HomeMy WebLinkAboutBLD1999-00593 ON °tf Jefferson County Permit Center * Department of Community Development
621 Sheridan Street, Port Townsend WA 08368[3601379-4450
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Project Description:
9 Digit Parcel Identification Number (from your tax statement):
Site Address Z73 048 iv., Hwy / ?/ 't f j
911#: -� ; ,,;' Road Name: Zip Code: '9 %4;
Legal Description
Subdivision Name:
���� � � ,L'"e c �';�' Block: L:5 Lot(s):
Section: /.P Township: d/,/ Range:
Parcel Size (acres or square footage):
Property Owner: Phone:
Mailing Address:
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Applicant/Occupant: Phone:
(if different from owner) ,
Mailing Address:
Authorized Rep: • Phone
Mailing Address:
General Contractor: v ; /dam
Or Manufactured Home Installer: Phone:Aar- /?‹'Z._.
Mailing Address:
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Contractor's State License Number: Expiration Date:
Septic Designer:f ? Phone: 4
'Mailing Address:
Architect:/Engineer: F Phone:
Mailing Address: ,�
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Loan Lender/General Phone:
Contractor's Bond Holder: 'Apt/
Mailing Address:
FOR O i-iCi USE ONLY
Fire District: _ Planning Area School District Zone:
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