1985, 06-19 Permit App: 00006009 GarageBUILDING 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's Naamee�yy���/�/,�/pA (last) (ust) (m) ment Only
(✓� fhv
/ A..[/ / / ✓/� /W// I
Comm
2 ProJe}Addr (not Mallin Address) or Road bli111113 Space. Zip
3 City./Community j��Community
ci'('4�6.-
State
it)•
Subdivision/Plat
r4IINCRES
Name
Nog/LE NO/16 SLAB
4 Assessor Parcel No.
'f- /
08547(_ t.20
Lot I Block
/ 3
♦ . . DEPARTMENT USE ONLY * * *
5 Sic Code
Zone Act. Nom/
Zone
RAW
Project No.
6 Dwell
I
No. of Ings
• t Z
Sq. Ft./Acre
Depth
/ 15
Frontage
15
7 Set Bads -Front 1 )S-2 Rear
-(07 1 (L S-1 , 5
Census Tract
Module No: -
Initials
(qMw
16 Architect Firm Name I Street Address
Zip
City
State
Phone
( )
Contact Person
Phone if different than above
( )
Contractor Firm Name
Street Address
Zip
City
I Slate
Phone
( 1
Contact Person
License No.
Phone 11 different than above
( )
8 Owner/Agent (If different than #1 above)
Business Address
9 Zip
City
State
Phone
( 1
12 Review Required
Plan Check (Y/ N)
Other (Y/N)
SEPA Exempt (Y/N)
Date
15 Type Work tp, Bldg
0 Fire
0 MH
0 Demo
!?1°.# New
0 Add/Alter
❑ Replace
0 Move
0 Other
14 Describe Work
DET:, ED (4j'4 _ . .;_ 9 (/60 of
10 Apogean 4,1.m /t t(`//'_
Street dress �'
11 Zip City
��� �_��
State Phon24( e ) 9zi - SQ
Lender
Street Address
Zip
City
State
Phone
Contact Person
Phone if different than above
( )
Additional Information
a
m
a
0
0
m
U
N
to -
u. LL
DEPARTMENT APPROVALS
•
❑
Application Type
(Standard unless
otherwise indicated)
Fast Track
Early Start
1 nis is nota Permit
(Indicated approvals required in either "release" or "release with conditions"
space prior to permit issuance.)
Release
w/cond 1
Hold 2
Environmental Health ❑ Commercial; ❑ Residential
W. 1101 College ❑ New Construction; 0 Bldg alteration/addition
Room 200 Additional structure;/
k
APPLICATION# 697 b 4
Conditions/Comments
/ Planning/Zoning: 0 commercial; 0 Cert. of Exemption; 0 Frontage; jr.'
N. 721 Jefferson d Setbacks; • 0 lot w/d; 0 lot size; 0 use/zone;
4(
.fr66, variance, zone change; shoreline; 0 fence; —
❑ Other
J
"S‘t
Conditions/Comments• o� 9 :..+-f^ '� S
//
•
Engineers: 0 Commercial; 0 Residential; 0 Flood Plain;
N. 811 Jefferson 0 drainage 0 new access/approach; 0 fence;
0 road improvements
Conditions/Comments.
•
Utilities:
N. 811 Jefferson
Conditions/Com ments•
Other:
•
Plan Exam
Fire Prev.
Conditions/Comments.
1 Information ❑
Project Representative Telephone
Agencies Performing Special Inspection:
1
2
3
1 Indicate above or attach conditions relative to final as built approval
2 Indicate above or attach reasons for hold
SPOKANE COUNTY HEALTH DISTRICT
tri E. O. PLOEGER, M. D., M.P.H., HEALTH OFFICER
N. 819 Jefferson Street
Spokane, Washington 99201 • > i _ n
•
I
PERMIT NO o -3l No 0 9.7.6.4•
. •�.. .�. , ;,.: .: me .._ .. ...-..-
APPLI ATION FOR PERMIT TO INSTALL OR RECONSTRUCT SEWAGE DISPOSAL FACILITIES
09.e6•
Name
t .f Le
Address
Address of Propo;crd)Site
. Type of Use
aA/�
Is base btftld
for ing p
Number of Bedroal .9— Building Capacity Camp Capacity
11 J
Water Supply i%r h -v--- (City, Well. Spring). Drywall
Septic tank capacity h S--K)
gals Style of tank
-.Length bf disposal field—/ -Sr 0 Absorption Pits
,a _ _ie,
dtTa�� 72
Other
Teach Bed
(1) Show relative location of: Proposed house. septic tank,
disposal field. well. garage and other out buildings.
('2) Make note of any heavy slope or swampy area or any
other important topographic details.
Installer .t� �/ 1 - _-4 • / �,�
Final Inspection Date al,� e ; ` '�-
Remarks.
021 o— .
CONTRACTOR Q'�W� • r O f �7�7 `
�� _ , %..,...r- ��,
7S'
i
_ss• ___,
-----------
k
/1' 1
-
UE
w
Q
0
/O •
W
701
/
at'
E S