HomeMy WebLinkAboutBLD1996-00432 Jefferson County Permit Center, 621 Sheridan St, Port Townsend WA 98368
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UNIVERSAL PLOT PLAN
Fill in the following information as completely as possible.
,Project Description: Ci .C6-s-.-
9 Digit Parcel Identification Number (from your tax statement) 46 0000 30
Site Address: r itc 8 ,376
911# & Road�'Name t aoz A (c,is g: sF
Legal Description: L:sr26iofe3r, "'—"Q`� 6F 660,a. A� a"TG s
Subdivision Name Block Lot(s)
Section ° Township ship -Z North/Range, E V ) WM
Parcel Size (acres or square footage) 4S00019-
Property Owner am" ( Yic*feA - D0-AL4 Phone-2- 4Si(ci
Mailing Address 118 I TOPsr e2c IAA. (.i1A RG�
Applicant/Occupant A..L-Pu,QPose, r2ec e4. Phone { 7 71G r
Mailing(if diffrent) ? 3�1 et&
Address D rr��-�L-,
Authorized Rep 244-AR-A O&J Phone boo 877G
Mailing Address —Pe) gos,c. 3( 1 atte^IJ?( qEAA
General Contractor u--0.024oat's Phone 16.77C0/
Mailing Address �tS&X ��� m ��- , W A 34
Contractor's State License Number At-e_ PuST Expiration Date 8, Mc
Septic Designer °J/A Phone
Mailing Address
Architect 1A4,1 v.-r, Phone
Mailing Address
Loan Lender/General Phone
ontractor a'Bond Holder
•Mailing-'Address .r 7-(1 . rc, c4 o
Ot. Licz QC pJs L p v 1'
FOR OFFICE USE ON
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Fire District Planning District School District Case Number C i �'P�o" •