HomeMy WebLinkAboutBLD1995-00728 Jefferson County Permit Center, 621 Sheridan St, Port Townsend WA 98368
UNIVERSAL PLOT PLAN
Fill in the following information as completely as possible.
Project Description: Qsnovai , enC+nce,.,r� �r�ss�-� roaCii7.5 w;i c � nsu 4:0=i
9 Digit Parcel Identification Number (from your tax statement) 9I2O QO 603
Site Address:
91 1# & Road Name j ,/ /4, J.L�p .Dk. - Port H cllOdk c< Zip Code 99 9
Legal Description:
Subdivision Name i 4. re' -rz. Block Lot(s) �jl' r
Section 7 Township 2.9 North,Range / WM
Parcel Size (acres or square footage) /9, "5/4/�
Property Owner Q/94/ C'®h/ .)56D - Pc2Lq% / ;// Phonee38 -7724
Mailing Address f// 1/;LLets D- - f3 - Avd1en..,k , t.6/3 98339
Applicant/Occupant ,O/,� Phone
(if different)
Mailing Address
Authorized Rep Cat Un er Phone
Mailing Address
General Contractor ,( ged e)
Mailing Address J 21_A j e Z��nof' > - Q ►i a 1.0)9 98-6702.
Contractor's State License Number L,L. I E/4.t - 41. OS'?.sTe. Expiration Date 03/ 29' 9(=
Septic Designer A-1/4 Phone
Mailing Address
Architect C�' n, ,� De6z1.7 C-yvo:,p Z„ C./9O,7 la•,ds) Phone 385 -6-64e
Mailing Address 4,66. gooseve/6 - f"or7• 7-84c)nScn.1 , L)19 98 P
Loan Lender/General / Phone
Contractor's Bond Holder
Mailing Address -
FOR OFFICE USE ONLY
Fire District Planning District School District Zone
Case Number