HomeMy WebLinkAboutBLD1999-00659 Jefferson County Permit Center * Department of Community Development
621 Sheridan Street, Port Townsend WA 08368(360)370-4450
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c'll Oe de jottaeoeig &AIWA as corn/deaf ad Project Description:
Description:
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9 Digit Parcel Identification Number(from your tax statement): ----7 (---, ; ,,--, ,;., ;‘,,,,, j
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Site Address , , ,,Z. ,
911#: , ./-4 ' 4I4 Road Name: ''' ,- P',:: ,- ‘ A ''' le Zip Code:
Legal Description
Subdivision Name:
Block: Lot(s):
Section: 1 Township. —,,,,,,, ' : --- ' --, I Range: : vi
Parcel Size (acres or square footage): '
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Property Owner: f-L-)LA, . o. et "„,,,:,—T (:,,, , ,,, , --' , Phone:
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Applicant/Occupant: Phone:
(if different from owner)
Mailing Address:
Authorized Rep:
I Phone:
Mailing Address:
General Contractor: ,..-,,,„, . 1
Or Manufactured Home Installer: „,.. :::I-Ho Dela - ''!- r I 'S e•Pho /2'':-. — .. / ‘I
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Mailing Address: m`m) ti'''', i''' ,'-I‘..,,„„ / \ , L
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Contractor's State License Number: ....-.._„.. 4 , ,-.,--- i :, Expiration Date:, /' ,) ') i i
Septic Designer: ki I fp Phone:
Mailing Address:
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Architect:/Engineer: f' i, I Phone:
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Mailing Address:
Loan Lender/General
Phone:
Contractor's Bond Holder: 1\.)
Mailing Address:
FOR 01-q-ICE USE ONLY
I Zone.I Fire District: Planning Area: 1 School District: I
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