HomeMy WebLinkAboutBLD1999-00656 (44--01Jefferson County Permit Center * Department of Canvnunity Development
' q, 621 Sheridan Street.Port Townsend WA 08368[3601379-4450
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Project Description:
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9 Digit Parcel Identification Number(fro/your tax statement): +
Site Address 1
911#: /5- Road Name: Na5,, ,1 i'L /Ia// ,k Zip Code: ? 3 31
Legal Description
Subdivision Name: Block: Lot(s):
Section: Township: Hai to cb Range:
Parcel Size (acres or square footage): / q 6 5" 5i1
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Property Owner: A / 4. ,T,,-,„, 5 /VOL IA 1(0 jk, i Phone:
Mailing Address: /
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Applicant/Occupant: Phone:
(if different from owner)
Mailing Address:
Authorized Rep: Phone:
Mailing Address:
General Contractor:
Or Manufactured Home Installer: (t c-t- Phone: .7 w-7 — 77 7
Mailing Address: f
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Contractor's State License Number: , i A cam` Expiration Date:
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Septic Designer: Phone:
Mailing Address:
Architect:/Engineer: Phone:
Mailing Address:
Loan Lender/General Phone:
Contractor's Bond Holder: 011 t .5-C' 7-, s,
Mailing Address:
FOR OH I C"l1 USE ONLY
Fire District: k PlanningArea: r School DistrictZane:
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