HomeMy WebLinkAboutBLD1999-00268 5rdeg, ifor-0444407 s -2:
g,$oN c�tr Jefferson County Permit Center * Department of Community Development
621 Sheridan Street Port Townsend WA 0836813601378-4450
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cll is the idiapat, 61444 " ea►syEi ete4 44 Amalc;
Project Description: /7/
9 Digit Parcel Identification Number(from your tax statement):
Site Address
911#: Road Name: Zip Code: 91-3C,
Legal Description
Subdivision Name: � ,,s2-7a;P 0e-e� _ Block: Lot(s):
Section: 7 Township: Range:
Parcel Size (acres or square footage):
Property Owner: c),4)&c- �� � - Phone: � 9/
Mailing Address: 7 / , zz(Z)z , yt3
Applicant/Occupant: - 4Ai€ Phone:
(if different from owner)
Mailing Address:
Authorized Rep: D 'e 6-5 Phone: 4/5,7_
Mailing Address: �'� t/e6e-- pY a 04,,,/
General Contractor:
Or Manufactured Home Installer: Phone:
Mailing Address:
Contractor's State License Number: paper i3e Expiration Date: 4,/,,A,
Septic Designer: Phone:
Mailing Address:
Architect:/Engineer: Phone:
Mailing Address:
Loan Lender/General 4/2 / -5 i/7� iff ":� Phone:
Contractor's Bond Holder: ,6F 00 m 413-7-67,7,20
Mailing Address:
Fire District: : Planning Area:: ... School District::a, Zone: :
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