HomeMy WebLinkAboutBLD1999-00685 �gSON Jefferson County Permit Center * Department of Community Development
. 621 Sheridan Street, Port Townsend WA 88368[360)379-4450
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Project Description:
9 Digit Parcel Identification Number(from your tax statement):
70 2 dx.2 005
Site Address A PPt.. ) D FOR 0 P- P LC., 0 P
911#: Road Name: L0 R D S tmk RP Zip Code:
Legal Description
Subdivision Name: (-O R i7 S (. - 0 P r"R v) C.T Block: Lot(s): 2.— 2.
Section: 2, Township: I 7 Range:g �
Parcel Size (acres or square footage): Z. A c 2 es
Property Owner: Ni. ice Phone:.
Mailing Address:
Z3 2.c ftitsT P SNoHOmisH viiA "32'76
Applicant/Occupant: Phone:
(if different from owner) 5 A rr) t;.
Mailing Address:
Authorized Rep: i Phone: 360 Q i-O5 c=£;
`> U tv'SE T W' E S ( 1 360-5ciSr&t, IPt
Mailing Address
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General Contractor:
Or Manufactured Home Installer: A: T liALE 5 j Phone: cif 0 i—G S 0 6
Mailing Address:
1-2,. C , -8C,, I 1 5 PCu-L.SaO, tit/A ci g3R1C)
Contractor's State License Number: tr o t1i✓ K Expiration Date:
��� ram' � 6 a Li -..: Oct;
Septic Designer: Phone:
N PTHvAlE. s re%zt ITERiz , Tolerc�,5 /iUc- • 36... 0 452 - $2`i ?/
Mailing Address:
7 1 i 5 : 12.71113G0y l j7T /qA`G1L .5, 14/7 3 /` S" 36
Phone: S SaG
Architect:/Engineer: rv\ C 111l,i sy, I /kJ C tv' 1EeA2,rvC
Mailing Address: ps. C o,�;,y u L T f nr j S. i W
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Loan Lender/General Phone:
Contractor's Bond Holder: N C% L e-Al .ER ?
Mailing Address:
t t i c it L. G R E-AJ c r,1 C.,_ r9 4 G;C Ury t~—L ST> EN L'Co c ri v.." ",t A cis 2,z
FOR OFFICE USE ONLY
Fire District: Planning Area 0 School District: ° - Zone:
4/98 H:\home\pincntr\forms\universal plot plan