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1985, 04-19 Permit App: 00005027 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) [/%,� CO(first) r (m) �citn Department Use ly Res. Comm 2 Project Address (not Mailing Address) or Road Name / Space Zip 3 City/Community ) e ececlot( e tate W Ck Subdivision/Plat Name mYs. 4 Assessor Parcel No.,Lot r. 2 6-jf� --1/30/ ((Zone / Block I / * * * DEPARTMENT USE ONLY * * * 5 Sic Code Act. # Zone srp Project No. 6 Dwell #/ No. of Buildingsp 1 Sq. Ft./Acre Depth Frontage 7 Set Back -F � I (L)S-1(R)S-2 1 Rear Census Tract I Module No. Initialer Ha) 16 Architect Firm Name Street Address Zip City State Phone ( ) Contact Person Phone if different than above ( ) Contractor Firm Name Street Address Zip City I State 'State Phone ( ) Contact Person License No. Phone if different th§0 above (5Q) 4_ - (T779 8 Owner/Agent (if different than #1 above) Business Address 9 Zip City State Phone ( ) 12 Review Required Plan Check (Y/N) Other (Y/N) r SEPA Exempt (Y/N) Date 15 Type Work Bldg 0 Fire ID MH 0 Demo W. -New ❑ Add/Alter 0 Replace 0 Move 0 Other 14 Describe Work 4 -r -14 -Oiled C' -Aryl_ e 5(0o 0 10 Applicant Name Street Address 11 Zip 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 ❑ Commercial; ❑ New Construction; ❑ Additional stru,ture; ❑ Residential ❑ Bldg alteration/addition APPLICATION # U Release Release w/cond 1 Hold 2 .�, 1117`_' �4 / Conditions/Comments• Planning/Zoning: 0 Commercial; 0 Cert. of Exemption; 0 Frontage; N. 721 Jefferson 0 Setbacks; 0 lot w/d; ❑ lot size; 0 use/zone; O CU, variance, zone change; shoreline; 0 fence; O Other Conditions/Comments• Engineers: 0 Commercial; 0 Residential; N. 811 Jefferson 0 drainage ❑ new access/approach; O road improvements Conditions/Comments• O Flood Plain; O fence; Utilities: N. 811 Jefferson Conditions/Comments• Other: Plan Exam Fire Prev. Conditions/Comments• Project Representative Telephone Agencies Performing Special Inspection: 1 3 1 Indicate above or attach conditions relative to final as built approval 2 Indicate above or attach reasons for hold Carl Kappen & Associates, Inc. N. 25 Mullan, Suite 304, Spokane, WA 04208 Phone (509) 422-1840 PLOT PLAN Requested Price 4/ 9,50 Lot Cost SOO ELEVATIONS: Crown of Street Finish Floor Scale: ,~p asic: .700 - -1 sq. Ft. aQ HA Case# 1Job# !� ortgage Co )wer Col rct, umbe Legal Address: z:/.0 e? z?,e/4.5 rte, , l am% - Ze/I7" %its /Fd -a5717004 2:S?