Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
1986, 10-28 Permit App: 00013978 Duplex
(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) vg ir1v1-.v r1111 -r1.... r11 i, 1 VI1 1-,1-.r/11-1 1 IVICIY 1 P1L VJC Project Number ori --1 E3 • v Owner's Name // LAST FIRST MI aliZZL Project dres treet Name & Number) Zip �.s ?/ :6L��fy,t& Applicant Address % "-d City State Zip C�' Phone d% Business Phone ( ) _d -r( k_-----_ Contractor/Agent Address City State Zip Phone ( ) Cont ct) ` - ') L e --CJ License Number (Required) LC.10/-ci_.6_ 444. /yd a rri Business Phone ( ) 9:4f - c)s 9.2_, Architect/Engineer Address City State Zip Phone ( ) Contact Business Phone ( ) Lender Q 2) /7; Address City State I Zip Phone • '" ` Work t «. 160 Ree. V Comm. t3Hbdly /Plat Name/Short Plat N (/` r Ns —7ki-ifY% L Assessor Parcel Number 023574/3-- 3 d7 /3— .F�4s2 Lot Le -6 7 f Block Plat Number Pertinent Fib Numbers f Zone Comp. Plan Census Tract Number of t�welliriq thtits , - Number of Buildings Lot Size (Sq. Ft. /Acre)Depth 90'X/1© '` f 1 ` Frontage ' 16 Front Setback t 1 34 Left Setback 10 % Right Set aclt © l Rear Setback R/W Width AddRlonai Information FORMATION Square Footage 1 BUILDING IN Number of Bedrooms (dl T nldan M• Date o.- (croup g-3 Type JNA DEPARTMENTAL REVIEW 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"� ' i /`�`t��"`14 I Date Approved CpApproval Hold Environmental Health Application # / � I b ' /'VI /�[ W. 1101 College Room 200 Planning/Zoning N. 721 Jefferson Engineers/ N. 811 Jefferson )' 1 1 Utilities N. 811 Jefferson I 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"� ' i /`�`t��"`14 I Date #609-51C /4/5 Do PA z.7-002. *AI " 6 ' 9 A-1 i „1 i 4. Fiiist4 pr-o0R., , n if povp 4- 8 F/Al is if. _FL / o o / /P 00 ' ) d • 1 361 1 V 11- j. id /1" . 11 V V(' tai 0 ltrign m tc Fe u_ 1 1 0 o cp../ c. 1- LOT 7 84.14.,2, rdidNE#25 ADD zor 1: iStg.1., 7-4e...JA1g)2,5 siDp. .5-4... intr_i Cou.0 /4 ".. ...57-. . ilso , 842 7 CALVIt4 3 2. 7: . 4 0 La L./14/ e ' cz6v.1 01.)r -S /AO 4,9L. .1) gi 'x / 2°A6rD4,24. asti Dou6Le eLdrvir3E X- 47- 2 54 A srtn 0 -36311-60-- -z. e PPE° e. D.5 . —x— INA k)\, If° 1