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1985, 03-18 Permit App: 00004521 Storage I • BUILDING 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 (last) (first) (m)! Department Use Only Ac- / aT/�� l"i k.. lin. y Comm 2 Project Address(not Mailing Address)or Road Name Space Zip I 020 S. a.2.3 3 City/Communit Stet, Subdivision/Plat Name City/Cr 1 'CLAt iY! 9x1\1- SDP( Tic) 4 Assessor Parcel No. Lot Block ,X is/S- -33 3 _ 0 p3 c Zio z i 7 * . * DEPARTMENT USE ONLY * * * 5 Sic Code Zone Act.# Zone Project No. I� -312f� 52 6 Dwell# No.of Buildings Sq.Ft./Acre Depth i Frontage k 2 I3 &- 156 t 7 Set Back-Front (L)S-1 (R)S-2 i Rear I Census Tract Module No. Initials -�tr��� p • Z> iU ( . * 16 Architect Firm Name I Street Address ,I Zip City State Phone ( ) I Contact Person Phone If different than above ( ) CoC-rector Firm Name Street Address G t? ,124/1,C.) e r 672E k%luc ;: J' Jr Zip City State/� Phone 3 IC --7( Fr&—. I / (.;sof ) 773- c2.1-60.3 "tftet Person License No. Phone If different than above cF�4i (io k-S1 ilk L5�1/ :7 ( ) 8 Ownerl Sit(if different than#1 above) ;/t 6 Business Address 9 Zip City State Phone ( ) 12 Review Required Plan Check(Y/N) Other(Y/N) SEPA Exempt(Y/N) Date 15 Type Work O Bldg ❑ MH ❑ New ❑ Replace ❑ Other ❑ Fire ❑ Demo g Add/Alter ❑ Move 14 Describe Work A°(TAtic G (1D!'4 - al0 ev1k n1 F 576,,C 10 Applicant Name Street Address 4 11 Zip City State Phone ( ) * * Lender Street Address Zip City State Phone ( ) Contact Person Phone if different than above ( ) Additional Information DEPARTMENT APPROVALS This is nota Permit Application Type (Standard unless (Indicated approvals required in either"release"or"release with conditions" otherwise indicated) space prior to permit issuance.) ❑ Fast Track ❑ Early Start Release Release w/cond 1 Hold 2 Environmental Health ❑ Commercial; ❑ Residential W.1101 College ❑ New Construction; C Bldg alteration/addition Room 200 ❑ Additional structure; 5—?/V-?3' 5 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 Prey. Conditions/Comments: a N -t▪ 1] Project Representative Telephone cn Agencies Performing Special Inspection: c 1. . O U '— co 7,3 ~ E 2. y O O LL 3. 1 Indicate above or attach conditions relative to final as built approval 2 Indicate above or attach reasons for hold feek sTibk-Ect BuILDI NGs Post Falls,Idaho (208)773-5809 Spokane,WA (509)455-5139 Name Address City State County Zip Telephone Representative Lois— ' /3 — Zz �5 `� 3? ,4 -47 Z 6/A `02- ZO � Z. 8/IE it 4c-r 77 071-,.'..s.-753 -o?3 " x 1 /3S 4.7%."--4? 5