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HomeMy WebLinkAboutBLD1999-00450 © Jefferson County Permit Center * Department of Community Development 6. 621 Sheridan Street.Port Townsend WA 08368(3601379-4450 uo:v2rscG olloi) oir(0 �eu i tic as cow/deed", as,e4a e: Project Description: Uew-Noerne ctfi 5 i3 14101,,tcovv er L-ome Pori' 1---(447L014, Areel* a 9 Digit Parcel Identification Number(from your tax statement): GI ctb _ADO —a ei Site Address 911#: ,J Lf 3 01 ell T C OMert1C,4 Road Name:HGvitGokr ei'�(i.GA-e- 9 Zip Code: S 36%5- Legal Description Subdivision Name: pa 2 T L U 0 L®Cv L i d Z Block: Lot(s): lj 7 Sections i ge,,c1 Z E 0.g.1E.Wfri Township: J e-C-Ctrs'ov' Range: 6 Q(. L c> 3 Parcel Size (acres or square footage): (2 , S F Property Owner: Phone: Nl R S. � M 2. e;tG+ (Z.�:� s 30 "� 3 Z-R � Mailing Address: 5`I /2. 1*-14.14 5 T. Ve t1Q,a (;T y Ca. °I S°is i 0 k 9 40D z a ss-.`��,� �,�(44-0 Applicant/Occupant: Phone: (if different from owner) LoA(A0E }-1. '(3 N 0 j(op <505- C 5- - ress Mailing Add : .�-- � �o G 0. Box- i, POST ( owe Sr/® LV . i836, B Authorized Rep: ' Phone: "3-Ca 6/7.7 S5 ---6 Mailing Address: (30.y P 7 l/t ro c4 E( 36. 8' General Contractor: Or Manufactured Home Installer: .1 n 5;(id.It y Pr06 .e 5 S Phone: Mailing Address: Contractor's State License Number: Expiration Date: Septic Designer: 6/� �( 4 ,d-e f Phone: Mailing Address: Architect:/Engineer: an Phone: Mailing Address: Loan Lender/General Phone: Contractor's of d Holder: AL2k.e't?"--if r Mailing Addres . FOR OkNCE USE ONLY Fire District: 3 `' Planning Area: ° School District; t Zone: 4/98 H:\home\pincntr\forms\universal plot plan