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HomeMy WebLinkAboutBLD1999-00825 Jefferson County Permit Center * Department of Community Development 621 Sheridan Street Port Townsend WA 88368(3601370-4450 , _:... ..p....-.,..„..-t:-....;- 4 UoGvers,(111 pg© Pko ell is de‘01144,409 el41(44 44 eosetiletelf ad Aoweele: Project Description: ..\. . 9 . _....__ CI, s_ --r--r, /- ,.., ,J.,...:,Y-,--, ,—c_,,.: 9 Digit Parcel Identification Number(from your tax statement): Site Address 911#: 1..,X:.,\-- 3,c- --),cr-<)cjo_q -,-, Road Name:(„Th_t-_-)\-\ t_ Cd- - Zip Code: Legal Description ) Subdivision Name: k, ) -- Block: Lot(s):Section: I Township: I Range: Parcel Size (acres or square footage): a o, Lt c ci rc::)S- A Property Owner:(;---\ .--'A-• - (\,-,) _,..- '-'-, ; Li_cc,„'-',c)\___; \- 1 ,),...,i9ge,:oc Mailing Address: , ,--- ,' yi - -P4.-- (1)-(..,Dr) .fLr..d.," i (.,,„2;. • (.2 'Applicant/Occupant: . 65...yi;)---1 ,;-., Phone: (irdiff _ ei from owner)Mailing Address: ___, - „)::_) ---,„„r2)- - 4.- (,:. &,-,--f k !t- Authorized Rep:Rep: f. .', , Th ' Phone:U - CMailing Address: r CI t•---4-1.. ) 1_" e---0. Ct - e-1--- ! -7 --1.,7 - -( General Contractor: , Or Manufactured Home Installer:(.,,, CU t --){, ,ukc (6rot-,,(6 Lb, Phone:Mailing Address: --_-> c-- f.:-_-- 1 rs i cc -----')\-..7)-----3 C___CA---4-1 ..,',',-- CO0_6 ' \-•) 1:.---r-,..., ...,„ Contractor's State License Number: IExpiration Date: c ic,I let Septic Designer: I\ ---- .,1---)' e d, Phone:, .....,, Mailing Address: Et) c.,,, _ ,,-,,,,,,:_ )c, , ! ,----1-(,,,,,,..L.s Architect:/Engineer:, Ph_one:k;(_,7„,:,c__1_,&!_t-,,,t-N.rip 1 i --r&I-C3tir1 ' ' ()-0 T...2,,,,c Mailing Address: Loan _____ .., . e_c_.:(71_d_. Lender/General i, in ,...., Phone: Contractor's Bond Holder: --.\----k (-4- i-----)-i--; . ....--Cifjp,_,,,,t--_,), 1...,...,_ Mailing Address: ---, - r -'--.‘--•, ( FOR..01-,PICE',VSE-OMX.; ...•. . . ... .':''..-.•. :.' :•.: •,:- .:: ..---.•i•,.:::-.•. : : .. -:.. :: ....:: .--• i Fire District :j :::::':'.';:-:,Fi.-..; i PIanning-Are ...','! ,± I 5c1-jool:pstrj..4;-...':: -::-:-' :, ..'.: i Zoe: ..•-i- • .",-•:: -:-.-:. ..-.--- I 4/98 H:\home\pincntr\forms\universal plot plan