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1984, 07-13 Permit App: 84001172 GarageBUILDING PERMIT APPLICATION WORKSHEET PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND (Please return this original and your building plans to the Department of Building and Safety) 1 Owner's Name (lRn Wast) I ko CLL nJ (first). L _ (m) Department Only P-• Comm 2 Project Address (not Mailing Address) Road Name f a4a space > Zip azrx- 3 City/Community State Subdivision/ Plat Name 4 Assessor Parcel No. ,q i _ 5 Sic Code Zone Act. N Lot Zone Block �- + * * DEPARTMENT USE ONLY Project No. 6 Dwell g l No. of Buildings i Sq. Ft./Acre Depth _ i 54 Frontage �S 7 Set Back -Front (L)S-1 (R)S-2 r , Rear Census Tract Module No. I 'tials 16 Architect Firm Name Street Address Zip City State Phone Contact Person Phone if different than above Contractor Firm Name 00k, z /� U Street Address _5� Zip ��05� At -Qzzs State �,o Phone (svp) ss ntact Per � License No. Phone If different than above 8 Owner/Agent (if different than M1 above) Business Address g Zip City State Phone 12 Review Required Plan Check (Y/ N) Other (YIN) SEPA Exempt (YIN) Date 15 Type Work -)3�– Bldg ❑ Fire ❑ MH ❑ Demo 0j , New ❑ Add/Alter ❑ Replace ❑ Move ❑ Other 14 Describe Work L 10 Applicant Name V cc�o 1C / Street Address f � %4"5 7 i' 11 Zip 95 City ��. YGz State LL Phone (,sop) Lender Street Address Zip City State phone Contact Person Phone if different than above Additional Information Application Type (Standard unless otherwise indicated) ❑ Fast Track ❑ /Early Start JI 7 DEPARTMENT APPROVALS This is not a Permit (Indicated approvals required in either "release" or "release with conditions" space prior to permit issuance.) Environmental Health ❑ Commercial; II Residential W. 1101 College ❑w Construction; ❑ Bldg alteration /addition Room 200 ,additional stricture;/ APPLICATION # <'/�� Conditions/Comments: Planning/Zoning: ❑ Commercial; ❑ Cert. of Exemption; ❑ Frontage; N. 721 Jefferson ❑ Setbacks; ❑ lot w/d; ❑ lot size; ❑ use/zone; ❑ CU, variance, zone change; shoreline; ❑ fence; ❑ Other Conditions/Comments: Engineers: ❑ Commercial; ❑ Residential; ❑ Flood Plain; N. 811 Jefferson ❑ drainage ❑ new access/ approach; ❑ fence; ❑ road improvements Conditions/Comments: Utilities: N. 811 Jefferson Conditions/ Comments: Other: Plan Exam Fire Prev. Conditions/ Comments: Project Representative Agencies Performing Special Inspection: 1. 2. 3. 1 Indicate above or attach conditions relative to final as built approval 2 Indicate above or attach reasons for hold Telephone 'J Release Release w/cond 1 Hold 2 �E,�. Telephone 'J _PK1� 'V IOT?- Post Falls, Idaho (208) 773-5809 Spokane, WA (509) 455-5139 Name / Address��Q City? State -4k)ctJ County Q Zip Telephone ;? 1 Representative StC Fi o� Al 0 NE �V SE y lv�F Asa Pv-u L # !? — %/3 °P �� O N lb� ;?61�( �10 I HoUSt X38©� E nth �wr I j