185, 06-04 Permit App: 00005731 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)
5556
1 Owner's Name (last (m) merit Only
l/ /� �/ /first))
1 1 ./C /fes.( #4 /� `V I Res. eek{ Comm
%74.0
2 Project A ress (not Malting Addles) or Road Name 'space Zip
/'/7 //9F& ��o/.
•
3 Cit mmunity
6�ePr9Qe, Ps
S to
�c%
Su ion/Plat Name
ReeN,4c�e--T Pie £J,Sf A
4 Assessor Parcel No.Lot
i�� �0
Block
* * * DEPARTMENT USE ONLY * * *
5 Sic Code r2oneAct.#
Zone /
/L-irl/y►
Project No. �+�J
J {" ✓ /
6 DSI ff
it
No. of Buildings
2
Sq. Ft./Acre
Depth
06
Frontage
i32
7 Set Back -Front
(L)S-1
(R)S-2
Rear
Census Tract
Module No.
Initials r ir
16 Architect Firm Name
Street Address
Zip
City
State
Phone
Contact Person
Phone if different than above
( )
Co o Firm Nam
%S',571,4 '
Street Address
/2` 6/`�%e?gA
Zip
9% 07
City
,o a/2 e-ZJavi---69)/(i-/-c,70.0,.
State
Phone
contact gOnl > ��� 4-5
L No�/ /�� ��
T
Phone If different than above
8/'Owner/Agent (ififdifferent�than #1 ve)
Business Address
9 Zip
"�--
City
State
Phone
( )
12 Review Required
Plan Check (Y/N)
Other (Y/ N) 1 SEPA Exempt (YIN)
Date
15 Type Work �( Bldg
/❑ Fire
❑ MH
❑ Demo
New
❑ Add/Alter
❑ Replace
0 Move
❑ Other
14 Descri ork
Cched (2)4E'a e f* c.��sl.4�s
polle
7tQ c S/foi((eits
Street ddress „,
/G` 4///a� Ele/S'/10
11 Zip C
99e%263 7pof /9 e,
7 State
7,1)&
Phone
6o1/) i-/'� >7
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 nota 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 structure;
APPLICATION #
❑ Residential
❑ Bldg alteration/addition
Release
Release w/cond 1
Hold 2
Conditions/Comments•
Planning/Zoning: ❑ Commercial; ❑ Cert. of Exemption; ❑ Frontage;
N. 721 Jefferson ❑ Setbacks; ❑ lot w/d; ❑ lot size; ❑ use/zone;
❑ CU, variance, zone change; shoreline; ❑ fence;
❑ Other
Conditions/Comments.
Engineers: ❑ Commercial;
N. 811 Jefferson ❑ drainage
❑ road improvements
Conditions/Comments•
❑ Residential;
❑ new access/approach;
❑ Flood Plain;
❑ fence;
Utilities:
N. 811 Jefferson
Conditions/Comments•
Other:
Information
Plan Exam
Fire Prev.
Conditions/Comments.
Project Representative
Agencies Performing Special Inspection:
1
Telephone
2
3
1 Indicate above or attach conditions relative to final as built approval
2 Indicate above or attach reasons for hold
Anal STRUCTURES STEEL BUILDINGS
N. 3556 Market
Spokane, WA 99207 1-509-484-2002
SES •
1 Bldg. must be 5' from property line
Bldg. must be 10' from drain field
Bldg. must be 25' from property line
if property line is next to a street
Bldg. must be 10' from all existing bldgs.
eL
NORTH
HOMEOWNER: 14 ri i?. K Il,,;ai6. K
ADDRESS: A' /(D/2. (-Logi'
PARCEL # C 17 5 5 j 1 &l'/C.
LEGAL: G R.�'Ee'4,€ 5 L) ; s T /l
5- I.32. F -T r w 270, 3 i=1 o
u /L ^3y
1`
si 2C
i)J2CCJ�c�
6Rir_#1 E
h
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SOUTH (Road)
1. Draw in all existing buildings.
2. Draw in new bldg. & how mann feet it is from existing bidgs. and property lines.
3. Name all roads next to property.
4. -Draw in drain field and whether you are on a septic tank or sewage system.
5. Size of property.
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