1984, 04-30 Permit App: 00000108 Utility BldgQ . -
.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), (first) (m)
DspartmeM Use Only
Ree. Comm
����
Min MAe4 W 4l // l /Ll6 CL6a F-.0
d Nae Space Zip
2 Project Address (not Mailing Address) a RRoam
/6 -La. •"1� LQ. ✓`^11O4
3 City/Community
aerie
State
USA
Subdivision/Plat Name
'-
Pe )4tuder- leI
4 Assessor Parcel No.
hag_.QSt12 - 9O!
Lot
Block
f * * DEPARTMENT USE ONLY * * i
5 Sic Cope
V
Zone Act. M
Zone ��n
y✓�
Project No.
6 Dwell 0 -
l
No. of Bulitlin s
Sq. Ft./Acre
23 + PICAfid S
Depth
Frontage
7 Set Back -Front +
9' —
(L)S-1
(R)S-2_ I Rear !
Census Tract
Module No.
Initials
18 Arc�hyit�ect Firm Name
s4 ZU'e
Street Address
Zip
City
State
Phone
( )
Contact Person
Phone If different than above
Contractor Firm Name
Street Address
Zip
aty
State
Phone
License No.
Phone If different than above
Contact Person
8 Owner/Agent of different than e1 above)
Business Address
9 Zip
City
State
Phone
( )
12 Review Required
Plan Check (YIN)
Other (YIN) 1 SEPA Exempt (Y/N)
Date
15 Type Work g Bldg
0 Fire
0 MH
0 Demo
fa, New
0 Add/Alter
0 Replace
❑' Move
0 Other
14 Describe Work l 1 1� /�,J t (dm,
�tiut tX cc 'i i"�`
10 Applicant Name t
7 iii%' �l1Sa
Street Address
/6 —q-JSL4C4 24
11 Zip
Z l2eG
City
S ae
State
Of A-
Phone
(✓a( ) 724, - 1476D
Lender
L2Kt45 4- lath.4 4 S 9
Street Address
s/dkfu a ?' Rza/id Y4
Zip City ,,,„„„ �//11
9ff2-o(, 9/ 4-st.e
State
IPA-.
Phone
Contact n
�0 4,�Vt a f{'3 1 (Y
Phone if different than above
( )
Addlt onal Inform ion
;
Application Type
(Standard unless
otherwise indicated)
❑ Fast Track
❑ Early Start
DEPARTMENT APPROVALS
This is nota Permit
(Indicated approvals required In either 'release" or "release with conditions"
space prior to permit issuance.)
W. 1101 College
Room 200
O Commercial;
❑ New Construction;
❑ Additional structure;
❑ Residential
O Bldg alteration/addition
APPLICATION #
Release
Environmental Health4,101
Release
w/cond t
Hold
/Ci'GConditions/Comments / . �.eL.A is ;moi .ice. ..La / i
iot _L.L!� .. A S. si /. !A_ L � / •i/1 4 %a iA.IL.�/.r ' "/ �� 4d- . V
/ r ,
Pia nIng/ ening: 0 Commercial; 0 Cert. of Exemptio 0 Frontage;
N. 721 Jefferson 0 Setbacks; 0 lot w/d; .0 lot size; 0 use/zone.
❑ CU, variance, zone change; shoreline; 0 fence;
❑ Other
Conditions /Comments-
f
Engineers: 0 Commercial; 0 Residential; 0 Flood Plain;
N. 811 Jefferson 0 drainage ❑ new access/approach; 0 fence;
❑ road improvements
Conditions/Comments.
Utilities:
N. 811 Jefferson
Conditions/Comments.
Other: ,
Plan Exam
Fire Prev.
Conditions / Comments•
Project Representative Telephone
(o. Agencies Performing Special Inspection:
c 1
.x 0
o
E 2
; O
LL
3
1 Indicate above or attach conditions relative to final as built approval
2 Indicate above or attach reasons for hold
/1
That part of the N.E. of the N.W. of Sec. 29,
Township 25 N., Range 44 E.W.M., SWokane County,
described as follows: Beginning at a point 852.5
ft. due South of a point on the North boundary
of Sec. 29 which is 521.8 ft West of the North
k corner of Sec. 29-25-4.4. thence westerly para-
lell to the North Sec. boundary. a distance of
208.71 ft., thence due North 440. ft., thence
northeasterly on a bearing o£ M1° 31' 37"E.211.01 ft.,
thence due South 471.09 ft. to the point of
beginning. 2.16568 acres.
old
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