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HomeMy WebLinkAboutBLD1998-00574 �,o co Jefferson County Permit Center * Department of Comnunity Development st. r , 621 Sheridan Street,Port Town nd WA 083681360]370-4450 w 'V� - ti 0 �� r;G`�° \4. .0''''',-"A3:;'. •. , Un'VeNC6 ? C . 7cll to tie jlt104,ag 6`a#ra 44 camftl f.e4 44 Aft/441e: Project Description: i‘eCcir-1 vn , m. . / n 0 I- : ,,;I R.: 5,1.e 9 Digit Parcel Identification Number(from your tax statement): SO,Z /6 2 .06• •, _ _0/ •/_ • Site Address 911#: 51I Due_ iu.Sk R Road Name: 'bkm_ & _ k j Zi. Code: • 7,320 Legal Description Subdivision Name: Block: Lot(s): Section: i L Township: -�'e,2 S Range: ,2 \,,/ Parcel Size (acres or square footage): O. 5 7 Property Owner: -- ( I Pho e: Mailing Address: J �ciyI I1 1-�P_et 512y 'f" -Bar bore__ Cr�e .Sor (3D� 7 9(o- .30 72 9 '3 1 I ue_kJou.5k ..R r i nnon W A 993z0 Applicant/Occupant: Phone: (if different from owner) S A.rr. . Mailing Address: Authorized Rep: Phone: Mailing Address: General Contractor: V/c Or- (fit- c4 aloe.. A- SQu-(4..2- Coi4rkA-von -/ Or Manufactured Home Installer: Phone: 34,0 79 to — 3 017 Mailing Address: 733 W p W A- o,n .oajr 'jr;nnon' W4 4'33azo Contractor's State License Number: S�uQR 0�3 2 8L Expiration Date: 7 G.vi • l74• S9f o9- 79 Septic Designer: ( Phone:3O)\ 796 - th 1 Mailing Address: --po -Uo,c (3 S , r-t nr‘o'n W F} 9 83zo :11, -.,.- 7).¢5,Sn L7e or: // // l / fit. rr9ne.K k.s 1 P( o� 95 - 393S ' c.�ryn t,��t� hld,b,��R�l�i,w.r, 303 f�2/1a�f',c�5 �• F�or7 lnwrl�,tllc�� ft)A `ti3by Loan Lender/General Phone: Contractor's Bond Holder: A/A Mailing Address: R OH 1c USE ONLY,< . ..... 'Fite D►srxict : .. ....: .......:. PlanningArea........ . School Dis c Zone: .......: . ..... :'. 4/98}I:\home\pinentr\forms\universal plot plan I CE Al o