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1986, 05-20 Permit App: 00011151 Garage(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) Jr1ML/CLl MIICMo nnc r" Vr1 L. -J=1 -nm l IVICIV 1 ML .-IOC iprojct Number •:-:, 1/5 /,.� x{,'k,'.{,',i,', Owwn�Aer'ss Name LAST FIRST' MI [.-22-4-4.).-4L /i n -k. a n DO n n a S Project Address (Street Name& Number) Zip / r '/4 F Alax we// 6 rc e /.ac €4 Lt/c..— Applicant (Address City Stale Zip Phone ( ) 4&&-fim Business Phone ( I Contractor/Agent Address City State Zip Phone ( ) Contact License Number (Required) Business Phone ( ) Architect/Engineer Address City State Zip Phone ( ) Contact Business Phone ( ) Lender Address City State I Zip Phone ( ) Describe Work x' `�; _ },._.xe� _ _`__ ih `. >r`�="�''`{^;`s� .. .�L.�n �prf)� ,.�nG�1 Tr n•n �1 __/ ,�M�'<C M1r:i'ix;:.��i-:+�", r: •ry.f . 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S lF\:'.q :. v+� - ( yl Y- 4• SFu,.r-.'1„(..a-'•_X``•:v an S+.l f `J;�th� cc��� c�SS3X .1.. t.,? .C., �"• :, f'i 1. 13 i.Y} F 3 "`Tr >fF6'c:s'ar•JiP;:::tf "W'-� eFt:-+:i .• w'." ..i _ ... ' rre• �)F{xF::+; u.r 'Rr �' '.,:. JIIIDING.IN FORM, ♦�i -.... 4^`p min y>+ CK...Gjiu i]'i T". � •:. ,4.,`�.�' » ,k!!+iY':>'... .... w Ni tiS: _ .IV..m '''�.'rt $ •'"e`,r;:vy,iFa±.ir.•.�"f!},'.j•V' ..,%i,`9}' s✓1. }.44,.=•Pr•:.'-f:i-0dt-f: �+kit�i =t''s}{" Yf~�-.Yf:VS YF'' . �.w L•' "i '•'wM1'';io?•,f.}'..u;: ,a�;° T,•:••ffe.• } wYaS.e ir ,^.�trr-;!q.*;..'....." i_.i`t.,`>Z<,a.'l'a':•�.r.�Xsi, 'am4 )".*�'1'.,, ::f.±Yr' id':i{"'S,S� 'QC,Fa:,i'CiCiri:Mj•",F'- LL 5•.; k:W-:"-'L.x� _•.isf !l� . 4. : ck-'�•v.�`Wt E..' WY^.b.r�9 'h {r, ,w ,nom.' qe, v..,,. .f xxAL' '{"a„+”-L'.L ]' CV ,{,.,Y ^[ •S Ra ,it'I,,,.jj$ Sy., y� ( "" ,.fit,.. s1• Y. eaf3ri4 iV,(ps '4 l �' Fhs t$s`�..? ,Is� . 't•.` 7 l � •L:?YL'.c.r• srR F z..kY ;..,.o;.ti :,..:."i:.:: _.:...'i ap` .� r yyP, �z .r Number of Bedrooms, ,<%• q I`'b( i �x 1:` Y .µ- t i" • Y^ic;5 ' 'E ,a•v .' F l' `M1..•>...:S;3+c:nw:.:4 i�k'k..c'L"..'I ,&llldlogirechniCYan" `:qt.'!'" y:x ,:+ ,4.. ".{•t'�L •��•(( '! xf:'I "T'_ ' a e. 8:x:/ :3 S✓:#s,- e'(%.�_ Ii,w ps((e,'ssF ,"- 'r :+x — A ;4�'p / a. IN/']1 (�t'f'..^... ' 'h� *k"; .,�as.;y:.{�, .r � i4 .' _ .; y�?;'.' '`�ii'>= t:^ • : _ �tilY'.'L"�-' `' > .. -'c`. :.t <!t i .•F _r -•.i . <. _.. .-,.... ,.. e.-. a..s--�h!"r:� GroLP„' .• a«'t1.�'�. �Y x( 3.1r'iw+yr}?[,' S.�:e.r.1,r; ::,A� ryT' c'^ a ypel.*.. ' .. —, e,• . xiEnvironmental Health W. 1101 College Ronm 200) DEPARTMENTAL REVIEW Application ft aacQA Approved Cond. Approval Hold Planning/Zoning ❑ . N. 721 Jefferson Engineers O N. 811 Jefferson Utilities O N. 811 Jefferson Plan 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. Signature ll C -.-.-ems .A i%✓ .7 Date FRONT ELEVATION