1986, 05-08 Permit: 00010914 MHS|GNATUREOF
OWNTLL-R OR AGENT
JOB ADDRESS
\^
225 N BANNEN ---
"°°""'
,TLEY/ FRANK E
^~~"==
5P25 N BANNEN RD
,.,,. Sr `.,.
, '/ANE WA 99216
^"'""^~`'
/` EY/ FRANK E
"°~`^~"`°=
EY, FRANK E
^=="""'
N BANNEN RD
,.,,. ~,. ,...
.XANE WA 9216
P"' LICENSE.:
509-928-7428
^="'"=.""=
^`"°"""'
"``. = `.,.
"°"C"=
J .0315
="^"^=
0999
'°"'E"`O"'
�^,~
U' .64400
LOT & BLOCK
000 000
FINAL
�AT~AM".
k' FARMS :RR TRACTS PL q
=~.~.
ZONE
ACRl
="
S 1
S 2
RSB
MOD
26 SINGLE WIDE MH
USE OF """=`'
^==""~""'
5225 N BANNEN RD
APPLICATION
DATE sC-7/C'
MOBILE HOME
PROJECT#
O00109
t51.50
MOBILE NOME PERMIT
.0BILE HOMES
Make Serial #
Number 1 Width 14 Length 70 Height 10
Misc Desc BLDG SC
'
O �-O R^ " -
�
. .~ "
OFFICE COPY
TOTAL FEE
Fee
Misc Fee
$51.50
50.00
1.50
777�� *�l�O�
^^..� '�'".0
(THIS IS NOT A PERMIT)
BUILDING PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
COMPLETE IN INK
(Please return this original and your building plans to the Department of Building and Safety)
Project Number
Owner's Name y� LAST `` FIRST `` MI \ �/ /� /` /-f)
11 d /vaya_. ' /4171' r / i /
Project Address (Street Name & Nu er) ��r Zip
CSS� L "/'"e / 'Cl A
Applicant
6.1 t (7 C.-4—) -ce_ii--/e /
Address
72.„....... kiin,,,,,-7
City
State
Zip
Phone
/
Business Phone
( )
Contractor /Agent
I Address
City
State
Zip
Phone
( )
Contact
License Number (Required)
Business Phone
( )
Architect/ Engineer
Address
City
State
Zip
Phone
( )
Contact
Business Phone
( )
Lender
Address
City
State
Zip
Phone
( )
ibe Work
VI ��1 Q L �.
�C'
Res.
��
Comm.
Sub
Subdivision/ Name /Short Plat Number
( T iAtal 5 -t t P LAI 4
Assessor Parcel Number
:(,.f, 4 -_b.3 i
Lot
Block
Plat Number
Pertinent File Numbers
Zone
Comp. Plan
Census Tract
Number of Dwelling Units
i
Number of Buildings
Lot Size (Sq. Ft. /Acre)
Depth
Frontage
Front Setback
Left Setback
Right Setback
Rear Setback
R/ W Width
Additional Information
1 BUILDING INFORMATION
Square Footage
Number of Bedrooms
jztlding Technician
Date
Group
Type
DEPARTMENTAL REVIEW
Environmental Health
El W. 1101 College
Room 200
Application #
Approved
s —t —r
Cond.
Approval
Hold
Planning /Zoning
El N. 721 Jefferson
Engineers
❑ N. 811 Jefferson
Utilities
❑ N. 811 Jefferson
Plan Review /Fire Prevention
❑ N. 811 Jefferson
o
Other (SEPA /CrIticai 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 to compile said application is true and correct.
Signature Date
Show on Site Plan:
Lot Dimensions
Existing Structures
Proposed Improvements
Structure Setbacks
Easements
Septic System (s)
Water Lines
Sewer Lines
Fences, Wells
Driveway(s)
Right of Way Width(s)
Names of
Fronting Street
Flanking Street
Additional Information:
Landscaping
Drainage Plan
Hydrants
Topography
Lighting
Signage
Shorelines
Highwater Mark
4--
1
1 ,
legaiDeseription
' at
H '
,
'
1 1 -
-
, t ' - t t
1
I '
-- - I
, :
I - —
,
I
I
,
, — 1 - t -I I-
, 1 I- 1; ]_.
,
' a -iii
111111- 1-- 1
f , -2.0-0
1
, i
T -I
■ 4-
11 1
1- - iii
r
1
'11 __I__ , __ j_ _, _IIM _.-1-- - t
, ,
r 1
1 1 [
[ 1
I I
1 I
1
I ,
r 1 1 1
I —I ■ 1 ' 1 1 :iiiFF.3 1 , 1 ' I 1
■
■ t 1;
1 '
d- -- - 1-
I I H. r---
, 1
, 1 '
I 1 I
-; -
L
' 1 '
— -- -1 - -
1 ;
l 1 11t t t— ;--1
1 ■ - 4 1- I
f it ; - , I I
I 1 1
1 ' I 1
1- i -
- ,
1 l 1 I
1 1 I- -1- I
' 1 l ■ 1 1 i
I ' 1 ■ ■ I : ,
,
1 1 1 1 i I 1-
1 ,
, h I
-, -
1 11 1, A
1 -1
1 Ti 1 I il I I I