HomeMy WebLinkAboutBLD1996-00720 , 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: ( elziA,Lask (c°vts(• /vWi t2YV1 - lkN fC,FUS tG
9 Digit Parcel Identification Number (from your tax statement) O0/1 ?/ ®
Site Address:
911# & Road Name L ®�— Aa410 14LA Zip Code 7g g)
Legal Description: �� _�
Subdivision Name i9- id H4/lU£�/ J�Aa7�t ��� Block Lot(s)
Section is, Township 3d/t-ei North,Range 1 W WM
Parcel Size (acres or square footage) 6. / 6
Property Owner •7-6-62-/• ►�/�[j�,t/�J Gt . Phone S SOS
Mailing Address `3? C CA.Lrt 'X_le0.4-C p.7. 34e;r
Applicant/Occupant Phone
(if different)
Mailing Address
Authorized Rep Wa tenba uu ) Const. Phone
Rd.
Mailing Address Tow Port nerd, A 98368
Waltenbaugh Const.
General Contractor .71 Phone
Crutcher Rd.
Mailing Address Port TowAsends WA 98388
Contractor's State License Number $z-if le /'2a/D f Expiration Date D 7 4 ?
Septic Designer 6"-P-NT-�L(e l G5e/Li Phon55 3 2
Mailing Address f4. ,-Tt < W-
Architect aaltenbaugh anStt Phone
Mailing Address port TrAVIISeili, WA 98368
Loan Lender/General r
Ftr5� �-�� , �-cJ/�S l jar9N Phone 385 I¢E �
Contractor's Bond Holder
Mailing Address
FOR OFFICE USE ONLY
Fire District Planning District School District Zone
Case Number