HomeMy WebLinkAboutBLD1999-00305 oJeffero County Permit Canter ` Department of Community Development
(4fr >: 621 Sheridan Street,Port Tow
nsend nd WA 98368[360]379 4450
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Project Description: 1
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9 Digit Parcel Identification Number(from your tax statement):
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Site Address \. S
911#: Road Name:
Zip Code: CI S" 3 (g, Es-
Legal Description
Subdivision Name: Block: Lot(s):
Section: I cl Township: Range: t
Parcel Size (acres or square footage):
Property Owner: --D Phone: l 4.,r « 4 h
Mailing Address:
Applicant/Occupant: t Phone:
(if different from owner)
Mailing Address:
Authorized Rep: Phone:
Mailing Address:
General Contractor:
Or Manufactured Home Installer: 0 _ ( \.,.\,.
M Phone:
Mailing Address:
Contractor's State License Number: Expiration Date:
Septic Designer: c _ Phone:
Mailing Address:
Architect:/Engineer: I Phone:
Mailing Address:
Loan Lender/General Phone:
Contractor's Bond Holder: rr .et„r. "� S
Mailing Address:
FOR ON-ICE`USE ONLY
IFire District: 1 , Planning Area: 3 I School District I(61 t I Zone: '
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