1986, 11-20 Permit App: 00014291 Storage AdditionL T -
(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 bpsynastute
FIRST MI
77 6e
Owner's Nemo Si
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Project Address (Street Name & Nanber)
-ra add3 I.S-1-;--ntii
Zip
Applicant
Address
State
w
Zip
94�0�
Phone
Business Phone
)Fay
Contractor/Agent
BRANSON STEEL BUILDINGS, INC.
Address
City
E. I I52s SPRAGUE AVE.
SPOKANE, WA 99206
Zip
Phone
)
Contect�
License Number (Required)
B N-4 0- l - �I Lea )C
Business Phone
Architect/Engineer
Address
City
State
Zip
Phone
)
Contact
Business Phone
Lender
City
State
Zip
Address
Phone
Show on Site Plan:
Lot Dimensions
Existing Structures
Proposed Improvements
Structure Setbacks
Easements
Septic System (s)
Water Lines
Sewer Lines
Fences, Wells
Driveway(s)
Right of Way Width(s)
Names of
Fronting Street
Flanking Street
Additional infbrmatiow
Landscaping
Drainage Plan
Hydrants
Topography
Lighting
Signage
Shorelines
Highwater Mark
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Legal Description
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Scale:
Date:
Revisions: Attachments;
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DEPARTMENTAL REVIEW
Approved
Cond.
Approval
Hold
Environmental Health Application #
W. 1101 College
Room 200
Planning/Zoning
O N. 721 Jefferson
Engineers
O N. 811 Jefferson
Utilities
O N. 811 Jefferson
Plan Review/Fire Prevention
O N.811 Jefferson
0
0
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.
Signature Date