SPRAGUE E 6712 Spokane Photo-Drive Thru Window
~ (THIS IS NOT A PERMIT)
BUILDING PERMlT APPLtCATION WORKSHEET
PLEASE PRINT AND COMPI.ETE ONLY THOSE PARTS OF THE FORM YOD UNDERS'TAND
COMPLETE iN INK
(Please return this original and your building ptans to the Department of Building and Satety)
SHADEO AREAS ARE FOR DEPARTMENTAL USE ~
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Owner's Name WST FIRST MI
t~iG~
Project Address (Street Name 8 NumDer) Zip
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Applicant Address
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City State ZiD Phone
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Business Phone
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Contractor/Aqent Addresa
City State Zip Pnone
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Contact license Number (Required) Business Phone
Archi tect / EnQ i neer AdG►ess
City S1ale ZiD Phone
~~tact Businegs Phone
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lender Address
Gty State Zip Phone
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oesalne wax Res. comm.
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SubdivfabnlPlat NamelShort Piat Number .
Assessa Parcel Number Lot Btock Ptat Number
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Pertinent Flle Numbers ~ • zo^8 Comp. Plan Censw Tract
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Number d Owellinp Unita Number ot 8uildinys Lot Slze (Sq. Ft./Aue) Depth Frontaye
Front Setback Ls1t Setback Right SetDack Reer Setback R!W WIdtA
Additlonal In(ormation Square Footape
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fq Number d Bedrooms
B~infl Technician Date ~ f Group Type
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DEPARTMENTAL REVIEW
Cond. ~
Approved Approval Hold
Envlronrnental Health Application N
❑ W. 1101 College
Aoom 200
' P1anning/Zonlnq
N. 721 Jefferson
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Engineers ~
~ N. 811 Jef f rson ~a•• V
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Utillties
❑ N. 811 Jefferson
Plan Review! Ftrs Prsventlon
N. 811 Jefferson
Other (SEPA/Critlcal Materlel/etc.)
❑
~ Faaf Treck/Speclal Inspectlon Informatlon
ProJect Representative Phone
Address
I certify that I have examined this application and state that the intormation contained in it and submitted
by me or my agent fo compile said application is true and correct.
Signature Date
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