1986, 05-22 Permit App: 00011175 Pool(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)
190
Owner's Name
SHADED AREAS ARE FOR DEPARTMENTAL USE
LAST
FIRST MI
P
Protect Number
Applicant
State
Phone
(5o`) 9;?;-5—
Business Phone
Contractor/Agent
Address
(s--. *c '
State
Contact
License Number (Required)
Architect/Engineer
Phone
Business Phone
Address
State
Contact
Lender
Phone
Business Phone
Address
State
Phone
Plat Number
Census Tract
Number of Buildings
Frontage
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.
Signatur
Date "��7
Approved
p
Appprrovov al
Hold
Environmental Health Application # /�.
,
W. 1101 College
Room 200
Planning/Zoning
N. 721 Jefferson
Engineers
N. 811 Jefferson
Utilities
N. 811 Jefferson
Pian 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.
Signatur
Date "��7
EN CONSTRUCTION, INC.
.rth 2312 Pines Road
Spokane, 4 shington 99216.
928-8660
DPj (177/
PLOT PLAN
Requested Price '•�, 9_57,
Lot, .Cost Wu
•
1 -
ELEVATIONS:
- Crown of Street 9�.9
Finish Floor .16.41
Lasic: :Sq. Ft.
/4100- S-6 1 /400
FAA -Ease ;386 1
Mortgage Co. ‘/ 9T 14/E5rEE/
Sower Eo.Water Co.
L Via)/'
STum6er .- ;Excavator
------
Legal ZDT r, $1 ae /4L--;41.02144_ 21212/2
Address -
4 .RE D. 4)B.9 a-a/2;46E.
• FEZ L r,