HomeMy WebLinkAboutBLD1999-00235 Jefferson County Permit Center, 621 Sheridan St., Port Townsend WA 98368
UNIVERSAL PLOT PLAN
Fill in the following information as completelyas possible.
Project Description: Pal Lju ,\( onr F3 Ar Ar ye,, GornI;A/,A ''a
9 Digit Parcel Identification Number (from your tax statement) 8® 5 3-0 I
Site Address:
91 1# & Road Name / "- O ,.Le j,;q,,j ! ((, C'v y'(c e,Ne.— Zip Code 9 R.17C,
Legal Description:
Subdivision Name Block Lot(s)
Section 25 Township North, Range 2 WM
Parcel Size (acres or square footage)
Property Owner , : AAA sJ e,o5 e_n Phone 7t 5- , ' 7
/
Mailing Address / J -t Pc . LU. Qu ,\ ce WA . 6)(137e,
Applicant/Occupant _sue p �� Phone
(if different)
Mailing Address
•
Authorized Rep Phone
Mailing Address
General Contractor $n u�d� 13v f''GI? t e y $)S )1. c. Phone ,'1..q7 -7?/ 7
Manufactured Home Installer e Phone
Mailing Address 3 7e F Fer r-5 A.,q Stogy '8 /
Contractor's State License Number _57z,L?,,,,,Q (n 5 027 Avg Expiration Date P • )4-/-4 7
Septic Designer - Phone
Mailing Address
Architect Phone
Mailing Address
Loan Lender/General J Q' / C G E-r- ��S Phone
Contractor's Bond Holder
Mailing Address Po v)S
FOR OFFICE USE ONLY
Fire District Planning District 10 School District3)....1-4Zone