1987, 10-05 Permit App: 87003340 Storage (THIS IS NOT/-% PERMIT)
BUILDING PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
COMPLETE IN INK
(Please return this original and your building plans to the Department of Building and Safety)
SHADED AREAS ARE FOR DEPARTMENTAL USE
[Project Number
Owner's Name LAST FIRST MI
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Project Address(Street Name&Num ) Zip
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Applicant Address
City State Zip Phone
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Business Phone
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Contractor/Agent / Address
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'WA" T t -/ "�C C LR�[ ��rG Ery J if.
City State ' fip Phone
(Tic Ott.'higezi , tt9fit 9d?5it7 I I 924-1557
Contact License Number(Required) Business Phone
_7ohri 0eel< L'mK Tom. C, ",1,247,116, ( 1
Architect/Engineer Address
1116 11 Ncfe e Ass("t %A � _ /V /7241. il4 Si DSP.
City I State I Zip Phone
C (/ 7� Sp*, W A , tit)14 , I ( ) 1 e 5,5Y 9
Contact / Business Phone
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1
Lender Address
City State I Zip Phone
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Describe Work ', f= s k Res. j Comm.
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Subdivision/Plat Name/Short Plat Number
Assessor Parcel NumberLot Block Plat Number
Pertinent File Numbers Zone Comp.Plan Census Tract
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Number of Dwelling Units Number of Buildings Lot Size(Sq.Ft./Acre) Depth Frontage
Front Setback Left Setback Right Setback Rear Setback RAN Width
Additional Information Square Footage
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m Number of Bedrooms
Building Technician Date Group Type
COOK BROTHERS CONTRACTING JOB r "� / -� � '5
Route 2 Box 853 B SHEET NO. E`.5.120 /fO
OTIS ORCHARDS, WA 99027 / r OF
(509) 924-1557 CALCULATED BY 3�.K5a DATE
CHECKED BY DATE
SCALE
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FORM 204 Available from/N/INC.Townsend,Mass 01470
OCT-05-'87 15:48 ID:HEALTH SPO TEL NO:509-456_-4715 _ #787P01
rRcJECY NUMBER--= B7003340 DATE-= 10/05/ 7 PAGE= Oi
.44*«to e,4*3*+ ******war****qtr** *** ** APPLICATION x****m*It*at*+ ***iu***********w**
SITE STREET 5220E 16TH AVE PAPCEL4= 26531-755
AtoRtss.. SPOKANE. WA 9i V
PtRMtT USEJ. STORAGE BUILDING
FLAT;= 999999 PLAT NAK= RANGE
BLOCK= LOT= ZONE= AGRI D:[ST47-. E
AIREAT. oecleoe o FIA= F WIDTH= 165 DEFTHrg 6. 0 k/W
T DF BLD6S= 2 DWI"LLIN(. °= t
OWNER= HENRY, ,.}C1HP D PHGNE..
STREET= 5220 T. i$T1-! AVE
ADDRESS= SPOKANE WA 99212
CONTACT ?JAMES JOHN GOOKPHONE: NUMBER = SO?-924- V
SETBACKS: FRONT 2y 8(? LEFT az i i5 kT:GFtT= 20 REAR= 332
***44,**,0**h***** * 4(******** FEV E(J INFORMATION ,rat+a**it xA,tAKK0* t****x**x*�t
DATE
D'EpApermENT NAME REVIEW COMCNTS JN/OUT INITIALS
ENV/RUN MENTAL. HEALTH IKr EAS£: IN ,,0..T COVERAGE 9 i 4}0 �: AtiI
x.*****A**********K4*** **4*,t*** Eei!_nT.tJ, PERMIT ******* *.y.**** **** 4.4A-*
CO3t1T; CTOR= COOK BROTHERS STEEL. BLI ILDTE+ S PHONE. 509 q?4 ' 557
yTRE.ET= 206(6 E I_AKE.V II=W Di''
ADDRESS,. O('I S OY(CHARDS WA T5T27
NEW= >- REMODEL= ADDT.T/ON, CHANGE. U3E+w
DWELL UN/TS= 4UCCU . LD= BLDC HE;TN. 's"?Oti7ES. i
ILDG W Y. D Ii; ;fib X 4g ZU t=T' 1440
PEG PARKING= 4MANDICAP= SEWER= N OYI)FANTN
DERCRIPTION GROUP TYPE SQ FT k'ALQATIOt
GARAG#::... _._- yy y
h.: t yNi 4A0 £3640.0q
PERMIT TYPE FEL AMOUNT AMOUNT PAID tai4GUNJ 0WIN(
SL1ILDINE: PERMIT .00 .00 .0
CO. .00 .D
PROCESSED EY WENDEL; GLORIA
*its*********at**********w,*xx***** THANK YOO **x****at***,*K***4*tt at�cttx****+gat***
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