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1984, 07-12 Permit App: 00001026 ResidenceBUILDING PERMIT APPLICATION WORKSHEET PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND oz, (Please return this original and your building plans to the Department of Building and Safety) 1 Owner's Name (last) Jaber (m) C. Department Use nIy ADKINS - th M. Res. Comm 2 Reject Address.(nnoo-t�aMailing Address) or Road Name Space Zip �7 �? M Rest Road 3 City/Community snokpne State Wash Subdivision/Plat Name Swan Acres First Addition 4 Assessor Parcel No. S7/2/g —• / o �/ Q 7 w Lot ' / IO�F Block / * * * DEPARTMENT USE ONLY * * * 5 Sic Code Zone Act. 9 Zone Project No. 10] _ !/�!/ 6 Dwell N 1 No. of Buildings 1 Sq. Ft./Acre Depth I(vot Frontage I a5' 7 Set Back- 4T-- t III g_ N 8 I IRI I Rear`_ census Tract Module No. Initials l-- 16 Architect Firm Name ( Street Address Zip City ' , N. State Phone ( ) Contact Person • Phone If different than above Contractor Firm Name Jasper C. Adkins Street Address E 10910 - 12th Zip 99206 CityState Spokane I WA Phone (509) 928 4898 Confect Person License No. Phone if different than above 8 Owner/Agent of different than 41 above) Business Address 9 Zip City State Phone ( ) 12 Review Required Plan Check (YIN) Otheer(Y/N) 1 SEPA Exempt (YIN) Date 15 Type Work (ie 0 BI� Fire ❑ MH (Virf 0 Demo New ❑ Add/Alter 0 Replace 0 Move 0 Other 14 Describe Work g -s 19 ca 10 Applicant Name Jasper C. Adkins Street Address E 10910 - 12th 11 Zip 99206 City Spokane State ' WA Phone (509) 928 4898 Lender Federal Land Bank Association of - Yakima Street Address 1450 North 16th Avenue Zip 98907 City Yakima State WA Phone (509)248-0593 Contact Person Steven T,. Downey. Assistant Manager Phone if different than above ( ) Same Additional Information The framing contractor will be either Harvey Lenhart, Kent Construc- tion or King Homes. plumbing & electrical contractors have not been nicked as of this time 3 07 96 542-4 7i SUNSP `fX7,a26o Application Type (Standard unless otherwise Indicated) Fast Track /Early Start Environmental Health W. 1101 College Room 200 Conditions/ Comments • DEPARTMENT APPROVALS This is nota Permit (Indicated approvals required in either "release" or "release with condltlons" space prior to permit issuance.) • ofnmercial; /Residential New Construction; 0 Bldg alteration/addition ❑ Additional structure; APPLICATION q ct CEK7 Release se Release d Gond 1 Hold 2 %/b1`f Lel ,�� v Planning/Zoning: 0 Commercial; 0 Cert. of Exemption; 0 Frontage; N. 721 Jefferson 0 Setbacks; 0 lot w/d; 0 lot size; 0 use/zone; ❑ CU, variance, zone change; shoreline; 0 fence; ❑ Other Conditions/ Comments: Engineers: N. 811 Jefferson Condition omments: #7 ❑ Commercial; ■/Residential; Flood Plain; ❑ drainage new access/approach; 0 fence; ❑ road improvements ev J,t�vzC-L% .fb� Utilities: N.811 Jefferson - - Conditions / Comments • Other: n M Plan Exam Fire Prev. Conditions/Comments. ee0 . ❑ m Project Representative Telephone ay Agencies Performing Special Inspection:y Y O c 1 i E 2 II O 3 1 Indicate above or attach condltlons relative to final as built approval 2 Indicate above or attach reasons for hold Lot 6, Swan Acres First Addition, as recorded in Vol. 15 of plats, page 48, Spokane County Auditors Office, Washington Owners:. Jasper C. & Ruth M. Adkins /0.6"/ / uo:c.9.4 `C "% 1 C c�-'-0 D� 1 SPO nil COUNTY HEALTH DISTRICT ev-DP.26 (3� /y 1a GA, ,4074/4" /12A4c pit 30/ Ott—) --/S(-\' ,Aticitify ; ��O < 'u t P � q , pvc As 3030 s©zona°-• Pittwa-a_ copra sDR..3 1 !L at -e. diteataa :211 gest gat i Y /a/ Lot 6, Swan Acres First -Addition, as recorded in Vol. 15:' of plats, Page 48, Spokane County Auditors Office, Washington Owners .Jasper C. & Ruth M. Adkins /06"1/ f yp7//G. 74526C 30/ N eare i gjopCG 12,4elektr -0 g \\\\. est Joac/• 0