Loading...
HomeMy WebLinkAbout1986, 11-18 Permit App: 87000436 Relocate Residence (THIS IS NOT A 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 Owner's Name LAST FIRST MI Project Address(Street Name&Number) Zip APPlicanJ 1 Address r .I }} �G .r .7r`7 >�=-—>•4-30-3 Z-- 72.4i City�r,^G� / State C� Zip . 3 7 Phone (5-0 j) Business Phone ( ) Contracto ,AgentAddress �, s.' 2 . f. �3 i-6.73 Z .3 1 � '‘ City State Zip Phone Z_..--/----/?--,---.10.25./ /—z-2/ ,',D37 (s- ,") ,c'. z z_j Contact License Number(Required) Business Phone C74 zea 9rS I ) ,7 Architect)Engineer Address City State Zip Phone ( ) Contact Business Phone ( ) Lender Address City State Zip Phone ( ) Describe Work Res. Comm. r ..o(+A`tom itsioes.1 CO !amu LL 8LSEMnkir Subdivision/Plat Name/Short PI t Number ' PaE 3E20 Assessor Parcel Number Lot Block Plat Number Ill 5G 1 — 1161 tI I Pertinent File Numbers Zone Comp.Plan Census Tract e Number of Dwelling Units Number of Buildings Lot Size(Sq.Ft./Acre) Depth Frontage Front Setback Left Setback Right Setback Rear Se RI W Width ir> lb /0 Additional Information Square Footage rEt_oeArtCsJ .11 o EASGEour G2'. SSD Z Q "'fit o0 A fi R2 PO o 14.Z a Z 0 J_ 5 m Number of Bedrooms Building Technician Date Group Type sr;. 4 -1 II—IS—Se 3 • DEPARTMENTAL REVIEW Cond. Approved Hold `/ q6 Approval 2( Environmental Health Application 0 W.1101 College Room 200 G _,/Planning/Zoning ' u N.721 Jefferson92freldij T � - -� /co." N.811 Jefferso _ I �' � �jyt 1J� Gl !: _ , �X Pte,!/ GG(/l /?/Y4 to/3 Utilities ❑ N.811 Jefferson Plan Review/Fire Prevention D N.811 Jefferson Other(SEPA/Critical Material/etc.) 0 ❑ 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. SignaturAk --' Date ., :.'.. . r . • — 1 I '-- 1-- - - T 7 : — i 7 1 ' ---'.-- ."— -1- 4- -r-4-111.- 1 f I , 1 I 1 • • , , •i -44 1 41 -11-• - - •I-• -14 1 ; ti.. , 1 il i 1 , .. , • „,„ . . . .., _ I, I I , , _11 .. . 1.... __ .i.' .t. i i .„.2. . 4 I 41 — , • ; I : j h - •'n,... _ • r r 4 1 ' : 1 - 1 i 4. 1 . t ' ' . !!.3". I i_----`111,-: 1 I f ! ! I .. ' 1 1•••••• ___--------: . . : 1 -..,-..- - - ----i-- --,- t 1 _ ...... . . ----- ---__ , • • 1 ...._ t , 1 I -----4----_ t I '---,,,, ____------- , , ,, . , . _ , _ , .., , 1.- i-• -- , - 1- 4- .„4_,-------- ----„ .- f , f , ,_ + , . . .f... " . , 1 ' , f. ! , . , 1 1 . Li , , . . , . , , .1 - i, , 4 I 1 1, ...\*• -----1-------1----71----- 1 , 1 7 , 3 ‘ 4%. ,D t . , p 4 ..hi_.., C.••• , " : 1.1.' ,! I!'11 ./.• t>"/ . i i '! ‘ !! ! 1 j I .„ ... 1 ,, . ' 1 . . ! 1 ; 1 ' I i t i 4 _ Tir i,.‘ - • -4- -----. : i r-t- ---t, -4 f -4-. . . t ' I ... I. ,41 0 1 -4.., 1 asig . g 1 0 Na: 1 1 -1- I i i I ..i.- 'Hi..4 t '!"---' t— ' 4 I i ', - r • i I ',' T t I4 4-- I- i 4 _• -t ''-`t• 4 ' ---- ''''E) -1- +-- . -1-- ' t- -111 't- 1 4 1 i , ••••ir::.) , "....„,....,, „.....,......"- 1 C./ ' i , 1 ! I I . I I'1--4-- ' ItI II" t --.-. I -Ife II-'' ' -7 ' -I- I: , I- h 1 1 1 ,i3 1- i i , , 1 I , I I_ 1 Z. 1 .. f , 1 ,i , __4_____,-, - , ---i--,---.4``%-t.1 4 . ' . ai.- .4i. '" j i ,e 4+25"1,1 i 1 i . .. . 1 '-r-- I i— , 1 i __ql I : [ II I I ' -[-----r- I 1 . . 11 .IN.I. p i 1 1 ., 1 1, _ ,• f_ . ........::_____..._,---._i ' ---- 1 1 .1 t- I-- , , i ...,0 , . • , : ••_.• • 1 • t 1 • 1 *A. . ..„.--r), , ; j , 1 l• ' I 1 r -t-- -bk''', -7--i— ' 4 -'-- 4 t , - 4 H t----- t-- - ' . • I - -- 1 1 i WW1 1 i r - I , - , , , , r. r • i . f, 1 I . , , ! i . -1 _ . ! , . - t , 1 1 ' 1 1 , 1 r : --,-- 11 - ----- -- 1- 7 - ---t,- 1 - • I I I 1 1 •• ' ,, II i 1 -4- • 1 I_4 ____. _ _ 4.._ .... • , I.• I I • rt ' . I ' I 4 — - r . I I . i I I 1 I , • , . 1I I -- { I --1 1 4- i "F I , 4,-. I 1 4 ' 1 1 1 -.1. --I- ---*, --+- -------7----------- -- 1 I - , • ! I i I i I 1 '....--.-. 1 ',... +- i , . , - OT , gr,2,7) .1fe, 2,6 rZ71 /yo ' 91 —71-- --- )hJ'Y-01 / 20,e 1 .lam / $ , i z 3& 2 4. '6 , 'b� 41' V2'' Ilt CIO i'.‘-t_ s� 8� 6-0 , S'�'0)-1- 23``sf i� z 9s i /4 - felt, ?VG - • 035 . qV f 101° f' -0-034 eih'1!aw. __ e l' i ' , eft^ e , ti- a _11,1,_ __., Otto ifr4i 1 a 1 1 '°4 4 v \ - ( V 1 ?2 (6 ' 25- _,// • ,l1! c� I 0 -. o> ' 9, ' 2 1t r1 ri1/4"- / irc YolOgairl,/ 6444) I? 4 2 , lst-(g / " . *Lim 0 • f / 14 4:441a/te. Itivd 81?(I a,oa 7---1 1 I . ?6i4/7' /o( c_ I' l-Ti V/-r frIA' '