Sprague E 17124 New Gas Station & Convenience Store
~ BUILDING PERMIT APPLICATIOH WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOD UNOERSTAND
(Please return thia orlginal and your butlding plana to the Department of Bulidinp and Safety) ~
1 Ownar a Nsme paat) (ftrst) (m) OeQertmenf lbeOnly
V~f 1 S o11 e G„oTg6 ~ oanm
2 ftieat Addroea (not Mall(np Addrm) ar Floed Name SPwo Z1P
17124 E. Sprague Avenue 99037
3 ClrylaonVr+unity stats sueWvtatonJPla1 Nenw
Greenacres Wa.
4 AmOaOf itir0el NO ~+0~ 610olt
19552-9045 aee s eet 34r legal *MPARTMENTUSEONIY
5 Stc Oode Zor+e AV i Zane Project No
-Z?
6 Dwell M No of Bulidings Sa Ft lACre Depth Fmntage
7sef saClc-FIront QL{S-t (R)&2 Rear (~nsua Tract Modute Pla Initials
/10 ' 37 (t 16 AroNitect Firm Name 6Uee1 Add►esa *
J. Denny Christenson, Architect N. 9329 Division St.
Zip dfy Stato PAone
99218 Spokane Wa. (509) 482-3600
GbnteC! Person Pl+one It dlfferant then aDove
Denny Christenson . c ~
Oonrrador A►m Nams ' screes nddreea
Qandervert Construction N. 9107 Country HorAea Blvd.
19 zIp ay 8iete Phone
99218 Spokan.e Wa. 509 )484-3092
Qsnted flerson Lloense NW if diNerent thsn above
Dick Vandervert
8 OwtreNAaemt (N dlHerent tMn tt e,bov+e) Buslnm Addtase
9 ZIp City Stete phpne
f 1
12 Fieview RequTred Pian Checlc (YlN) Othet (Y/N) SEPA Exempt (Y/N) Oete
15 Type Work )p 8ldg Q MH 10 New D Replwe C pther
0 Fire O Oemo E' AddPAlter 0 NFove
14 D=rlbe Wark Construct new gas station/convenience store :24tx:),1P
10 AppHont Name Street Addrese
Denn,y Christensan N. 9329 Division St.
11 Zip Ciry State Phane
99218 Spokane Wa. 609 s 482-3600
* I.ertdet Sireet Addresa ' •
27p Gty Slate Phane
( )
Ccntac! Person Phcne If diiferent than above
( 1
Addltional IMormetion
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~ DEPARTMENT APPROVALS
This is r,a,~t, a Permit
Application Type
(Startdard unless (Indlcate0 approvala requlred !R ellher 'rotease• or "relsase wlth conditions'
otherwiae Indicated) space prlor to permlt isauence ) Fast Track qelease
❑ Early Start Releaae w/cond 1 Hotd 2
•
L
[3 Enrironnanfal Hqlth O Commerclal; ❑ Residenttat
W 1101 Coliepe p New Conetructlon. p 81dp attetatianladdltion ~
Room 200 O Addltlonal atructure,
APPIICATION # ^ LL..~° ~ 7/n
.
Conditiona/Commsnts
D Planning/Zoning: Q Commercial. Q Cert ot ExempNon. 0 Frontage, ~
N 721 Jetlerson Cl Setbacks, O tot w/d, ❑ lot size. ~.J use/zone,
EJ CU, variance, zone change, ahoreline. 0 fence, )*eA1aA*tt;L*Z4~r-.e
O Ot er • • ~ ' '
1 CondNtons/Commen a
,
0 Enptnesro: ❑ Commercial: O Resldenttel, . 0 Ftocd Piain:
N 811 Jefferson O drelnage 0 new accesslaPProach; O fence;
p road improvemente
Conditiona/Comments• ~ - ,
~
0 uHnuea: -
N 811 JeNeBOn
GondittonalCommenta. W.-2.LJ~ "fAtz;,64
0 Otiter:
❑ Plen Exem
Fire Prev
Oor►dltlona/Camments n ,
o~
Project Representative Telephone
CL Apenctes Pertormirtg Special lnspectlon
Y O
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H E Z
LL c
3 '
1 Indkats ebove or attach conditlons ntstive b tlnel ee bullt epprovel
2 Indkate aDove or ettach renaone tar hold