HomeMy WebLinkAboutBLD1999-00670 5ozv �o Jefferson County Permit Center * Department of Community Development
r, 621 Sheridan Street Port Townsend WA 88368[360]379-4450
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Project Description:
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9 Digit Parcel Identification Number (from your tax statement):
Site AddressLao
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911#: Road Name: Zip Code:
Legal Description ;
Subdivision Name: ti i e-t' k k Block: Lot(, :
Section: Township: Range: 2
Parcel Size (acres or square footage):
Property Owner. R® aod e c;( Phone:
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Mailing Address: 2,70 Rv,oakadeAti jvv.....1
Applicant/Occupant: m Phone:
(if different from owner)
Mailing Address:
Authorized Rep: Phone:
Mailing Address:
General Contractor:
Or Manufactured Home Installer: -,., , Phone:
Mailing Address:
Contractor's State License Number: Expiration Date:
Septic Designer: } Phone:
Mailing Address:
Architect:/Engineer: 1\1/14: Phone:
Mailing Address:
Loan Lender/General t Phone:
Contractor's Bond Holder:
Mailing Address:
FOR OH'ICE USE ONLY
Fire District 4 Planning Area:. t- School District 4. t Zane
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