HomeMy WebLinkAboutBLD1999-00169 ¢aoN: o Jefferson County Permit Center Department of Community Development
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k�' 621 Sheridan Street,Port Townsend WA 88368[3601378-4450
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Project Description:
9 Digit Parcel Identification Number(from your tax statement): ei 90 _/00.19/6.7
Site Address C� 0911#: 6 l 3 Road Name: 0 4°'` 4? ti'to. Zip Code: ,' 4 w_
Legal Description
Subdivision Name: ' t�`�f c5c. Block: Lot(s): "
Section: i
w Township: 2 i „;t,' Range: / Z,
Parcel Size (acres or square footage):
Property Owner: a.ixe____ - Phone:
�, a r° / . "-,'Mailing Address: I � x G 1 �� FCC .�_ � � � /"�"I)i ee,, .(;,L� c, l v ',(:- S
Applicant/Occupant: Phone:
(if different from owner) 1 i.
Mailing Address:
Authorized Rep: ,. r-f` -4 44,.., 6 (.=;f _ Phone: 4`' , A72 (-,v
Mailing Address: ,•.
General Contractor:
Or Manufactured Home Installer: - Phone:
Mailing Address:
Contractor's State License Number: Expiration Date:
Septic Designer: Phone:
Mailing Address:
Architect:/Engineer: Phone:
Mailing Address:
Loan Lender/General _ Phone:
Contractor's Bond Holder: �t r� j ��'1 f- ge/p -- 54S? - 6)Z_`Z 42
Mailing Address:
:FOR OFRCEUSEONLr... ..
Fire District Plannin ,Are-a: School District: Zone:
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