HomeMy WebLinkAboutBLD1999-00619 ¢50 Jefferson County Permit Center * Department of Community Development
4.4 ' ° , 621 Sheridan Street, Port Townsend WA 08368 [360]370-4450
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Project Description: /7)0 d f T i /0, 'r / SA`'. f�1Ole (6s 46/ / X/ 4 /L/-
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9 Digit Parcel Identification Number (from your tax statement): 967 -C Cs 6-5
Site Address Cd
1911#: 550 Road Name: /%i/(-.`(f/ Zip Code: 36i
Legal Description t s
Subdivision�/ Name: /I✓(4 (O(;r�1� * / Block: Lot(s):39 i 3/c
Section:x, �J / `(a,, �i`� Township: 30 /i' Range: /kJ
Parcel Size (acres or square footage :
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Property Owner: /),f C // / f ZYz9/ i,f / — Phone: 7 5 '5&?
Mailing Address: SSC (/�'`6C r '�!Jr,l . /j M/4' -/0/ ieNe e vc_<LC/
Applicant/Occupant: n Phone:
(if different from owner) ,. -/4'3D-7 e
Mailing Address:
Authorized Rep: j�7"/ �} �. f� Phone: 3 0/r ,2
Mailing Address:
/je" /15-3 ,t/`".. /0" r7y - r0( (,,c/.4
General Contractor: _
Or Manufactured Home Installer: 6C�///� 67?"9-f, _JAI Phone: -3efq
Mailing Address:
Contractor's State License Number: i - r 1 Expiration Date:
Septic Designer: xi/9Phone:
Mailing Address:
Architect:/Engineer: t. Phone:
Mailing Address:,, C c �c ,L 7 )/ L -f6 Mil- Q2
Loan Lender/General Phone:
_- �
Contractor's Bond Holder: C ( 3 5 V ?2 7
Mailing Address: �-
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FOR ON-ICE USE ONLY
Fire District: Planning Area: School District: i Zone:
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PI.-00K r9NI�)N PLAN
This &.wins is dte exehuive peopo iy of
Tandem Damn Otatp, and can be.ptodwA
only with the pambaiott Ordw Desipw.
Va *Wm and mddifAA&m to wont dwwa `
On dlis d.wins smo m be Gaoled oat witima
wtitke peo,ow"intt IFan INeDeslbttet'
PI.-00K r9NI�)N PLAN
This &.wins is dte exehuive peopo iy of
Tandem Damn Otatp, and can be.ptodwA
only with the pambaiott Ordw Desipw.
Va *Wm and mddifAA&m to wont dwwa `
On dlis d.wins smo m be Gaoled oat witima
wtitke peo,ow"intt IFan INeDeslbttet'
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This drawing is the exclusive property of
Tandem Design Group, and an be reproduced
only with dw pemmission of dw DasiVw.
Variations and modifications to work shown
on this drawing shall not be carried out wWma
written permission from the DesWW.