1986, 09-15 Permit App: 00013146 Garage, Covered Deck(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)
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Owner's Name LAST FIRST MI
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Project Address (Street Name & Number) ' Zip
Applicant
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State
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Zip
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Phone
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Business Phone
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Contractor/Agent
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Address
5,,,,c, 41.) /-7
City
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State (
Zip
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Phone
( - ) 1d? - C 77 3
Cont
Lic nse Number (Required)
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Business Phone
( )
Architect/Engineer
Address
City
State
Zip
Phone
( )
Contact
Business Phone
( )
Lender
Address
City
State
Zip
Phone
Describe Work
Alr--A 0 Fl E 0 G -A PA
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Ree.
Comm.
Subdivision/ Plat Name/
hort Plat Number
SE-SSo25 PLA -r- e
Assessor Parcel Number
Lot
Block
Plat Number
Pertinent File Numbers
Zone/*kccl
Comp. Plan
Census Tract
Number of Dwelling Units
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Number of Buildings
#
Lot Size (Sq. Ft./Acre)
DCVO
Depth
Frontage
Front Setback
Left Setback
Right Setback
Rear Setback
R/W Width -
Additional Information
BUILDING INFORMATION
Square Footage
2-/e0
Number of Bedrooms
Building Technician
o�J
Date
Group
Type
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Show on Site Plan:
Additional Information:
Lot Dimensions
Landscaping
Existing Structures
Drainage Plan
Proposed Improvements
Hydrants .
Structure Setbacks
Topography
Easements
Lighting
Septic System (s)
Signage
Water Lines
Shorelines
Sewer Linea
Highwater Mark
Fences, Wells
Driveway(s)
Right of Way Width(s)
Names of
Fronting Street
Flanking Street
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Legal Description
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RALEIGH D. PETTY
GENERAL CONTRACTOR
8921 N. LEHMAN RD.
SPOKANE. WASHINGTON 99207
AREA CODE 509 924-0773
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DEPARTMENTAL REVIEW
I certify that 1 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.
Date
Approved
CpApproval
Hold
/Environmental Health Application # �
5
W. 1101 College
Room 200 4
Aett_LITT 1 901 Pc Q —
,
Planning/Zoning
N. 721 Jefferson
Engineers
N. 811 Jefferson
Utilities -
N. 811 Jefferson
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Plan Review/Fire Prevention
N. 811 Jefferson
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Other (SEPA/Critical Material/etc.)
Fast Track/Special Inspection information
Project Representative
Phone
Address
I certify that 1 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.
Date