1985, 08-25 Permit App: 00007164 Garage a . , f
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DEPARTMENTAL REVIEW
Cond.
Approved
r� Approval Hold
Environmental Health Permit Number /IF (9-2-?-2-'1 V' , .K
W. 1101 College
Room 200 (E�401�/��� „ �(1 �
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Planning/Zoning
❑ N.721 Jefferson _
Permit Number
Engineers
❑ N.811 Jefferson
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Utilities I
ElN.811 Jefferson
Plan Review/Fire Prevention
❑ N.811 Jefferson
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 is true,correct,legal,and binding.
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Date —i"c)`a' "CiS'
Owner's Signatur _ _ _��✓U.�`'���-)- /' , dd
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