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HomeMy WebLinkAboutBLD1999-00168 Jefferson County Permit Center * Department of Community Development 621 Sheridan Street,Port Tovmsenti WA 98368(360)379-4450 n 0 un'versa 74 0? a to g de tollowig9 6&ia edsoktely ad,60424ilde: Project Description: f6/1/76126Z /9/94/77; 9 Digit Parcel Identification Number(from your tax statement): 76- P Site Address 911#: ; OZ Road Namei5c;tir/7/5)/2/ ,e,v: Zip Code: ,•",,F.„. Legal Description if)/ / Subdivision Name:/74097—L-COLW 4/1/476: Lot(s): /0 Section: — Township: Range: — Parcel Size (acres or square footage): Property Owner: Phone: / 9/ /9//i 4676/1/ .Lie, #9A e/R .960L3T 7767/ Mailing Address: 5.0e/r/Y /3,41/ lCbAl 6/40 W./9 ?" Applicant/Occupant: Phone: (if different from owner) Mailing Address: Authorized Rep: Phone: Mailing Address: General Contractor: • Or Manufactured Home Installer:60,60447ie //I 04,76 5 Phone ..„/57.... ó&o Mailing Address: (.720'cik ,44-; Icave. /vojea‹ 7.,147Y 6 Contractor's State License Number: Expiration Date: 6 0c5 6-14//7/70 o6"az- ,Reyoc,) Septic Designer: Phone: Mailing Address: - - Phone: Architect:/Engin e erecivf-344// Core 6-77 Mailing Address: //oai° S. 6', /IV- 4/ 5 E' /?6/76 ye./ 0/../P Loan Lender/General Phone: Contractor's Bond Holder: Mailing Address: FOR OPPICE.USHONLY. . : . . . .. • • Fire DitriCt:. i]. School District: 4/98 II\home\pincntr\forms universal plot plan