HomeMy WebLinkAboutBLD1999-00651 Jefferson County Permit Center, 621 Sheridan St., Port Townsend WA 98368
UNIVERSAL PLOT PLAN
Fill in the following information as completely as possible.
Project Description: ,. `rl,o w.p, t S�
9 Digit Parcel Identification Number (from your tax statement) 9ci q Z ® 35
Site Address:
911# & Road Name ()000D Ol1p1,-e-Pt? c ar-L-1/4. IelLi Zip Code 9 Q, T g
Legal Description:
Subdivision Name G..)DOptzt p J.J. )kc t t,t) ( Block Lot(s) 3
Section '- I Township 2-g1U North, Range /
Parcel Size (acres or square footage) sq Oc>CD
Property Owner 1 J. VD Phone28f -c}q2-c39fq
Mailing Address 11p1S "rr--e_ct OAKS , W �4�. 7X -7 -79SO
Applicant/Occupant S,-yn� Phone
(if different)
Mailing Address
Authorized Rep ohNilE2- LASTOIv\ Tom* "^e5 Phone 3(o ) q37 O 7 /
Mailing Address j7. O. (3a,c c 5-e1,Y7 -7- 1-(.4(2/er./� l.J�4 1836s
General Contractor L4tupE2 �esiynl�,t,p „„ey Phone C-/!7 Zsn/
Manufactured Home Installer /'/F}- Phone
Mailing Address . go)c S+5 7 R e o1/4 k',4— 12936 s--
Contractor's State License Number Expiration Date
Septic Designer C•j/t} Phone
Mailing Address
Architect (' rtto PA-rR1L /-1SSOL. Phone2-06 S2241-
Mailing Address 392 3 PA-1 c. nJp DR 043I.J .R,O6.f ES L. e/ 8//O
Loan Lender/General / /''7 ti J fT _ Phone
Contractor's Bond Holder
Mailing Address
FOR OFFICE USE ONL Y
Fire District Planning District School District ��j Zone