1986, 12-04 Permit App: 00014489 Storage Bldgvie x
(THIS IS NOTA PERMIT)
BUILDING PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
COMPLETE IN INK
13
(Please return this original and your building plans to the Department of Building and Safety)
SHADED AREAS ARE FOR DEPARTMENTAL USE
�ar-,a/ia/Iiiiii1
Name Number)
Applicant
iGuG L'/v
State
(X/�J
Zip
467,6
enc`tit! mEer:
Address
Contractor/Agent
City
SON STEEL BU
E. 11524 SPRA
&Nes, INC.
UE AVE.
Contact
V.•
"206
.Phone
Business Phone
! 1
Address
Zip
License Number (Required)
Phone
)
Address
Contact
Lender
Gty
State
Phone
1
Business Phone
( )
Address
Zip
Phone
.Show on Site Plan:
Lot Dimensions
Existing Structures
Proposed Improvements
StructureSetbacks
Easements
Septic System (s)
Water Lines
^Sewertines
Fences, Wells
Additional Information:...
Landscaping
Drainage Plan
Hydrants
Topography
Lighting
Signage -
Shorelines
_Higdwater
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DEPARTMENTAL REVIEW
1 certify that 1 ha e examined this application and state that the Information contained In it and submitted
by me or my ag * compile said applicaa n Is true and correct.
/1 signature
�• ,
Date 13/46/e6
O
Approved
Pp
Cond.
Approval
Hold
Environmental Health Application M
W. 1101 College
Room 200
rr,�. //
X 6 —a3 �o?
/•/ j
�$ ' V,
Planning/Zoning
N. 721 Jefferson
Engineers
N. 811 Jefferson
Utilities
N. 811 Jefferson
Plan Review/Fire Prevention
N. 811 Jefferson
Other(SEPA/CrItical Material/eta.)
Fait Track/Special Inspection information
Project Representative
Phone
Address
1 certify that 1 ha e examined this application and state that the Information contained In it and submitted
by me or my ag * compile said applicaa n Is true and correct.
/1 signature
�• ,
Date 13/46/e6
O