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HomeMy WebLinkAboutBLD1999-00145 ¢ o co Jefferson County Permit Center # Department of Community Development , , 621 Sheridan Street,Port Townsend WA 98368[3601379-4450 w :.. 'a. " ti ND .4 0 '- ' Uri' Ver gr6 4.s o Pi©t 2'll la de pekoe, algid. ad comfrldelet ad faaaifle: Project Description: 9 Digit Parcel Identification Number(from your tax statement): c®( 2,-® Site Address 911#: 22--- Road Name: S.DSc aik Zip Code: 'g (. `.b Legal Description Subdivision Name: Block: Lot(s): Section: Z® Township: co Range: ,._,A,. .....7— Parcel Size (acres or square footage): Property Owner: LA:_c_ '-; ' phone:.in . 7� �2�, 3 Mailing Address: d�/ Applicant/Occupant: Phone: (if different from owner) ' Mailing Address: Authorized Rep: Phone: Mailing Address: _ , General Contractor:Or Manufactured Home Installer: ' , -/1 �lp 9 ,�(2-. Phone: Mailing Address: Contractor's State License Number: Expiration Date: Septic Designer: zer-- "e Phone: Mailing Address: Architect:/Engineer: `1):7_4,dL-D 0-13 0 Phone; Mailing Address: Tn 13 6,4 `J i i.... l 1\f/v- i(57/ Loan Lender/General Phone: Contractor's Bond Holder: Jf Mailing Address: Fox OPrICE usE:aNL Fire District .:..>....... ;' Planning:Area: `° School District: ! IQ l Zone ::.....i.....:. .... . . 4/98 H:\home\pincntr\forms\universal plot plan