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1984, 04-17 Permit App: 00001215 Residence
BUILDING 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 (lest) (first) ' ' (m) [kpertnrnt lly�Only HIMALAYA HOMES, INC. Pes Comm • f 2 Project Address (not Mailing Address) cr Road Name Space Zip 11208 E. Frederick 3 City/Community Spokane State WA Subdivision/Plat Name FAIRACRES REPLAT 4 Assessor Parcel No. 09542-1601 Lot 1 Block * * * DEPARTMENT USE ONLY * * 1 5 Sic Code Zone Act.* Zone - Project No 6 Davila No. of Buildings Sq. Ft./Acre Depth t -o Frontage get 7 Set Back -Front (L S-1 3o I z� 0' (R)S-2 Rear , 3Zt0 (ansus Tract Module Nom. S�� 15.a.„.._, 16 Architect Firm Name Street Address Zip City State Phone l ) Contact Person Phone If different than above Contractor Firm Name HIMALAYA HOMES, INC. Street Address S. 104 Freya, Suite 104B Zip 99202 City Spokane State WA Phone ( ) 535-6602 Contact Person Zak Parpia License No. Phone if different than above 8 Owner/Agent (if different than #1 above) - Business Address 9 Zip City State Phone ( ) 12 Review Required PlanCheck_((/N) `{s Other_(YY//N) I SEPA lEs (YIN) VVII Date 15 Type Work /Bldg 0 Fire 0 MH 0 Demo a New 0 Add/Alter 0 Replace 0 Move 0 Other 14 Describe Work new residence. 10 Applicant Name Street Address 11 Zip City State Phone ( 1 Lender Street Address Zip City State Phone 1 ) Contact Person - Phone if different than above ( ) Additional Information i CI 40 VII nMP.t N FC.66 7ro 43 u r BrsEcNT Application Type (Standard unless otherwise indicated) Fast Track arly 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; E( Residential (a New Construction; 0 Bldg alteration/addition 0 Additional structure; APPLICATION # Sy-793�o Releasee Release w/cond 1 Hold 2 I1/' #W Conditions/Comments. Planning/Zoning: 0 Commercial; 0 Cert. of Exemption; 0 Frontage; N. 721 Jefferson 0 Setbacks; 0 lot w/d; 0 lot size; 0 use/zone; ❑ CU, variance, zone change; shoreline; 0 fence; ❑ Other Conditions/Comments. Engineers: 0 Commercial; Lo( sidentlal; 0 Flood Plain; N. 811 Jefferson 0 drainage new access/approach; 0 fence; O road improvements Cond l t ions / Com men is• s Utilities: N. 811 Jefferson Conditions/Comments• Other: Plan Exam Fire Prev. Conditions/Comments. 0. m xo O 0 U '- N co t` E m O co LL Project Representative Telephone - Agencies Performing Special Inspection: 1 2 3 1 Indicate above or attach conditions relative to final as built approval 2 Indicate above or attach reasons for hold ... . : 4. ii MS :• TI1 - k .,.:.!:73“1-4::_i-•;rnit 7t.,: :If, 4-.. :• ? "73- •.--2.:17:- -• • ,T -r -f, : -.1". il .: ,,..t. -.,J :,--t- .• i 9 us u •• :4 4 firptir•14-4:4:-If -14- ‘17;:r4r4-.. - - - ...,,, ..-. le., Ii' - a. 4. .:1_1_, I : --‘44.1..4.-.4=,-.-•-!--4- - .1.'1 -.-f;:-44- r -1--r-L-I- - -4'3-4- -4-44 I t 4.. ; ' '-...i.r.: ; : i .. . . , • • i. i. - 1-1....iL s ' '' '1.-.!1:-. "" : ' '' 7 ; 1. 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