1986, 03-26 Permit App: 00010199 Garageez-
--
(THIS IS NOTA 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)
IOC A0 AOC
ProlNum&er ry
c r '
Owner's Name // LAST FIRST !!MS�I
Jmt f//h r".. %Ty I 1G
Project Address (Street Name & Number) Zip
rjry SSO6 Best Sfokczt.te wA 99216
Applicant
LDLV\) I k. Sfr #t,
Address
N.S'SO• Qest
City,State
pokane
tu,4
Zip
49xI6
Phone
Ls -09) R2.$-565'7
Business Phone
()5-oq )rf2Z.- 41`001 Zri3S67
Contractor/Agent
Address
City
State
Zip
Phone
l
Contact
License Number (Required)
Business Phone
( )
Architect/Engineer
Address
City
State
Zip
Phone
I )
Contact
Business Phone
1 )
Lender
Address
City
State
Zip
phone -
I )
Describe Work
t4�baadYG'`4rta4E 7—Arg 2 4
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comm.
Sutitlivisron/Mat /1111024-tat Numbs s Y e t.•....
n-gig-S:aplu.* 1255' - 2- A00r71o.V
AsseorParcelNubrlHiii �� -
a
:5172303
LotBlock
3
Plat Number .
Pertinent Fite Numbers ++s'u Zone
r a.. l ���
Comp Plan - `•
Census Tract
Number of Dwelling Unds - „¢
Number of Buildings
Lot Size (Sq. FL/Acre)
Depth
tSQ:_
Frontage
asr
SIB tpetbxk .. * # aY+. _
IL Setback -'
Right Setback
RearSetbac .., . <
R/W Width
`Additional Information' -"t
,
BUILDING INFORMATION I
Square Footage
ge _ ..
51(,
yFr4
' sl
Number of Bedrooms
Building Technician.L
Date
Group t
Environmental Health
W. 1101 College
Room 200
DEPARTMENTAL REV:EW
r7EL
Approved
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Application N SS D / U �
Cond.
Approval
Hold
Planning/Zoning
❑ N. 721 Jefferson
Engineers
❑ N. 811 Jefferson
Utilities
❑ N. 811 Jefferson
Plan Review/Fire Prevention
❑ N. 811 Jefferson
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 to compile said application is true and correct.
Signature Date
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