1985, 03-11 Permit App: 00004500 Residence r.I
BUILDING 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 / (last)
(llastt)) (first) ,�/ (m) Department U�e'Only
/-i /ir! ACS 4 ! 7'4 /0/14 �S. // v C� S. c/ Comm
2 Project Address(not Mailing Address)cc Road Name Space Zip
7 o 17 Al S/c f,G✓0A7-711
3 City/Community State Subdivision/Plat Name
SeDGc, 04Ar-- W-4- IA LL c= Y /1't D 619-C SJr3I %/)3/ o
4 Assessor Parcel No. 1t f/ Lot I Block
I ` 5 Z — 692-1
9 2-j A / I I 2 . . .* DEPARTMENT USE ONLY * * *
5 Sic Code Zone Act.# Zone _ Project No. L700
6 Dwell# No.of Buildings Sq.Ft./Acre Depth t Frontage
1 I 12-1 70 t
7 Set Back-Front` I(L)S-1 ` (R)S-2 I Rear Census Tract I Module No. Initials
j 249 ,.- J 0 N i'N .
* 16 Architect Firm Name Street Address *
Zip City State Phone
( )
Contact Person Phone If different than above
( )
Contractor Firm Name � �/� Street Address, � �� r.
�,�-t 7- � S CCS 0 L-/ i-kac x4
Zip City Statenn Phone
4 ,9 2 srd t ft ( gZ!-t ) S- 6 4 CJ
Contact Person Lice se No. Phoneif different than above
8 Owner/Agent(if different than#1 above) Business Address
n
9 Zip City State Phone
( )
12 Review Required Plan Check(YIN) Other(Y/N) [SEPA Exempt(Y/N) Date
15 Type Work ,- Bldg ❑ MH ..K. New ❑ Replace ❑ Other
❑ Fire ❑ Demo ❑ Add/Alter ❑ Move
14 Describe Work i'1'1 --- tP _C
10 Applicant Name \ Street Address
11 Zip City State Phone
( )
* *
Lender Street Address
Zip City State Phone
( )
Contact Person Phone if different than above
( )
Additional Informa ion
ME= Ott
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
Early Start Release
Release w/cond 1 Hold 2
Environmental Health ❑ Commercial; ❑ Residential
W.1101 College ❑ New Construction; ❑ Bldg alteration/addition
Room 200 ❑ Additional structure;
APPLICATION# -0 3 6 S"
Conditions/Comments:
El Planning/Zoning: ❑ Commercial; ❑ Cert.of Exemption; ❑ Frontage;
N.721 Jefferson ❑ Setbacks; ❑ fot w/d; ❑ lot size; ❑ use/zone;
❑ CU,variance,zone change;shoreline; ❑ fence;
❑ Other
Conditions/Comments:
Engineers: ❑ Commercial; ❑ Residential; ❑ Flood Plain; % /
N.811 Jefferson ❑ drainage ❑ new access/approach; ❑ fence; /
❑ road improvements
Conditions/Comments: A-/(j4 — 013
Utilities:
N.811 Jefferson
Conditions/Comments:
El
Other:
❑ Plan Exam
Fire Prey.
Conditions/Comments:
0.
Project Representative Telephone
o Agencies Performing Special Inspection:
c 1.
O
U '-
l4 �p
~ E 2.
W O
LL
• E
3.
1 Indicate above or attach conditions relative to final as built approval
2 Indicate above or attach reasons for hold
�-- SPOKANE VAL,L E(' SIRE DEPARTMENT h
Sd a� , Ades ,ate /
EAST 10319 SPRAGUE AVE. • SPOKANE, WASHINGTON 99206 • TELEPHONE (509) 928-1700
7/. 8zeeicee.ne .az
December 17 , 1984
Spokane County Planning Department
Attention: John Mercer
N721 Jefferson
Spokane , Washington 99260
Re: Short Plat 81-192
Dear John,
Fire District #1 is approving this short plat with
the following provisions :
1. Sec. 10. 207 (A) requies that dead-end fire department
access roads in excess of 150 ' long shall be provided
with approved provisions for the turning around of
fire department apparatus :
This will require a cul;de-sac with a minimum 45
foot radius orra+ hammer-head that will meet fire
department approval.
Fire District '1 approved, the water supply for
fire protection on June 1, 1981.
Sincerely,
Clyde Wisenor
Inspector
CW:sn
ho
1984
PRE VENT FIRES - SAVE LIVES I
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CONTRACTOR:
• 1 I HIMALAYA HOMES, INC.
W
f tom) . ADDRESS:
/
,129 0 c 1017 N. Skipworth
)it, ./flifLEGAL DESCRIPTION:
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CONTRACTOR: I I I
HIMALAYA HOMES, INC.
1
PROPERTY ADDRESS:
1017 N. Ski7,worth 't I _
LEGAL DESCRIPTION:
N'_, I
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PARCEL NO. : 16542-0921 I
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