1984, 06-14 Permit App: 00000679 GarageBUILDING 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, I( (first) (m)
1 I� J y1I/� v
No /(e" b ecl� j7G✓✓y FE1 -1"
Department Use Only
f§s. Comm
2 Project Address (not Mailing Address) o Road Name Space Zip
94/0 E M/ss,on) 9q.2/.1
3 City/Community
SPo /4 A Pi E
State
W H SN
Subdivision/Plat Name
( iL(.-} (N13ow �S
4 Assessor Parc�e+l''N�{oy.,/
pc/
Lot
Block
* * * DEPARTMENT USE ONLY
5 Sic Code
Zone Act. 0
Ir
Zone a—1
ALL
Project No. `
ier
6 Dwell /I
No of Buildings
Sq Ft./Acre
Depth
l05
Frontage
la 6r
7 Set Bads -Front I (L)S-1
3' ' IF
(R)n f Rear
Census Tract
Module No.
Initials
16 Architect Firm Name I Street Address
Zip
City
State
Phone
( )
Contact Person
Phone If different than above
CC(o��ntractor Firm Name nn / /n! / ///�
2aJ,a✓k SiccI �V r�PA5s 6y Wt/<v7/I 0,71Sf✓Jjh
Street Address`/ -r�9
N./0(T Lake [49.
Zip
gg 2/ a
City -
SPO LH r -ie
State
G-5Asrl
Phone
(Soq) s' rs- Si/ sem
Contact Person
/L(/166OF- /7agfg»SO C.i-c'ft 2(IL.
License No.
CO -CK-RC't2—o8C/
Phone if different than above
( 1
8 Owner/Agent Of different than #1 above)
Business Address
9 Zip
City
State
Phone rrII
12 Review Required
Plan Check (YIN)
Other (YIN) ISEPA Exempt (Y/N)
Date
15 Type Work �r Bldg
/❑� Fire
0 MH
0 Demo
,YNew
0 Add/Alter
0 Replace
0 Move
0 Other
14 Describe Work //`` // q
6Grefe W?.51O r[.1�.
10 Applicant Name// q, //�� /1
Lad4kncrk �7'Ze ( /s14s Iv ( ockr°// �,.r1✓U.�fi`m,, �-r
Street Address
N. /o/`( Lakc 4,
11 Zip
/+
/7a/�
/City A
SPO K/446
State
6. -)A --r,
Phone
(SOq) SS's -sits" -
Lender
Street Address
Zip
City
State
Phone
( )
Contact Person
Phone If different than above
l 1
Additional Information
&WY? 94x46
-
GKPDp1 1;,t.4o =
Application Type
(Standard unless
otherwise indicated)
Fast Track
Early Start
DEPARTMENT APPROVALS
This is nota Permit
(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;
APPLICATION #
❑ Residential
❑ Bldg alteration/addition
Release
Release
w/cond 1
Hold 2
IW
•
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•
O
Engineers: 0 Commercial; 0 Residential; 0 Flood Plain;
N.811 Jefferson 0 drainage 0 new access/approach; 0 fence;
❑, road improvements ,
Conditions/Comments'
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
LANDMA !, '1K
STEEL BUILDINGS°
BY COCKRILL CONST. INC.
N. 1014 LAKE RD.
SPOKANE, WASH. 99212
(509) 535.5115
OWNER Nat,/ ke, L NoticLec.k.
.8410 E. )ass on
9z4-Sgsq
LEGAL:
.3'
_w.
;IB
78'
1
0
$A/O '5.. ;74°ssfioc
"Why have just a building,;when you could have n LANDMA