1986, 09-17 Permit App: 00013170 Residence(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)
. �� ....�... ,...� . ... �... ,.. ,�
' Project Number
Owner's Name LAST FIRST MI
Himalaya Homes, Inc.
Project Address (Street Name & Number) Zip
' 3408 S. Pines
Applicant
Himalaya Homes, Inc.
Address
S. 104 Frey a - Suite 203
City
Spokane
State
WA
Zip
99202
Phone
1509) 535-6602
Business Phone
(5092 535-6602
Contractor/Agent
Zakir H. Parpia
Add
S.
ess
104 Freya - Suite 203
City
Spoakne
State
WA
I Zip
99202
Phone
(509) 535-6602
Contact
Zak Parpia
License Number (Required)
HIMALHI161DE22301
Business Phone
( 509) 535-6602
Architect/Engineer
Address
City
State
Zip
Phone
( 1
Contact
Business Phone
( 1
Lender
I Address
City
State
I Zip
Phone
Describe Work
Req.
Comm.
Subdivision/Plat Name/Short Plat Number
i"i 1 01 LO ►vm 4" A0Pj -n 0 rJ
Assessor Parcel Number
..' .3';--4 ---- 5co-4 rc-v.-nokl )
Lot
L__
Block
2—
Plat Number
Pertinent
Pertinent File Numbers
Zone
Comp. Plan
Census Tract
Number of Dwelling Units
1
Number of Buildings
I
Lot Size (Sq. Ft./Acre)
Depth
(,_/,g
FrontNe 1
Front Setback
Left Setback I
Right Setback
Rear Setback
R/ W Width -
Additional Information
3P - 31-30,
BUILDING INFORMATION
Square Footage
Mr= -i()- °
Punt% _ 4V:: -
tlG, 76o
•
(Ali, - mfg. ii
Mr✓c _- a... -e-____
_. .... coo°
e
Number of Bedrooms
dI TetchMdRn
Date /
2 / i
J
Group
Type
�
DEPARTMENTAL REVIEW
Approved
Cond.
Approval
Hold
Environmental Health
W. 1101 College
Room 200
Application 0
Planning/Zoning
O N. 721 Jefferson
Engineers
0 N. 811 Jefferson
Utilities
O N. 811 Jefferson
Plan Review/Fire Prevention
O N. 811 Jefferson
0
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 agen to compile said a• • cation Is true and correct.
Signet
Date
MECHANICAL PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
I certify that the above information as submitted by me is true and correct and further, agree that all pro-
visions of laws and ordinances governing this type of work, including inspection requirements, will be com-
plied with whether specified herein or not. The granting of a permit does not presume to give authority to
violate or cancel the provisions of any state of local laws regulating construction or the performance of
construction.
SIGNATURE OF
APPLICATION
OWNER OR DATE
Project it
Owner's Name Last First MI
Project Address (Street Name & Number)
City
State
Subdivision/ Plat Name
Assessors Parcel M
Lot
Block
Plat ft
Applicant
Address
City
State
Zip
Phone
Business Phone
Contractor _
Address
City
State
Zip
Phone
Contact
License N
Business Phone
Describe Work
Fans
Evaporative Cooler
Hoods
Electric Furnace/Ducts
Miscellaneous
Dryer
Range
Gas Log
Gas Water Htr.
Solid Fuel/Wood Stove
Air Handling Units
0-10,000 CFM
10,000+ CFM
Refrigeration Systems/
Heat Pumps (BTU)
1-100M
101-500M
501-1,000M
1,001-1750M
Over 1750M
Compressor
0-3HP
3-15HP
15-30HP
30-50HP
50+HP
Gas Piping
1-5 Outlets
6+ Outlets
Gas Fired Heating System
1-100,0008TU 11Q,,;,
10v,..;00+ BTU
I certify that the above information as submitted by me is true and correct and further, agree that all pro-
visions of laws and ordinances governing this type of work, including inspection requirements, will be com-
plied with whether specified herein or not. The granting of a permit does not presume to give authority to
violate or cancel the provisions of any state of local laws regulating construction or the performance of
construction.
SIGNATURE OF
APPLICATION
OWNER OR DATE
N
W
Q
I-
X
X
L
U-
0
W
m
7
Z
PLUMBING PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
' Project I/
Owner's Name Last First MI
Project Address (Street Name & Number)
City
State
Subdivision/Plat Name
Assessors Parcel a
Lot
Block
Platy
Applicant
Address
City
I State
'Zip
Phone
Business Phone
Contractor
Address
City
I State
Zip
Phone
Contact
License 0
Business Phone
Describe Work
Bar Sink(s):
Drinking Fountain(s):
Floor Drain(s):
Washing Machine(s):
Deh Wshr(s): I.
Garb Dlsp(s):
Kit Sink(s). I
Lndry Tray(s):
1 I
Sew Eject(s):
Urinal(s).
Wtr Closet(s):
Ufa):: 2.
L�
Shower(s). I
Tub(s)' I
Bidet(s):
Other: Type;
Waste/Grease Interceptor(s):
Sewer Y N Septic/ Health No.:
Electric Water Heater(s): I
Drains -Roof:
REPAIR OR ALTERATION: Drainage, Vent, Water Piping/Treatment: Y N
Lawn Sprinkler System (s), including backflow device on any one meter:
Vacuum breakers or backflow devices in excess of Ilne 16:1-5.
(Or) 5+
I certify that the above information as submitted by me is true and correct and further, agree that all pro-
visions of laws and ordinances governing this type of work, including inspection requirements, will be com-
plied with whether specified herein or not. The granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state of local laws regulating construction or the performance of
construction.
SIGNATURE OF
OWNER OR AGENT DATE
APPLICATION
,iS
I -.
tor- If .13 •
GA A FOS1 AD.D,77 6;1!
/091c e: 9 MA-
.
Contractor:
Himalaya Homes, Inc.
:
Scale:
1" = 20'
• - .... • •
85'
T
Go) •
71-1
i fl
Contractor: w
Himalaya Home4:11-6 i1
-Address:
3408: =S.:>tineh'... el.:C.�-.1
Legal:
Lot ?; glk 2 l{idi�tlire7�
- Scale.
1" 70'.._.!.
4-1
n rn�u�o
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