1986, 02-25 Permit App: 00009795 ResidenceBUILDrNG PERMITAPPLICATION 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) (first) (m) Depart mentpse Only
Hanson David L. Ras. ✓� Comm
I
2 Project Address (not Mailing Address) a - Road Name Space Zip
E • 'I29 2.S Guthri- Dr. Sookane. Wa. 99206
3 City/Community ,
Spokane
State
Wa.
Subdivision/Plat Name
Hill rest Acres 2nd Add.
4 Assessor Parcel No. -
8-6- 27542. - Zci IC
Lot .Block
15
3 * * * DEPARTMENT USE ONLY * * *
5 Sic CadeZone
Acta
Zone n 6� 0 Project No q 7 9
IL �' ta I `�1J-,
6 Dwell p
No. of Buildings
Sq. Ft./Acre
Depth
123 34i
Frontage
loo t
7 Set Back -Front 1(L
�o l{I
I 5-1 t
(R)� I Rear
Census Tract
Module No.ale
Ini ial
16 Architect Firm NameStreet Address
Hanson 'Carlen Const. N. 5309 Sullivan Rd.
Zip
99216"
City
Spokane
State .
Wa.
Phone
( ) 928-7456
Contact Person
DPwev Hanson
Phone If different than above
-(
Contractor Firm Name
Hanson Carlen Const. Co.
Street Address
,N.' 5309 Sullivan Rd.
Zip
99216
City
Spokane
State
Wa.
Phone
( ) 928-7456
Contact Person
Dewey Hanson
License No
HANSOCC187 RL
Phone if different than above
( )
8 Owner/Agent Of different than 41 above) (D/,r7/0Ce
Business Address
9 Zip
City
State
Phone
( )
12 Review Required -
Plan Check (r/N)
Other (Y/N) ' SEPA Exempt (Y/N)
Date
15 Type Work - Bldg
0 Fire
0 MH
0 Demo
W New
0 Add/Alter
0 Replace
0 Move
0 Other
14 Describe Work
Erect new residence
10 Applicant Name -
Street Address
11 Zip
City
State
Phone
Lender
Washington Mutual Savings Bank
Street Address
W 818 Riverside
Zip
City
Spokane
State
Wa.
Phone
( ) 838-3101
Contact Person
Carol or Lynn
Phone if different than above
( )
Additionaln,/I`nn�formation r
sie s QA P.
&IF _ e
Application Type
(Standard unless
otherwise indicated)
Fast Track
Early Start
DEPARTMENT APPROVALS
This is not a Permit
.4
(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;
❑ Residential
❑ Bldg alteration/addition
APPLICATION #
Conditions/Comments-
Planning/Zoning:
onditions/Comments
Release
Release
w/cond 1
Hold 2
S.F/vu
2/2S$3
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; 0 Residential;
N.811 Jefferson 0 drainage 0 new access/approach;
O road improvements 6y / it5yy
Conditions /Comments —•d�r C�
❑ Flood Plain; 1 ux'/a6
❑ fence;
A
Utilities:
N. 811 Jefferson
Conditions/Comments.
Other:
Plan Exam
Fire Prev.
Conditions/Comments •
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
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