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HomeMy WebLinkAboutBLD1999-00792 V.sori p Jefferson County Permit Center * Department of Community Development 4� �. 621 Sheridan Street.Port Townsend WA 08368(3 -r 0 60l 379 4450 IK,,-,9-P--'---„,.-0-I-,,,o- U :vr :ll Pll©t ro Ica tie de 44 eo getely44 le Project Description: E ,,� t, ,, t . x F 9 Digit Parcel Identification Number(from your tax statement): c -, --- ,. Site Address r 911#: A 4- Road Name: ! '°: - ., Zip Code: Legal Description Subdivision Name: Block: Lot(s): Section: Township: Range: Parcel Size (acres or square footage): Property Owner: , g i l t Phone: ram,, )s-- ,�- ' ,," E j , I 4i,, Mailing Address: 1-/ �, + --' E ' ' "� . �. .t_t yam. "^s r Applicant/Occupant: Phone: (if different from owner) Mailing Address: Authorized Rep: Phone: Mailing Address: General Contractor: Or Manufactured Home Installer: ,j-=\Vi. L„;-t , I°tq r Phone „ n ` `' Mailing Address: �� t� mow. Contractor's State License Number t Expiration Date: Septic Designer: Phone: Mailing Address: Architect:/Engineer: Phone: Mailing Address: Loan Lender/General Phone: Contractor's Bond Holder: Mailing Address: FOR opricr USE ONLY I Fore District: ;, . _ Manning Area: School District Zone: 4/98 H:\home\pincntr\forms\universal plot plan