1985, 08-05 Permit: 00006544 Residencer '
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OWNER OR AGENT
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18613 E BALDWIN AV
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BRATLIE/ HAROLD R
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4116 N CARRY RD
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99027-9902
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BRATLIE/ HAROLD R
CONTRACTOR:
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PARCEL*:
075542702
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INSPECTOR:
PLAT*: 545
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002 001
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SIMPSON'S 4RD ADD TO CREENACRES
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ZONE R
FSB 030
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01+001 RESIDENCE W/ GARAGE
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18613 E BALDWIN AV
STRUCTURE
APPLICATION
DATE
SEQ. °'
0007241
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08/05/85
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00006544
Structure Fe* $350.00
FEES:
$350.00
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CA
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CG
NC
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El/R h I T
STRUCTURE
Description N DWELL Group R-3 Type VN
Square feet 001424 Occupancy Load 0000
Description N PRI GAR WE Group M-1 Type VN
Square feet 000571 Occupancy Load 0000
Est Pin Chk $0.00 Actual Pin Chk $0,00 Var $0.00
Energy Study Surcharge Fee $0.08
Building Code Surcharge Fee $0.00
TOTAL FEES $350.00
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DEPARTMENTAL REVIEW
I certify that I have examined this application and state that the information contained in it and submitted
by me or my agent is true, correct, legal, and binding.
Owner's Signature
Date
Approved
Cond.
Approval
Hold
Environmental Health Permit Number
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.7r `G� 3
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W. 1101 College
Room 200_
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Planning /Zoning
N. 721 Jefferson
Permit Number
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Ail
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1
Engineers
N. 811 Jefferson
Utilities
N. 811 Jefferson
Plan 811 1 J/Fire Prevention
N. 811 Jeffe
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Other (SEPA /Critical Material /etc.)
Fast Track /Special Inspection Information
Project Representative
Phone
Address
I certify that I have examined this application and state that the information contained in it and submitted
by me or my agent is true, correct, legal, and binding.
Owner's Signature
Date