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1986, 10-09 Permit App: 00013546 Garage (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 Project Number /3 5 LA! / Owner's Name LAST FIRST MI (O ii- IT Project Address(Street Name R Number) Pbnt � �� Zip F" / (//i W a bashes - p Karg e_ QQ t 4 Applicant Address (7Drni ait 5-J"rocli'cpri E 6/U "- Ltitor;ver Dry Cit State Zip Phone3poKaa-,.e 1.314- 99, e)7 (,-57-)y) Business Phone t5Z:V 1459 s7/D Contractor/Agent Address City State Zip Phone ( ) Contact License Number(Required) Business Phone /VC)ierylATC 4 c ipzi(1,D__ ( ) Architect/Engineer Address City State Zip Phone ( ) Contact Business Phone ( ) Lender I Address City State Zip Phone ( ) Describe Work Res. Comm. ATt-AC I E C7 0-412.40-&(14 X j,L �- Subdivision/Plat Name/Short Plat Number t i)c-LLEsCe , Aloor 'iTJ/ Assessor Parcel Number Lot Block Plat Number /3 _ 1 pig 8 2.- Pertinent Pertinent File Numbers Zonew r Comp.Plan Census Tract Number of Dwelling Units Number of Buildings Lot Size(Sq.Ft./Acre) Depth Frontage ;Front Setback . Left Setback Right Setback Rear Setback. RAN Width Additional Information Square Footage 576 V z 0 . I-:. cc z • Z • o y <„ ;) m Number of Bedrooms ""�I�� �.' � �Date Group i Type . it-,41 4111111.01111.0111111.16o 4111111101.11111111111111 { DEPARTMENTAL REVIEW Cond. _a 3ct APProved APProvalHold Environmental Health Application# 7� I LrJ W. 1101 College Room 200 494 Planning/Zoning ❑ N.721 Jefferson Engineers ❑ N.811 Jefferson Utilities 0 N.811 Jefferson Plan Review/Fire Prevention ❑ N.811 Jefferson Other(SEPA/Critical Material/etc.) o 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. Signature .' �� [!i'1d() 17.t rn Qit 1 Date/ /9g6 '11 . ' 1- . 1 I •1 I 1 -I I, .1 1 _ 1. • . I .1 . I • ! . i 1 1 1 . • • i -• . . . I t ' 1 • I , i 1 f I I • , , • • . I i 1 t- [ 1 ' -'----, - , 1 , , . _ _L • I , , ; i . , ii H 1 - 1- 1 ; --- 4-.H , , • . f -- 4 , 4. -4 ' f ‘ : ...„... 4 : ! • 1 1 1 1 ,_ i: .,' 1 aL ..L.. - • i. , . 4 , 4 4 , 4 ; ; 41 ;1_ 4 , , , , , ; , . ,1 ,_... ___ ._1. , ,.. ___ " ; , ., 4 t 4 -t + ! 1 ' ---•-• -1-- -4 .------ 1 i II I i ' i 1 _ i i I I. -I 4 --4 - 1 ! f I -.,- --r-,- _F___ 4-- i______i_ .1 L i , i. • • 1- 1, - 1 II 111 1 ii , ' ' III i -4 4 ' ---H. ' - 4___. ..„.„.... ... ,- 4•• ' '. 1t tt . 1 . ii ! ii .. ! I I ; , ; 1 , i , , ti , , , r , ; • ; 1 , , 11 ! .I. .i ' --. i i ' ill ' `1111- 111' 1 —* I. ' 1 ' ! • I 1 ' I i _____I . ' 1 ___4. .__4. - __. L I L 11' 7- ' 4 I, ,: , , , 1 • ; ; , . , . ----r- - 1----,-- i , t. - , + --- - ---r---t- - - ---i- ---..-- . . - - ;f , --t-; -f; ----t;- t ' ! t 1 ; I I i . , ; , - ---4 - 4- ; . 1 ,, ! t t : i ; I I --- . _ . I I [ . .. - T 1 , . : 1,- -... 4- I-- ' •' -I- ' ' I 1 t I__ - I I- - , I j- ' j ' 1 ' ' ' ' I 4 . I ; i , ! 1 ' 1 41 4 ft'..-. 7 1 . I , ; • i f ' --II- Ii 1 ; i ' i 7----- 1 ,• ii it 1 , 1 - T . 1 r I 1 -.1,---- fli _ d__ _H ...,_ 1— • , , . T. 4. -• ,. I,' I. ' - ' I- 1 ; .1. j - T - ii !t- 1 I l' ' ' I I ! t i I i L . , .., , [ i i,, _ ---- -- 't7--- , !' L : ! ! I:r -- I I 1-- ' 4• FL 1 •••1 4 fr - - • r- - I • 1, ,j. I I ! ' 1 I ! I ---4, ' 4- --"-• t i 1 --r t- i' ' t ; i --1-- 1 t 1. i . • - i 1111 . 117 1 , i 1 1 i t .! - ; i i i , i 1 : Ti.41 .. . I lit - 'T r . 1 --i i I 1 Iq __:_i '' I 1 I I -1 1 I - +14"916-ci i I i 1 i 1 l' t • -4,' --1 , I ' ! , 1 I 11 ; 1 frt-••--i-• ----t- 1 --------f-- -I-- I I -I-- 1 ! -171- t- t 11 -1- < I --1 1 ' —f --I 1 r4r 1111 ' i ' III 11 ; Lill ; I ; /- i t! l ; f 11 ' HI ili 4 4 , 1 1 ; ;_..,, , _i_ • 3tif, , __...._ -1 -- - I 1 1 1 1 i . 1 i 1 1 1 1 t 1 If 1 , I 1 . , . • i 4_ 1 i ! , • , -4- -- 1 it -r - i 1 ! i--F --i ' 1 i 1 1 1 1 1 ,i •, ‘,-4 . i f LI - i 1 i i 1 , _ __ , 1- 1 1 ill 41 ; III. ii 441 1 —fr 1 ----r 1 i 1 1 ___ ..LL_ 1 4 .-- I ; 1-.--- • ------_i ---i--; -I - t.4 Li. - 1--- --,,j.---_H _4;- - Ill ..., i, ,_....„ _„.-,_-\ ...4__4.. , i 4_______, , __ ,1 , 1 * 4 4 _; i _-____f____ .f...._ ' ' I I I 1 I " IH I I ' I I I -1 -t I I, - : ;; i . I j r. -t I 1 , , [ i t 1 1 i i 1-7: . , 1 1 , i , , I 1 1 i 1 , T I 7 ' ' ' , ; ;„ , ;___ ,______,. _L ; , .7 -; -- 1• ,, i 1 ., „,. ___1..„..._„ • .i. I ,,„,_,____ ,t-ii_, .1,_ ,i... 4,....t: ,_4._ I _. _ _ I . 1 ___:" ._ 1 I , I t ___, _. _„ .__ , r !Lill 1 1* AI ;It