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1986, 10-28 Permit App: 00013984 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) JriMUCU A11CAJ ArrC r tir1 LJCr'Ar1 I MCII I HL uom Owner's Name LAST FIRST MI ) FF Pr Jedddr (Street Name umber) Zip (/: Sl/ _ 9 / 7 / 9 e,L L -G -•C.� (--;:---(-7/'‘', Applica AtII / // C�/ �� lJr!Z� U` Address eG' /fid4t/? /�%V City State Zip Phone Business Phone ( ) Contractor/Agent Address City State Zip Phone ( ) Conffacj , License Number (Required) (1j,//2 L t -,--c /004.rz_ c)_ ..4 No „6.,7 Business Phone ( ) ,e1- r� Architect/Engineer 7 Address City _ State Zip Phone ( ) Contact Business Phone ( ) Lender ,L,left'3-1—"nd."--/Z--/Z—c:--Z,-) //,.)// / it— 4/4/1 - Address laity Stay/— I Zip Phone ( Describe Work b Res. v / V Comm. // 7� ?Ylr✓�iZG-t L-t_p-c) ' 1 stet,/^ Suuat Name( Shrt Plat Nber G -, i-tC`'3 o I --e.--.) Assessor Parcel Number 61:3--C7/9 --jli.3/x.5 3 —.=9/i,/ Lot 1st /3 V1 Block _ Plat Number Pertinent File Numbers Zone Comp. Plan Census Tract Number of Dwelling Units Number of Build•ngs Lot Size (Sq. Ft./Acre) /1/© `x 9'7 Depth Frontage Front Setback Left Setback _ Right Setback f. 7 Rear Setback R/W Width Additional Information L- BUILDING INFORMATION Square Footage Number of Bedrooms Building Technician 3 0 e Date I 0.7�t3 -8G Group f2 r Type V N. 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 t. J41 �Let�' �.f�,>S/CIL /' Date o /i� Approved CpApproval Hold Environmental Health Application # b —1 'V "1 W. 1101 College Room 200 Planning/Zoning N. 721 Jefferson Engineers(n N. 811 Jefferson e_4(i.-' `-P u � . 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 t. J41 �Let�' �.f�,>S/CIL /' Date o /i� .....::::.n:-.1 i ',..T,i....1.....; ; ...._....4.._... :_i., ,. __1.... , • ' -- ---.1.—. ..- -- i• 1--,.1.-:-1.4• ., ' i • : - , -!,-T71-;...-4-..1 ..:,i. ' ,-.-; .• - -- ';•-•-- .. , • , . -*14- --;-• i-- .... 1 1 '-; . _i ' : • • . . ..... 1-i :.1 7 - T 7- -1 — - - • 1: • - .*_.4. ....+..i. 4 J... .. . . •,- • , • ..., .1...,. :... .1..2,2..._:,...)...!..1 .: -I - i- • ••'''' ' • '-';- '-': -.-u---t.--4--i-4_1-; :: 7 : - : • o ; •.," -: :--• --i- !.. : "!-'.--- -7i— + -r-r4--,.:;;-- . , -4--1-!.. .-1-1--• it, i- r • • • : ; -1 -- ---• -1-- 1••-, -1- -r • . ' • t- • : • , . I I • --1 .; • - -1-;‘• • " • r-• T. • - • ••••• •• • •• • • • . • . - • -; ; 1 ; • • t•••••10 • • t • , ; ; • : "' • - : • . • • , „ •+••!•••-•-: ••• • .1 .---- - - - 1 ..- •,, , 4 • • • ' I ' .l." ; - •• 3d' .',... . I • --1 .. - 'I.. -... '- .i , . f..1_,_ ! . ,..-. . 1.-p!.!-,-, , - . , . ..4 i• . .... , , • 3 " . . I •-• t. • 7•••• ••• I I "-• ',"" • -1: • , ! 7-1 ' , . • . ...... i...: • -rt.:. : : .' "'t • ; - r• 1,.. : ' • _ 1- . • -; ..} - . ! -; .1- • . ' -' : --L . ;-.1-, ' •-• " ':- ' • : I mom% g I) • --.--1-.... 1 I" , '' : • 6 - • J._ i..... ..... • , • A' '..-. • 1 •;--; - - ' D04: 1 ":-'• -: • —r: , r-.- • I f -t --1,1-Te.-----111 1,' • _ sfir • - : • •:-., ••• .;- • 'fi////$4,--',1-4°K.• g•C • : . • I , • • ' • . - • • -,- ..i • . I • • ' .•'-'.1,- i -t.. -I-7 1*.tr • ..••:.:-. --i ..4.:,.. i ..„,,.. +.4. - - -i•!4: -4..7 . 1 . .. , • ......i... 4...4...4. , -7"...-. '.1-rn • I -I-, -r-:•- - --• - 1 -r-t- .• ' -.- -7-i ---t,-1-t ---:--;- 1___ , -1-:;- -,----r -4-- ,.;.44 4,..-S.._.... . , - ',.. •-i-.1.- —I. .........4 • . u4b L.% r . S " • ; cogi • r/d/JN ; iLcoA. r .s* • t- ••••• . , • 447.'44 Dadet..Z"._ ! -4 • • ' irahl. e4S- •109 s M D o3 341 . • . • t• i • , • •,•1 • I ! r r !: :1 • ". ' aide. Pg.•eJ •--; b 0 • 7.5;611:79.17.",isAi.-viri .7;3- 15'2° CoriG. PRot4 • ; or lei I if cle 2- • 977.71:.-c4ciihr; •.: • . • • r.7„. r z41 , .•., .. • . • 1 - ".* "7' 1. C A PPaD :• S • ' 1"- r • H • • • ;•'-• ! •--I • 1 - • -• • •.•• •• • , • • • ' • • • • •..,, • • . r• • 4 1, •••••••• • • ••••:, 1 ... 0 • • • •••• 1. .• . . • . ••• .• • •• •• . • • 1--1 • •••••• i•-: .44 -P .. • • . 4. • ;. • • • r I , ' • . • r • ,