1984, 10-09 Permit: 00002754 Garage| �
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S|GNAJUREOF APPLICATION ^� �� ��
OWNER0RAGENT�� �� ���� DATE � �� « ~~ �
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SEQ. �. "~= ="'°.
1307 N ARTIES CT 0002885 10/09/84 00002754
BATES , DANIEL R Structure Fee $61 . 00
1307 N ARTIES CT
ZIP:
CREENACRES WA 99016-0000
BATES/ DANIEL R
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INSPECTOR:
185514212 0999
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LOT& BLOCK FINAL
001218 012 004
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UPPER COLUMBIA ADD
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ZONE
SFR 000 010 000 000
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24X24 ATTACHED GARAGE $61 . 00 X
1307 N ARTIES CT / 10/09/84
STRUCTURE PERMIT
STRUCTURE TOTAL FEES $61 . 00
Description N PRI CAR WF Group M-1 Type VN
/ Square feet 000576 Occupancy Load 0000
Est Pin Chk $0 . 00 Actual Pin Chk $0 . 00 Var $0 . 00
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SIGNATURE OF APPLICATON
OWNER OR AGENT DATE
JOB ADDRESS:
OWNER:
ADDRESS:
CITY: ST: ZIP:
APPLICANT:
CONTRACTOR:
ADDRESS:
CITY: ST: ZIP:
PH: LICENSE*:
ARCH /ENGINEER:
ADDRESS:
CITY: ST: ZIP:
PARCEL*:
CENSUS TR:
INSPECTOR:
PLAT*:
LOT & BLOCK
FINAL
PLAT NAME:
ZONE *:
ZONE
FSB
S - 1
S - 2
RSB
MOD
USE OF PERMIT:
JOB ADDRESS:
SEO. 42:
DATE:
FEES:
PAID BV:
COUNTER APP:
PLANS EXAM:
DATE•
INSPECTOR'S COPY
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4 PROGRESS
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6 ROOF DECK
7 FRAMING
8 |NSULAT0N
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7 FIRE DAMPER
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BUILDING PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
(Please return this original and your building plans to the Department of Building and Safety)
1 Owner' ame (last) (first) (m)
/ Department Use Only
TF'S r/��/�'/L° ! l Rs. ./` !Comm
2 Proj Address(not Mailing Address)or Road Name Space Zip
/315 7 /9k r-i,--5 c_r" cj 5 /�v
3 City/Community State p Subdivision/Plat Name 1-3 'e ,4ciLe°s G��/ Z/3/--a! d h -i r o`
4 Assessor Parcel No. Lot I
Block
— 2 ( v 7,2 k
* * * DEPARTMENT USE ONLY * * *
5 Sic Code Zone Act.# Zone 'Project No.
�F (_ 2_75e/
6 Dwell# No.of Buildings Sq.Ft./Acre Depth Front6ge67
7 Set Back-Front ll(L)S-1 (R)S-2 Rear Census Tract Module o` Initials
EY 15riI (, I 10 I I r JON I'Y)
* 16 Architect Firm Name � „,i
Street Address
Zip City State Phone
( )
Contact Person Phone if different than above
• 5'0q ) 912-01– /1:3oZ17
Contractor Firm Name Street Address
Zip City State Phone
( )
Contact Person License No. Phone if different than above
( )
8 Owner/Agent(if different than#1 above) Business Address
9 Zip City State Phone
( )
12 Review Required Plan Check(Y/N) Other(Y/N) SEPA Exempt(Y/N) Date
15 Type Work 7i,. Bldg ❑ MH l`t New ❑ Replace ❑ Other
❑ Fire ❑ Demo ❑ Add/Alter ❑ Move
14 Describe Work
241 ( 2-4 6 P-6 G- C TA-C i- D)
10 Applicant Name Street Address
11 Zip City State Phone
( )
*
Lender Street Address *
Zip City State Phone
( )
Contact Person Phone if different than above
( )
Additional Information
DEPARTMENT APPROVALS
This is not a Permit
Application Type
(Standard unless (Indicated approvals required in either"release"or"release with conditions"
otherwise indicated) space prior to permit issuance.)
Fast Track
El Early Start Release
Release w/cond 1 Hold 2
Q Environmental Health ❑ Commercial; ❑ Residential
W.1101 College ❑ New Construction; ❑ Bldg alteration/addition //4/4-5'
Room 200 ❑ Additional structure;
APPLICATION#
Conditions/Comments:
• Planning/Zoning: ❑ Commercial; ❑ Cert.of Exemption; ❑ Frontage;
N.721 Jefferson ❑ Setbacks; ❑ lot w/d; ❑ lot size; ❑ use/zone;
❑ CU,variance,zone change;shoreline; ❑ fence;
❑ Other
Conditions/Comments:
• Engineers: ❑ Commercial; ❑ Residential; ❑ Flood Plain;
N.811 Jefferson ❑ drainage ❑ new access/approach; ❑ fence;
❑ road improvements
Conditions/Comments:
• Utilities:
N.811 Jefferson
Conditions/Comments:
Other:
• Plan Exam
Fire Prey.
Conditions/Comments:
d
c
Project Representative Telephone
Agencies Performing Special Inspection:
-"i2• 5 .
0
O
R! f6
E 2.
;
• E
3.
1 Indicate above or attach conditions relative to final as built approval
2 Indicate above or attach reasons for hold
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