HomeMy WebLinkAboutBLD1999-00594 ��o a Jefferson County Permit Center * Department of Community Development
c 621 Sheridan Street,Port Townsend WA 08368[360]379-4450
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Project Description:
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9 Digit Parcel Identification Number(from your tax statement):
Site Address
911#: 5 ;'3 ..ttyr, I d ( ) Road Name: Zip Code: 9 eiel
Legal Description
Subdivision Name: I r 6tw Pt v pt." f)arA Block: Lot(s):
Section: / Township: 3 0 A„,-, g
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Parcel Size (acres or square footage): 1 - " nie
Property Owner: ,> / Phone :., g
Mailing Address:
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Applicant/Occupant: Phone:
(if different from owner) l °e 7 ,. e 'er (1 c
Mailing Address:
Authorized Rep: Phone:
Mailing Address:
General Contractor:
Or Manufactured Home Installer: O(/ Phone:
Mailing Address:
Contractor's State License Number: Expiration Date:
Septic Designer: Phon
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Mailing Address: 1, /
Architect:/Engineer: Phone:,
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Mailing Address:
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Loan Lender/General Phone:
Contractor's Bond Holder:
Mailing Address:
FOR O1~1-1Ck USE ONLY
Fire District: Planning Area. School District: Zone:
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