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HomeMy WebLinkAboutBLD1999-00684 gsorr coy Jefferson County Permit Center * Department of Community Development 621 Sheridan Street,Port Townsend WA 88368[360]379-4450 Uovrflpfl©tpg g0 e jollooeg,. ‘141141. as co rcd,* as , Project Description: •c-4792, /es--/Ze---"ter_c 19 Digit Parcel Identification Number fro your tax statement): Site Address 911#: 6 / // Road Name: / ��3yQ Zip Code: Legal Description Subdivision Name: Block: J Section: Lot(s): -2 Township: 4, , Range: Z Gl/ Parcel Size (acres or square footage): Property Owner:0, ,, 4' ri /goy Phone /�3� 3 `��Mailing Address: - � Applicant/Occupant: (if different from owner) Phone: Mailing Address: Authorized Rep: Phone: Mailing Address: General Contractor: _ / Or Manufactured Home Installer: /�'y/ /,vq�q &/e_, Mailing Address: Phone: 3/olJ��i�' 8� e� Contractor's State License Number: SC Q I Expira Septic Designer: R,0 64I5.0 /S Phonee.,, // 3-84� Mailing Address: 5�0 Architect:/Engineer: � /tf® v/C r� I Phone: 0 7 _ Mailing Address: 1/4 /9 /. 1-2j Si-- /i v/es .f3C 2-- Loan Lender/General Contractor's Bond Holder: 1 � ' / 2 I Phone: Mailing Address: n G FOR OPPiCE USE ONLY [ Fire District: Planning Area ` District Distric " I 4L$ .._ I Zone: I 4/98 H.\home\pincntr\forms\universal plot plan