1986, 11-14 Permit App: 00014160 Garage i
(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)
SHADED AREAS ARE FOR DEPARTMENTAL USE
L
ProjectNurnber
..
Owner's Name LAST FIRST MI
0.
Project Address(Street Name&Number) Zip
k)ORT 1+ 17 2 `it S 7 A 10 g1gi212
Applicant Address
5Ak.re, E /ell/6 211.-TH
City .DPoKlv G State w� ZipGO 24�o Phone (50q Q2 0-'350i/G Business Phone L
( )
Contractor/AgentAddress Q
PAL( F ICJ 0.1"/OTIZ. ki /0 8 L
City State Zip Phone
3 POIedW E qG 2 ( )
Contact License Number(Required) Business Phone
.0 c4 i c, y L.-2.7-- (Soy) 531k-43a IF
Architect/Engineer Address
City State Zip Phone
( )
Contact Business Phone
( )
Lender Address
City State Zip Phone
O
riow
-77,-Fth.Work a e p 0 �Aa G Res:1..../ Comm.
A (50 g 36)
Subdivision/Plat Name/Short Plat Number
Assessor Parcel Number Lot Block Plat Number
61540—* 405
Pertinent File Numbers Zone/`1l a.�, Comp.Plan Census Tract
1
Number of Dwelling Units Number of Buildings Lot Size(Sq.Ft./Acre) Depth Frontage
i Jg18 r65
Front Setback Left Setback Right Setback Rear Setback R/W Width
Additional Information Square Footage
Z
0
H
a
2
cc0
LL
z
o
z
0
J
5
m Number of Bedrooms
Building Technician Date Group Type
,d I t— 14-- lid--1 V►v
Show on Site Plan: Additional Information: ( -
Lot Dimensions Landscaping ;
Existing Structures Drainage Plan j i - �� I, I
Proposed Improvements Hydrants { f _
Structure Setbacks Topography
E
Easements Lighting — — {
Septic System(s) Signage — _ I � I
Water Lines Shorelines 1I I
Sewer Lines Highwaler Mark — 1 1 — -. -+ —! —
Fences,Wells j I 1 �
Driveway(s) I 1 } ! ! I
Right of Way Width(s) — } ._ 4_ i_ — I :-4 j ,—= I
—
Names of
Fronting Street
1 }
anking Street — . — _ {
1
I
I
t--}-- -
Legal Description — i i
— tEig8Pr ofw2.i
c* K.) /QoFT OP Sett) /
OF 'Sw//L 01 I/ -- a
1
t
s?4� } i-,....,•-,- t .1 +,-.• . i r: ,z. .K:2 z i r biz? MS.i<,ii krr�.;. rsa re n «�s '. :...7 ,...':",`. �saa. ux:3t
.
f {
I 1 , 1
{ i
I
yJ } -- —
{
- - _ _ i {
i - ;"
I { i I
-
1
{
T:-.7. .-..H.... '.,..'..} ��
13 i 'r T:./...--- -t-- - '7,7:7:::.
•- - -
I
i
iliillliiii. 3 i1i'•i{titii9} } `t }F; ';i`?}} '{ ,:
S aie i, , :: f
Ra38'
Weuis�ons` n; bmen)s
i .;. ,S3 ii.,.i}!�3}}..i}> j{i.}}f;$fi}}..'.f1.'. S 3.. }ii ....`,.1.,.i? :, ..,,.. .<., ., .. . . ... - - .. .... ... .. -
DEPARTMENTAL REVIEW
Approved Cond. Hold
Approval
1IEnvironmental Health Application NW.1101 College (�
Room 200 ,•'
4iLtSL C —1iW A n-dl
Planning/Zoning
❑ N.721 Jefferson
Engineers
❑ N.811 Jefferson
Utilities
❑ N.811 Jefferson
Plan Review/Fire Prevention
❑ N.811 Jefferson
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 agent to compile said application is true and correct.
.r/li
.Date �� / �6
Signature
... ..,. . .
•
-,..,
1 1 I I 1 i I1 I 1 1
. ! I I
. .•' 1 I 1
• . _
r.ri , .••--.. J' , I I
1 i
1 . .
, I
LT -4-
1-.--- .
: • .1
1_, IES1:':.‘, 1.c•1:• J. -1- ' I .
. i
—,_--.- .1
_ _ . . i ___L • _ 4._ __L_ ..
I t ! !
1
. 1.-- i
. . _
t ; . .• • •
. :
. . : • t :
. 1 I
1 t I . . • ,
11 i E ..
:
I 1
i I
i 1 1 r I i i
. .
• . .I .:
-----' 1 /-1:- ---1— —1— ::' --'--- 1 1
-1
1
._ i:r•':. .:.___. ...,____ i 1 i
! .
i — I .
•
•
._,
4 ,
. ,
I I
I 4"
. ..
l• I
1
-1-- I I I :,___ I
I .
