1985, 04-12 Permit App: 00004933 SunroomBUILDING PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
(Please return this grit l nal and your bu lid Ing plana to the Department of Building and Safety)
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1
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IAIS3 Rev
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Module No.
Initials
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16 Anthill Firm Name
Sired Address
ZIP
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Additional Information
DEPARTMENT APPROVALS
/ Indicate above or attach conditions relative to final as built approval
2 Indicate above or attach reasons for hold
Application Type
This is not a Permit
❑
(Standard unless
otherwise indicated)
Fast Track
(Indicated approvals regulred In either^release' or 'release with conditions'
space prior to permit issuance.)
❑
Early Start
Release
Environmental Health
W. 1101 College
Room 200
Release, w/cond 1 Hold 2
❑ Commercial; ❑ Residential t
❑ New Construction; Bldg alteration /addition
E 4�r�
❑ Additional structure; ❑
,p
APPLICATION 0
Conditions/ Comments:
❑
Planning/Zoning:
❑ Commercial; ❑ Cert. of Exemption; ❑ Frontage;
W 721 Jefferson
❑ Setbacks; ❑lot w/d; El lot size; ❑use/zone;
❑ CU, variance, zone change; shoreline; ❑ fence;
❑ Other
Conditions IComments:
❑
Enpinasrs:
❑ Commercial; ❑ Residential; ❑ Flood Plain;
W 811 Jefferson
17 drainage ❑ new access/approach; ❑ fence;
road improvements
Conditions/ Comments:
❑
Utilities:
N. 811 Jefferson
Conditions/ Comments:
❑
Other:
❑
Plan Exam
Fire Prov.
Conditions/ Comments:
❑
Protect Representative
Telephone
Agencies Performing Special Inspection:
t.
E
2
3.
/ Indicate above or attach conditions relative to final as built approval
2 Indicate above or attach reasons for hold
Spokane mortgay 1-0. *J.-Uu
MAP SHOWING LOCATION OF IMPROVEMENTS ON & BOUNDARIES OF
Lot 6 in Block 1 of Stevick Addition
AS PER PLAT RECORDED IN AUDITOR'S OFFICE, COUNTY OF SPO—
KANE, STATE OF WASHINGTON.
I HEREBY CERTIFY THAT I HAVE SURVEYED THE ABOVE DESCRIBED
PROPERTY AND THAT I FIND THE IMPROVEMENTS SITUATED AS SHOWN
HEREON AND THAT THEY DO NOT OVERLAP OR ENCROACH ON PROPERTY
LYING ADJACENT. NO IMPROVEMENTS EN�H ON T�PH SES.
�' »(lAMERGN
OWNER:Edward'L. McHugh PROFS AL LAND SURVEYOR
N. 4226 Woodlawn Rd.
SURVEYED,Aprll 14, 1976
LOAN:
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PROPERTY CORNERS NOT SET