1985, 01-28 Permit App: 00004050 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 Name //�� (last) n (first) p
�L/j / -2,e;Comm
//7�GL
Department Use Only
2 Project Address (not Mailin Addr Road Name Space Zip
// 9/6" c#712 e e)
3 Clty/Community`%
S� o,e( e
Stat ;�
(�tJ(ie
Subdi i$Sn/Plat
C ' f
Namej
Cit1-tiNIA,
4 Assess&parcel
r J
/ / 062 /
Lot
Block
* * * DEPARTMENT USE ONLY * *
5 Sic Code
Zone Act. 8
Zone
/ c»u h
Project No.
50
6 DwellB
No. of Buildings
Sq. Ft./Acre
�vT
Depthr6/`
Frontage�
,C/
7 Set Back -Front (L)S-1
--
(R)S-2
Rear
Census Tract
Module No.
Initials
ae,/
16 Architect Firm Name
Street Address
Zip
City
State
Phone
( )
Contact Person
Phone if different than above
( )
Conttrr%or Firm Name �� '
//CC_j S e/ ��Zi//Gf/1 J
Street Address
1//—JCS i�� �f/ X
Zip
7°7 o 7
City
�,o r t _
State ,
Ge)/2
Phone
(. ) 6 2
Con Person r �rC Liwile No.
j�
�j62-j16)4
LL'` /7 / /, S �/� I! ss %' 2A
Phone if different than above
( )
8 Owner/Agent (if different than 41 ve)
Business Address
9 Zip
—
City
State
Phone
( )
12 Review Required
Plan Check (Y/ N)
Other (Y/N)
1 SEPA Exempt (Y/N)
Date
15 Type Work X Bldg
D Fire
❑ MH
❑ Demo
74.F New
❑ Add/Alter
E Replace
❑ Move
D Other
14 Describe Work
D (11.)(10/ a/4 e
10 Appl' nt Name
/Qs Ske/ . - Vw :5
Stree Address
„3,4:6Z12207-,,e-X.,Cti
11 ip
99
City
State
Phone
Lender
Street Address
Zip
City
�---
State
Phone
( )
Contact Person
Phone if different than above
( )
Additional Information
Application Type
(Standard unless
otherwise indicated)
Fast Track
Early Start
DEPARTMENT APPROVALS
This is not a Permit
(Indicated approvals required in either "release" or "release with conditions"
space prior to permit issuance.)
Environmental Health
W. 1101 College
Room 200
Conditions/Comments.
❑ Commercial;
C7 New Construction;
❑ Additional structure;
❑ Residential
❑ Bldg alteration/addition
APPLICATION #
Release
Release
w/cond 1
Hold 2
El
Planning/Zoning: 0 Commercial; 0 Cert. of Exemption; 0 Frontage;
N. 721 Jefferson ❑ Setbacks; 0 lot w/d; 0 lot size; 0 use/zone;
O CU, variance, zone change; shoreline; 0 fence;
O Other
Conditions/Comments:
Engineers: ❑ Commercial; ❑ Residential; 0 Flood Plain;
N. 811 Jefferson 0 drainage 0 new access/approach; 0 fence;
O road improvements
Conditions/Comments:
Utilities:
N.811 Jefferson
Conditions/Comments
Other:
Plan Exam
Fire Prev.
Conditions/Comments:
Ad- t e(1,
Of /86
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
1412 STRUCTURES STEEL BUILDINGS
N. 3556 Market
Spokane, WA 99207 1-509-484-2002
tULES :
1 Bldg. must be 5' from property line
.2 Bldg. must be 10' from drain field
3 Bldg. must be 25' from property line
if property line is next to a street
;4) Bldg. must be 10' from all existing bldgs.
NORTH
HOMEOWNER: 4- -( C y CZ --
ADDRESS:
PARCEL # /45-17,/ OL A./
LEGAL:
300'
(51
/0
SOUTH
1. Draw in all existing buildings.
2. Draw in new bldg. & how many feet it is from
3. Name all roads next to property.
4. -Draw in drain field and whether you are on a
5. Size of property.
(Road) A360/)
,2.11017.
existing bldgs. and property lines.
septic tank or sewage system.
0