1986, 10-14 Permit App: 00013798 Storage Bldg BUILDING PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
(Please return this qriginal and your building plans to the Department of Building and Safety)
1 Owner's Name ,Alast) f (first), (m) I Dspautment Only
'L9- rt 4 ZC./ Ca.'..c...1-2-7.-/ Res. Comm
2 Project Address(not Mailing Address)ar Road flame / Space Zip
v b +4.441 -". 11.
3 City/Community tate Su vision/Plat Name
(.52.---74..e '}.J w Ro*1 esTAl-E& kb.3
4 Assessor Parcel No. Lot ei Block
2-67011--— t * * * DEPARTMENT USE ONLY * * *
5 Sic Code Zone Act.# Zone No.
SFD 0 1Q8
6 Dwell# No.of Buildings Sq.Ft./Acre Depth Frontage
2q5,7-0 240 I 20
7 Set Back-Front I(L)S-1 (R)S-2 I Rear Census Tract I Module No. Initials
f
*
* 16 Architect Firm Name Street Address
Zip City State Phone
( )
Contact Person Phone If different than above
( )
Contractor Firm Name Street Address
BRANSON STEEL BUILDINGS. INC.
Zip E. 11524 SPRAGU E9AWE. 1 State Phone
SPOKANE, WA 99206 ( )
.Cpntaot Person, License No. Phone if different than above
8 Owneri(,Agent(if different than#1 above) Business Address
9 Zip City State Phone
( )
12 Review Required Plan Check(Y/N) Other(YIN) r SEPA Exempt(Y/N) Date
15 Type Work Bldg ❑ MH ❑ New ❑ Replace ❑ Other
❑ Fire ❑ Demo ❑ Add/Alter ❑ Move
14 Describe Work
„v1 , ., :,fit X ,
10 Applicant Name ti' Street Address
11 Zip City State Phone
( )
* Lender Street Address *
Zip City State Phone
( )
Contact Person Phone if different than above
( )
r
Additional Information
` I.SO
DEPARTMENT APPROVALS
This is nota Permit
Application Type
(Standard unless (Indicated approvals required in either"release"or"release with conditions"
otherwise indicated) space prior to permit issuance.)
Fast Track
El Early Start Release
Release w/cond 1 Hold 2
Environmental Health ❑ Commercial; ❑ Residential
W.1101 College DINew Construction; ❑ Bldg alteration/addition
Room 200 ❑ Additional structure; ((
APPLICATION#
Conditions/Comments:
Planning/Zoning: 0 Commercial; ❑ Cert.of Exemption; 0 Frontage;
N.721 Jefferson ❑ Setbacks; ❑ lot w/d; ❑ lot size; ❑ use/zone;
❑ CU,variance,zone change;shoreline; 0 fence;
❑ Other
Conditions/Comments:
O Engineers: ❑ Commercial; ❑ Residential; ❑ Flood Plain;
. N.811 Jefferson ❑ drainage ❑ new access/approach; ❑ fence;
❑ road improvements
Conditions/Comments:
Utilities:
N.811 Jefferson
Conditions/Comments:
Other:
Plan Exam
Fire Prey.
Conditions/Comments:
ci
❑ Project Representative Telephone
ca Agencies Performing Special Inspection:
c 1.
Y O
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�6 fti
E 2.
O
LL
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3.
1 indicate above or attach conditions relative to final as built approval
2 Indicate above or attach reasons for hold
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