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1986, 04-01 Permit App: 00010293 Garage(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) JrIHIJCIJ HMCHJ HMC YVM UMI -'HM 1 IVItIN 1 HL VJt Project Number /0r....I Owner's Name ,� // LAST //FIRST MI , 4e.tOp`�'o/2 P2aAar/ O. Project Address (Street Nam/ & Nu {ber) Zip % 5 /9/ / C..Ct &i/J Oe.ea IGC./L�, l�Cs&I. 7' 7Q,9/ Appl ican ,o5 5//ehez----c3 Address /3. �� 71747,gEel S' City glaolP State //la , Zip rr�G7 Phone fi%) ,/8 , /' UO�i Business Phone vY) 748 c,7p©o2d Contrac /Agept %:� 5:/ -,4,1 -?.s. Address ,'2 i 7124,1 /s/ City 5�PA i9a State Zip r'r�a 7 Phone (_ f )�8 fie, a.2 Cont / ice/ / / ��45 / / S Lic nse Number (Required) 4rJ/s /1�L2 ,5/' Business Phone •(--o7 )h/g�,-- 2 Architect/Engineer Address City - State I Zip Phone Contact. Business Phone ( ) Lender Address City State Zip Phone Describe Want • f V "T t lel 3� ", . 21 Y2p) 1..---- m - Subdivision/Plat Name/Short Plat Number ?ATA,-( PA1 ' APO Assessor Parcel Number 14 21 — 37o3 Lot 3 Block 21 Plat Number Pertinent File Numbers Zone 5r ,,� Comp. Plan Census Tract Number of Dwelling Unite `` Number tidings G.. Lot Size (Sq. Ft. /Acre) Depth t .rte Frontage ,t Frant Se..11i11 46 t eft Setback Flight Setback _ ` Rear Setback — Aldi ai Information '. w N D I— Z W Square Footage e7 q 1— cc Q a w 0 Buil ngT niciiu► raj` DDa[te - 1�Jt {3roup DEPARTMENTAL REVIEW ))______44 / pprovedi Cond. Approval Hold Environmental Health Permit Number J.,' �% . '.' J W. 1101 College Room 200 Planning/Zoning N. 721 Jefferson Permit Number AMEN Engineers N. 811 Jefferson • 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 is true, co rect, legal, and binding. Owner's Signature Date 37 A',l STRUCTURES STEEL BUILDINGS N. 3556 Market Spokane, WA 99207 1-509-484-2002 ,tomo -"Ili kat A;), c f. r �,S9 4ddrae -S / 9 2ty cid ;aunty 9 90 JY fdephaM cam . -- ?L 3 b iepraonvar. Sara of Lod i l� , 5r -4._._. k I' t -?- 1-- i i r- i j i I I -7-t-t t 1 i- if T I i ' -j _..} -.-i_...3-_--7- I -1--r ± +, i H 1