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Sprague E 7803 Cameron & Waybright Strg Ren I 1^ ' ~ ~ ~ • BUILDiiVG PER11AfT APr, tt,♦,TYQN WQRKSHEc f PLEASE PRlNT AND CUMPLETE ONLY 7 F-I(.r:~,, PARTS OF THE FOkM VjU Ur~DERSTAND (Please return this origfnal and your bu(tding ptsns to the D:partment oi 8uiia:ng and :)atety) 1 Owner's Nsrtm ~(ies~l, ttt.st} , lm~ ~meni Lseonly. ' rR.O~ W t~ie - ~►~0i?)1+~ ~ II~G comm 2 Prqeat Acldrese not Mailin9 Add~tsaor N m S~ - 7603 r~ SfA~oV 3 GIroComrnunity ~ ' Ste1e gupdivlsfonlPiat NameA 4 Asseasor Parcet No 1' Lo! - 8lack ~ ~ ` ♦ ~ ~PARTMENT USE ONLY t ~ t IDF~1' I i 5 Sk Gbde Zsns Act A Zone Prcject No e Dwell 0 No 018uIIdIngB - $q FI 1 Acre pepih Frontge 7 Set Badc-Frant (1.)S-1 (RW2 Rear Qmsus'i'ract Moduie No ~ltiale - * 18 ArChlla.y flrnn Neme ' w Stiaet Addressa - y ZiP ~ pb State Fhone (bfllac1 ftI80/1 Pltaflo if diKa811t ih8f18bt1YE ( I ~ QoMre~or Fltm Name Street AQdfess . 21 Ou,u~arN~ _ s 4z1) P GIY State Photte • _ "-7040 WA q z ~ ~If ai,fe.e„t 1~,~ 8 Owner/Agent (it different t qthan ebovej ~ Bu81r e8s AQdreee P4 a~ #3 O*L..- 9 Ziq C1tY State ~ Phone { j 112 Rsvlew Requtretl~- P ani Checc (Y!N) `OtAer~(lflN) SEPA Exetnpt (Y!N) Date - iS Type Wor1t 81dg Cl MH ~ New O Rsplace p'pum _ 0 Fife CI DB'mo ),A-AddlAlter I Move ' 14 Oescrlbe VYork STON/'T&~ RV l ~./Y ~ c a"vVArl0h _ 10 fAp~icant Name Street AddriAt ~ - 6 . S AIWo vf-- 11 ZiP City State Phone 1 ) * Letide`r . . Strwt AQdregs zjP Clly State Phone ~ I ( ! r Ccnis~l PerBan - Phoneifi dlfferant than ebove I ( ~ Addtllonaf intormafian f~ r ~ - DEPARTMENT APPROVALS This is not a Permit Appllcatlon Type (Stendard'unless (Indicated approvais required in efther "retease" or'refease wlih conditlona' - Q ~ otherwise indlcated) apaoe prior Wpermit issuance Fasl Track ' ~ E#u'ly Stert ReleaBe ~ Reteaee , w/cond 1 Nold 2 ~ . ~ Envlronmental Health `O Commercial, O Residentiai ' W 1101 Collepe El, New Construction, 10 81dg alteration laddition ~ Room 200 0 Addlttonal structure, , ~ APP,LICATION li . Condltlons/Comments _ ~ Plenning/Zoning: O Commercial, O Cert of Exemption, O Frontage~ ~b N 721,Jefferson O Setbacks, 0 lot wld, ❑ lot alze, O use/zone, ' ❑ CU, varience, zane change, shoreline, C] fence, ❑ Other Conditlons/Comments , ~ Enetnoere: G Commerclal, O Residential, 0 Flood Plaln; N 811 Jefterson ❑ dreinage O new acxess/,approach, O fence. - =ro 0 road improvements ~ Condittons/Commente - - . ' . ~ o , uaiiaei. N 811 JOffereon ~ CondltlonslComments ' - , Q~ L . 0 Other: ~ . - ❑ Pien Exem Fire Prev. CondltionslComments ° _ . _ 1 . C ~ Pro)eat Repreaentative _ Tefephone Agenclea Pertorming Special Inspectlon 4 ~ H o ' 2. ~ c .3 - 1 Indkate abave ot attach condltlons reletlve to Nnel ea bulit approval 2 Iridkate abave ot attech reaeona /or hofd 1....., ae~~~ - t.~.~`"~~i`' `?~"j' - ~ ~ ~ ~ f ~ 1~y+~~~ ~ - t _ _ _ ~ ~ • . ~ . ~ ' r 5 ^ 4 • , J { • _ - - ; . • , ` 5~- ~ f ,...~f'`~ rr . _ ' . dio + ~ ~ r I do ~ ♦ ~ ! J" • ty Pj ! ~ ~ " t ~ r. • , qI r~ ~ .,a ~ .1 • ! ~ .r~ I 1 - h • I' J • ( '.V~~~ tSr'tt1fr ~x op , . • ~ t~ ~ _ , 1 ~ . S ' ~cY l ~ . ~ ~ 1n 1 • °w ~L C~V ~ ~ i ~ i ~ ~ . ~ • L - ~ 9 . ~ • ~ - - - I r ~ / ' , _ _ / , , ~ 0 , ~ ~ ~2 4;, ~9 47_1 A)e (Y ~a ~ owim ~ n ' ' •1 ~ ~ ~ ` ~ ; . • i 7r~ ~ r., f'~ Q.^~' • ~ ~ 1 ~ Ft . , ~ ~ ~ . ~N > t ~ ~ ♦ n r • ~ ~ 9 Y/ .2 9 . ~ , , ~ ~ ^ ~ • F S f p 1 ~ ~ ~ 4 ~ ♦ ^ • .s ~ f e ° J /