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1984, 05-25 Permit App: 00000221 Relocate Duplexr 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 (last) (first) (m) TOMBARI William Anthony Otyartment Only F. Comm 2 Project Address (not Mailing Address) v Road Name Space Zip 8908 E. Main Avenue 99206 3 City/Community Spokane - State WA' Subdivision/Plat Name Hutchinson's Resurvey Block 26 4 Assessor Parcel No. 18544-1943-5 LotE.72.3' of lots 12, Block 26 • 13 & 14 * + * DEPARTMENT USE ONLY * * * 5 Sic Code . Zone Act. M Zone Project No. „l'1 6 Owed e - No. of Buildings Sq Ft./Acre Depth . Frontage 7 Set Back -Fr; 0 I (I_ 1 (� (R)S-2Rear Il l esus Tract IModule No. Init(als_0 J �lrYll 16 Architect Firm Name Street Address PFI N4407 Division Street Zip 99205 Clty _ Spokane Slate WA Phone (509 ) 489-3200 Contact Person _ Dan Altimore Phone If different than above ( ) . Contractor Firm Name - Street Address -. Zip City Slate Phone l 1 Contact Person . License No. Phone if different than above • ( ) 8 Owner/Agent (if different than et above) TOMBARI, William A. Bust ess Address 2720 E: Sinto 9 Zip - 99202 City Spokane State WA Phone 1509) 534-1444 12 Review Required Plan Check (YIN) Other (YIN) ISEPA Exempt (VI N) Date 15 Type Work 0 Bldg - 0 Fire 0 MH 0 Demo 0 New 0 Add/Alter 0 Replace ti Move ❑ Other 14 Describe Work Relocation of a duplex . 10 Applicant Name Street Address 11 Zip City State Phone Lender Street Address Zip City State Phone ( ) Contact Person Phone If different than above ( ) Additional I of ormat'on 0/3 l',d vv U 5.9k -c, si2c/tPet IASPF-Dribi PIM@ 0 4,A..11z1`I9v.-a82V X176.12: Application Type (Standard unless otherwise indicated) Fast Track /Early Start 4 DEPARTMENT APPROVALS This is nota Permit (Indicated approvals required In either "release" or "release with conditions" space prior to permit Issuance.) Environmental Health ❑ C mercial; Residential W. 1101 College New Construction; 0 Bldg alteration/addition Room 200 0 Additional structure; APPLICATION 0 f7tu-n�'� }-�St-A £ Si Conditions/Comments' 1:172, • Release Release w/cond 1 Hold 2 SDI! z 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' O CU, variance, zone change; shoreline; 0 fence; ❑ Other Conditions/Comments Engineers: 0 Commercial; esidential; 0 Flood Plain; N. 811 Jefferson 0 drainage new access/approach; 0 fence;: O road improvements Conditions /Comments: Utilities: N. 811 Jefferson Conditions/Comments: Other: Plan Exam Fire Prev. Conditions/Comments c 73— ci. cod c o co 70E y LL Project Representative Telephone Agencies Performing Special Inspection: 1 2 3 1 Indicate above or attach conditions relative to final as bullt approval 2 Indicate above or attach reasons for hold ! 8. ' C `� C EfLTMM DISTRICT Al aV r. N0 % G2 3 k ��i000 0 C.0, 0 eo.; n-Ei e p. 0