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1985, 10-18 Permit App: 00008210 Pole SignBUILDING PERMIT APPLICATION WORKSHEET 6-6) 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) 1cns Name ' a ,. / t t (first) frn) Cepartrnent Use Only ((last) nit z,e/ co - _ett,(5/)29 I.. Comm 2 Project Add not Mailing Address) cr Road Name Space Zip gulloo SL 125' MOre.. 3 •' ...WmplunIty ireme, Sate Ng Subdivision/ Plat Name 690frie.MigY 4 Assessor Parcel No. /16-42— 1 Lt al Lot 4-1- Block 0+1 . . . DEPARTMENT USE ONLY * * * 5 Sic Code tone Acta Zone ivtivn - Project No. .0- 0,...2. ., 1 fi , /- I L., 8 Cwe41 X No.411 Buildings So Ft /Acre Depth Frontage 7 Set Back -Front .. «.5-1 (8)S-2 Rear Census Tract Module No. Initials JON tY) . i OatarbolAthierti-Ciii 1 Street Address . „ Q):)Ari2chiteqn Nwe ::/D16-17iyazti-O Zip W243 city State fr7/47 Phon(e_v ) 469_40 .,..fieed/ne.) 477617,404a7 'X�%'( Phone If different than above ) vn auaPA u2- Contractor Firo2Na9m1Z,r StreeteAddree(oddizhb Zip g9 Cty ib ant StaWg 5ss Phon Od7-) 4917/66P42 Perpnitucen,e 8de/4/KW anian ik No. geeon-726g- • Phone If different than above ( ) 8 Owner/Agbit (If different than al above) Business Address 9 Zip City State Phone ( ) 12 Review Required Plan Check (Y / N) Other (Y/N) SEPA Exempt (Y/N) I Date 15 Type Work 0 Bidg, 0 Fire 0 MH 0 Demo0 0 New Add/Alter 0 Replace 0 Move PriDliaPkokvie.. 12' X2-St640.5yetaxe ie et_ pek he,414-- /31 Applica Weyer( / Street A Address Ed Msa /5 Iidizige „ Zip 20Z.2 City fit t t s Pra e # Pho a( --Oe ) 49-494 Lender Street Address Zip City State Phone ( ) Contact Person r• Phone if different than above ( 1 Additional Information cs-yode p /OW* 4 m c m m m U A H toL.L DEPARTMENT APPROVALS 1 Indicate above or attach conditions relative to final as built approval 2 indicate above or attach reasons for hold 4 This is nota Permit Application Type (Standard unless otherwise indicated) (Indicated approvals required In either "release" or "release with conditions" space prior to permit issuance.) • • Fast Track Early Start Release Release w/cond 1 Hold 2 Environmental Health ❑ Commercial; ❑ Residential W. 1101 College 0 New Construction; ❑ Bldg alteration/addition Room 200 0 Additional structure; APPLICATION # Conditions/Comments- onditions/Comments- Planning/Zoning: Planning/Zoning: 0 Commercial; 0 Cert. of Exemption; 0 Frontage; N. 721 Jefferson 0 Setbacks; 0 lot w/d; ❑lot size; ❑ uselzone; r04Sf ❑ CU, variance, zone change; shoreline; 0 fence; ❑ Other Conditions/Com ments• "ret 5€4,5,44 i r rar0 -6-irra P • Engineers: 0 Commercial; 0 Residential; 0 Flood Plain; N. 811 Jefferson 0 drainage 0 new access/approach; 0 fence; /040i ❑ road improvements Q/ Conditions/Comments• flip/ Mat %O E.uco.a4<-4 /4/740 & „ry 9 cJ hie /24,-J • Utilities: N. 811 Jefferson Conditions/ Comments El Other: • Plan Exam /o/(;' 0 Fire Prev. Conditions/ Comments- ❑ Project Representative Telephone 0 Agencies Performing Special Inspection: 1 .'5 E 0 2 c 3 1 Indicate above or attach conditions relative to final as built approval 2 indicate above or attach reasons for hold 4 St. No. Location Legal City mullon a 12550 0 9iapeA /%G 14 Date /M-8.5 Owner Pini Saba/ w awnete/od Traffic Address P6 -)&x PA558 Location Class +oigl htic vv- 25 ,-{-er, i -T 145' 1, Ci5e05 4 Parcel #17543-1431 Part of Lots 4 and 5 lying North of the North line of the Spokane, Quer d'Alene, and Palouse Railway right of way in Tract 141 of OPPORTUNITY, EXCEPT the North 99.06 feet of said Lot 4 and EXCEPT ;that portion within the Mullin Road right of way, according to plat recorded in Volume "K" of Plats, page 20; situate in the Qunty of Spokane, State of Washington.