMBER
PARCEL NUMBER 1 / 4 SECTION
SECTION " TOWNSHIP oC NORTH RANGE , A / WM
BUILDING INFORMATION
BUILDING TYPE TYPE 'OF IMPROVEMENT SQUARE FOOTAGE / �
O SINGLE FAMILY [] NEW BUILDING ` MAIN FLOOR �. rn,3%
❑ MOBILE HOME 0 ADDITION 2ND FLOOR
❑ MODULAR HOME 0 ALTERATION BASEMENT
`r DETACHED/ATTACHED ❑ REPAIR\ CARPORT
( GARAGE ❑ REPLACEMENT GARAGE _..
WOODSTOVE 0 WRECKING/DEMOLITION COMMERCIAL
❑ MULTI - FAMILY 0 RELOCATION/MOVING INDUSTRIAL
NUMBER OF UNITS MOBILE HOMES r
❑ COMMERCIAL $ 40
SIZE
—� a
❑ INDUSTRIAL
❑ HOTEL/MOTEL/DORMITORY YEAR @ $ 20
NUMBER OF UNITS MAKE 0 a7 $ 1 0
❑ OTHER - SPECIFY EST I-rv1ATED COST OF \ 0 @ $ 1 0
IMF' OVEMENTS TOTAL FAIR MARKET VALUE
UBC OCCUPANCY GROUP $ $
SELECTED CHARACTERISTICS OF BUILDING
PRINCIPLE TYPE OF FRAME PRINCIPLE TYPE OF HEATING FUEL
❑ WOOD FRAME 0 LECTRICITY 0 COLLECTIVE SOLAR
O MANUFACTURED WOODSTOVE 0 PASSIVE SOLAR
O STRUCTURAL STEEL 0 GAS 0 COAL
❑ REINFORCED CONCRETE 0 OIL 0 OTHER - SPECIFY , Ic7P
O MASONRY ( WALL BEARING ) DIMENSIONS
❑ OTHER - NUMBER OF STORIES TOTAL LAND AREA
DEPARTMENTAL REVIEW
HEALTH DEPARTMENT TYPE OF SEWAGE DISPOSAL NUMBER OF PROPOSED BEDROOMS
O PUBLIC OR PRIVATE NUMBER OF EXISTING BEDROOMS
`Q. INDIVIDUAL ( SEPTIC ) NUMBER OF PROPOSED BATHROOM
APPROVED DATE ❑ INDIVIDUAL WELL NUMBER OF EXISTING BATHROOM
PUD TYPE OF WATER SUPPLY
O PUBLIC ( NAME OF WATER SUPPLY.)
APPROVED DATE 0 PRIVATE ( NAME OF WATER SUPPLY ? ' & s eC <r Wa
PLANNING DEPT . WITHIN SHORELINE JURISDICTION
O YES NAME OF ADJACENT WATER BODY
D 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 i
IDENTIFICATION
~_ NAME MAILING ADDRESS ZIP TEL NO
F
OWNER
I"as / 10 ii �q 3U5-
CONT
TT i1. CrtFNSL NO
ARCH
THE OWNER OF THIS BUILDING AND THE UNDERSIGNED AGREE TO CONFORM TO ALL APPLICABLE LAWS,
S)GNATURE OF APPLICANT APPLICATION DATE REDS I PT "NU�M\JBER I CHECK NUMBER OR CASH
. , .' ill.) ti I C)
APPROVED BY P rj FEES
/6 BASE FEE INSPECTION
4 . BLDG SURCHARGE / 1c, 3' PLAN CHECK
ENERGY SURCHARGE $ . 0-- , TOTAL
911 NUMBER REFUND DATE DATE ISSUED
BUILDING OFFICIAL
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