HomeMy WebLinkAboutBLD1998-00128 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: 4/9/ 777// (2 r f/(-4
9 Digit Parcel Identification Number (from your tax statement) , (-)
Site Address:
91 1# & Road Name 6> l
,./(5,47 177. Zip Code
Legal Description:
Subdivision Name �'/p ,ZeW 446' / .. Block
Lot(s)
Section
Parcel Size (acres or square footage) Township �/ North, Range �° WM
Property Owner ,y..„K�l/ �r%/� 'z �t�, ' °i✓ G<�` Phone _ e:)
Mailing Address e,„,1 .7
Applicant/Occupant Phone
(if different)
Mailing Address 5, 9,
Authorized Rep Phone
Mailing Address
General Contractor .(7'- 7://.fi717-62 `,L! l//1/C. Phone yzY7-, `?�i 6-0
Manufactured Home Installer Phone
Mailing Address j
Contractor's State License Number ED 0/ 'ev K' Z Expiration Date /_ / "7
7-b
Septic Designer — Phone
Mailing Address
Architect '/ 6 7/Gi'6r-��_ 6/✓'7 w ��
��`��1� ✓'�� Phone��=�3-
Mailing Address :3'7 tom' Ss',7 //.4 -,rr dt
Loan Lender/General
Contractor's Bond Holder Phone
Mailing Address j�!''f' —"��.�— , 7s1
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FOR OFFICE USE ONLY
Fire District 3 Planning District School District 2 t Zone