.
..•
I ; I .
I
1111 i 1
, I
. I I I
I I r I i
•
„
1 i i ,
Si f
. ,
! ' I
! I i
, A .
_____, ___ 7. ..
I — ;
' 1 .
I
1 1/( „
. :'
. .
____.
1 -, -"----- ,1it _t__.
. 1
1 1----- -'. ..: —±1 I — 1 * ." "-- '.--
I
L ,.,,,•,,,, i , i ;
. !
I i .
:
.,
- 111:Pf;4i
1 , f
I " .
T i 1 1
1IL1 I I :
1 1
1 „
: 1
; -4-- ---,1--- .
_ .0
col
, 1
11 •a'
CI • :
: I
• 1
I I
• i
I i :
–±-
--t-- ; •---• 1.
I .
i II
I !
I :
il 1 i
. • • Ir 4 i + , __!„. — ; _..4._ ,-...--- — — .-. - - -
8 _..4.._ ,.._ ....,
. .
. 1 , , , ,
,
4 .
•
. .
--- .,5 3 :
-.II '
N •,,, I . 1 ---t--
! I ;• ""4:44,,,` . \.43. I
I-* ' c!\*' )1_ ;44,. "44''*-------TCPi ,_ --E----...„.
.i....44-4
1 se . I I
1 1 , I•r i-r'..
.• :•_ _ . : _ 1 t --. -1 ,- „,,,,_i___,, !!,' -- ---...4------L -- r72- _ , 1... , -----.- -
1 ;
: 1
NORA AV bl
. , 1 ,t ; ir NE:s •-'4.1•ZoF E !198`2: ,
Art
1 !
-4- 4 ,
i 1
i , ,-i 1- 1 f ,
. 1 If I
. . .
f
, kZ5 r I:Ci I
! .
. . . i
. ,
: !
I ! 1 1
I 1 1
I !
---t
4 - I! n- s
•-- 4-----; '--- ! I; '. 1; ..IIIir•-• 01 ,'
-4--- --I
i t
• •4 .I „ '
i -1- —I— • 7--
it: ..;•, i 1------t— :
I 1 ,
: I 1 --( I - I r I 1 .
4 ; •____.
1 " t
I
;---i• 0'
. .
'
rihi
h
_-! - 4""•i
.._.
--.i;
•
, : (1) ••• 1 ! { ! I .
: 1 ,
., 1, _ i
• 1 • i 1
-------: i I" ft.I
I .2.111f, 1 ! 1 ! w!
,
,
• I t tti ..,,,.! ,
.;_ f , t ; 7 , .T . . :
. . Q 1 ! .
.
I .
. • ! : 1
.1 Y . . , I' • . . . .
. . .
•
_
1 : II•'
I .• \ 4.e‘fr,;.!,!4-: L Sii31*z4'54'kil lbot 1 . .
. .
I I '
,.., ---! . .
I -1.)-N•4t• .! • 1- - --t •t
I -- : •1 . ! 1 : . .
• 1 i'c, . .
I- - - 4- • 4L. 4, tit .titi....‹.•._EA........ i
1 :
t ! 1 • %NT , 1
. • . 1-'' E .
1
•- 1 t -11
1 I
1---- • 1 7 – -.1 – Ir
1
. . ,. .
I
! . --1 • -4 --;;- --1- -if -I- i
• ! "
. • ; " ; 12 II -I -1- .4;' - t. - 1 -!" -.1 I
*
: SI
• :
. '
• 1 i Hvt...- t r ---,- - • _ _i•
I i t t • :
:
I lit I ,
:
. I i -1 .
:,1 : ii .!,
i
i 1
t
i
I 1 ! i 1
1 1 : — i
II
:
_ .
- . '. 1 • :-, - : -4; i —• 1 i itt { .:
• i 7 I ti•. 'Z' I r 7 - : -
4- : ! , 4,14.•••k..: ...1 ! '
,
.. .
• I ' II.
, I 1 I 1
' , : . , :
:
.
. E , • i 1 lkier).r4v.i..4.t
• , ,--r-t..-0....-. - --t-.......
-.1- , • • ,
1 . .
, : •.;h (.1 r,...,1-.C....! !&Z-4+7.1t IC),1 ef1..'\er 1).•. : if1.71 `-::f
,
1 rt.:•01:61 NA:rid.A1.441..T
-- --•-• -... ---- I S4k3 4': i t ,
. --f-- , -.•
E I ,
i , 1 , ! .
E '
1
: !
..
I ' I 1
I , ,
. ,
1 ,
1 1
--ts.r...-..• ' • !f""•,'..'''-.4.'
. t,.. .,. .•.1.t: 7....'... .:...'....‘
•
- '
'
, : . f:a.I g 4 rr:,-;...ar..-W,,--t.1
-