Loading...
1986, 06-23 Permit App: 00011779 Pool(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) SHADED AREAS ARE FOR DEPARTMENTAL USE Pr --7 '� i / f l� Owner's Name LAST RFs Tefr4ob FI%T s' MI Project Address (Street Name & Number) Zip /1/1yoi✓ ?0 z e Applicant Address City State Zip 4>4 Phone Business Phone ConOd� Age'W�/G ✓ Address� / Z000-W0e--� CityA . . State - - A ZIP9, Phone Conta Li se Number (Required) Business Phone Architect/ Engineer Address City State Zip Phone Contact Business Phone Lender Address City State Zip Phone ( 1 Describe Work Res. Comm. Subdivision I Plat NamelSho;�A�a�tt,Number y Assessor Parcel Number Lot Block Plat Number y Pertinent File Numbers Zone Comp. Plan Census Tract Number of Dwelling Units Number of Buildings Lot (Sq. Ft./ Acre) Depth Frontage Size silo Front Setback Left Setback r Right Setback Rear Setback r R/ W Width i Additional Information Square Footage Z r 1„0 -----.._..--------- Q cc 0 Z 0 Z 13 J W Nur of Bedrooms. mbe Building Technician Date Gr^� oup al r■n ■❑ 91 101 0 n DEPARTMENTAL REVIEW 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 Date Approved Cond. Approval Hold Environmental Health Application # W. 1101 College Room 200 Planning/Zoning N. 721 Jefferson Engineers N. 811 Jefferson Utilities 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 Date Chnw nn Ci#n Dien Lot Dimensions Existing Structures Proposed Improvements Structure Setbacks Easements Septic System (s) Water Lines Sewer Lines Fences, Wells Driveway(s) Right of Way Width(s) Names of Fronting Street Flanking St, -p-+ Additional Information: Landscaping Drainage Plan Hydrants Topography Lighting Signage Shorelines Highwater Mark Legal Desc—�}——�-- Op z - r- ---- i - - -- _.- I i I. _ ..._- j( -+ - W I hereby certi y_..�uesitionj hat I-surve ed,the abolve described property Ind that'I fi#ld t e improvements to L6 Ji! he premises In an that they 4o not CDCI.OSCh_,pII IOpert� I*ttg Ldjaeent there o— -�---- EX E T.- Nb improvem,nts engroa h on these premises—Except: OWNER R AG T &�JSPAF OR ... 1 E ti t 10 1Q N xoi AVerlllC'. ±. C NS LT C1VIt....Ef OI NO SURV ( �— _ ._ North 10116 Newport Mldhway ( i Spokane, : • E � , { I- �fi , r 1 �.......-..._ 3 }— T;, _ _ I r� )OV6._ _ 1 GAn 1: --1 _. 1 � � � I - i fi IN - I �' 7) ` �: - -- �_ _.. erg/ ( F j 'rj .._ — T C •T' /2 _ — f 'l: d 5.. �3 • i i 1 v�. 7 �f i, ,},, •3•. •i i}: 'ri . ; ;:; ,,;.,{ 7 }} { i S t , �3.. + i.•rr, ,�,, Si! _ .•.�h.,Nf ... dts>.SiS.... . ... ... . ........U�7:.....t:73111;L,S..,........ u:!�i:1:'., , f.x,u•.•.t..L,.! ,..3' ........,...).5.3.3 ... , , . .�..-.. ;�n,. _ .i:;: StS...,. 2•`7'`:SS•�4..sh%::'`'''•':•..