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1986, 07-28 Permit: 00012321 Residence
SIGNATURE OF ----- ---~- uwm�nun*��m/ JOB ADDRESS 1,)1 13,4itil 5 i N BANNEN "°=' 07/21 OWNER: b '1BY/ ENTERPRISE 5 ,. ." BUILDING $455.08 ADD""",' H BANNEN RD ,.ner 6.(0u^es Surcharge $15.80 CITY: ST: ZIP: ' Li. �n� WA 992)' ^'"""^"`' CROSBY, ENTERPRISITS INC CONTRACTOR: CROSBY ENTERPR H =""~= ' BOX 13' CITY: ",. .... ISHMAN °e �213 "~' LICENSE*: ,�9-922-2200 cr0�BI*218h� ^"='""=°E"". ~~"^~^"' =="^' ".,,. = ,.,. . " "^""=~' |="=""= |56430711 | '°°'=`""' DATE: ~== 001 18800 `°,a"== FINAL �A`N^ME' P�CE ef:-.DDITI019 ^""E ACSUB """ 5-1 5-2 ^"= ""= 1- 11-001 RESIDEN W/C;,` USE "~""""'`' , JOB ADDRESS: N BANNEN RD STRUCTURAL oilding Code Fee / nergy Studies Surcharge `UILDINC Jaluation: Corr 58432 # of Floors 01 * of Bedrooms 000 •MARY STRUCTURE: c)es : DWELLING Group: R-3 Sg-Ft 1412 Occupancy Load •'E[ONDARY STRUCTURES: Desc: DWELLINGUB Group: -3 3q-Ft 1412 Occupancy Loa Desc; GARAGE Group: M-1 Sq-Ft 597 Occupancy Load APPLICATI ON DATE ~7. ~JYJ-F4 PROJECT# """, ' 0013649 "°=' 07/21 0001' BUILDING $455.08 nO.ldino Cod Fee $1.58 ,.ner 6.(0u^es Surcharge $15.80 """"' $471.50 =="^' . " CO ^' "",�" """"""^M. DATE: * of Rooms 000 Type; VN Rate 32.00 Type: VN Rate 6.00 Type; VN Kate 8.00 O7~7 O"~-6 .. ^~ .. OFFICE COPY TOTAL FEE TOTAL FEE TOTAL FEE Permit Fee $1.50 $15,00 $455.00 455.00 4 84l *87l5Dz