1984, 05-23 Permit App: 00000327 Residence 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) j Department Only
'5 P-14,1.--P__ c-r-5 c,...IA/ CS Fes. Comm
2 Project Address(not Mailing Address)T Name Space Zip
E Ss t '7 Ls
3 City/Community State Subdivision/Plat Name ^
S t.icouS cQ
4 Assessor Parcel No. Lot Block
-2 3 S 3 - /O 0 4, / * * * DEPARTMENT USE ONLY * * *
5 Sic Code Zone Act.0 Zone �' Project No. ,
6 Dwell N No.of Buildings Sq.Ft./Acre Depth Frontage
133 1 CC-
7 Set Back-Front (L)S-1 c (R)S-2 / Rear Census Tract Module No. Is
b I , 2 5 1 c. (,-,.'S Jy
* " *
16 Architect Firm Name Street Address
Zip City State Phone
( )
Contact Person Phone If different than above
( )
Contractor Firm Name Street Address
Gd b b N F iv --g°9 kil k("ac n/
Zip City State Phone
al la U•c_r-� k([_._ U..) ( ) 2.G- 70[3
Contact Person License No. Phone if different than above
FI NC 6 - 2S, P- ( ) Z 2$ -17'77
8 Owner/Agent(if different than 01 above) Business Address
9 Zip City State Phone
( )
12 Review Required Plan Check(Y/N) Other(YIN) ISEPA Exempt(YIN) Date
15 Type Work -Bldg ❑ MH few Cl Replace ❑ Other
❑ Fire ❑ Demo ❑ Add/Alter El Move
14 Describe Wrk /
T2., -- �� t 0 e/.>�J
10 Applicant Name Street Address
11 Zip City State Phone
( )
* *
Lender Street Address
Zip City State Phone
( )
Contact Person Phone if different than above
( )
Additional Information
I 4' 4
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
❑ arly Start Release
Release w/cond 1 Hold 2
ofr
fe, ,
Environmental Health ❑ pommercial; esidential
W.1101 CollegeNew Construction; ❑ Bldg alteration/addition S �lr�-
Room 200 El Additional structure; 5/
)--lot
# g4-06'5 2---
Conditions/Comments:
O Planning/Zoning: ❑ Commercial; ❑ Cert.of Exemption; ❑ Frontage;
N.721 Jefferson El Setbacks; ❑ lot w/d; ❑ lot size; El use/zone;
El CU,variance,zone change;shoreline; ❑ fence;
❑ Other
Conditions/Comments:
-a2'ZVY
Engineers: El Commercial; sidential; El Flood Plain; r,
N.811 Jefferson CIdrainage raccess/approach; ❑ fence;
❑ road improvements
Conditions/Comments:
J
O Utilities:
N.811 Jefferson
Conditions/Comments:
El Other:
O Plan Exam
Fire Prey. ,,
Conditions/Comments: f p f1 m 11- PQ 0 ' 63A — 4-i(C)
c
!o
i° Project Representative Telephone
iD
a. Agencies Performing Special Inspection:
Y O
1.
co a6
H E 2.
y8
f0 E
LL
3.
1 Indicate above or attach conditions relative to final as built approval
2 Indicate above or attach reasons for hold
October 1O 1 84
Jim Manson
Director Spokane County Buildings and Safety
Mr. Mason:
With regard to your recent final inspection at East 5517 15th
Street, Spokane 99212. Per an agreement with the builder,
Mr.Sordon Finch, grading on the east side of my house will
be completed by a landscaper at the time final landscaping
is completed. I estimate this will be before December.
Project number is 000007.27.
Thank You
Peter J. Bucki
,.
, .
.. , .
, .
. . , .
. . ,
,
iS
o
N.
1 5' u_r/L i r-/ .4-'4,5/7e ert \
, -
, I - •
\ L \I e) \
I 3 .
. 9
.„,
, .ii
',' 1,1,•4,....
6 1 °v ‘-_-------- ------ ---'r -- 1,..
___----- - I
'I-
47
0 . ,,
s..D
N 1,
Cf) \
CC)
....s1
r4
Cl •
c-1
L. -- -
-• .____ .
‘S
3 e
s 5 19
2 AM.
Lo-t.
' e..9 A •-
+''-- 4-•:"---
,
-
...,_
...