1985, 04-08 Permit App: 00004828 GarageBUILDING 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 L� (last) (first) (m)
{_ z 6 ���/�/Z (/v.
Department Only
Fes. Comm
2 Project Address (not Mailing Address) or Road Name Space Zip
E- 6,*� l q Ve)7U e-
3 City/Community State Subdivision/Plat Name -�-
S a K&,Ie w� U� ale vey) 1�1'/1s P"
4 Assessor Parcel No. LotBlock
C2 6537— U } D� I Ib9 DEPARTMENT USE ONLY
5 Sic Code
Zone Act. N
Zone Project
No. 4SZ b
6 Dwell N
No. of Buildings
Sq. Ft./ Acre
Depth
Frontage
7 Set Back -Front
(L)S-1
(R)S 2
Rear
Census Tract
Module No.
Initials
16 Architect Firm Name
Street Address
Zip
City
State
Phone
Contact Person
Phone if different than above
Contractor Firm Name / _
Street AddressGUGtI'li^S
Zip
City
SP6/�a�,"
State
Phone
(5-e5)
Contact Person
License No.
Phone If different than above
6 Owner/ Agent (if different than #1 above)
Business Address
g Zip
City
State
Phone
12 Review Required
Plan Check (YIN)
Other (Y/ N) SEPA
Exempt (YIN)
—7
Date
15 Type Work 1 Bldg
❑ Fire
❑ MH
❑ Demo
'JK New
❑ Add/Alter
❑ Replace
❑ Move
❑ Other
14 Describe Work
eee /6 i/'� " Neta l 6n -age ov ecee-,ret A&5A .' : / ,36 "Cleot lGIle door
10 Applicant Name
%,ERRIGo Edu..�ard C�
Street Address
C 6 9/5
11 Zip
�%9� 12
City
State
Phone
(5D'7)
Lender
Street Address
Zip
City
State
Phone
Contact Person
Phone if different than above
Additional Information
Application Type
(Standard unless
otherwise indicated)
❑ Fast Track
❑ Early Start
SND
2L -)D
DEPARTMENT APPROVALS
This is not a Permit
(Indicated approvals required in either "release" or "release with conditions"
space prior to permit issuance.)
Environmental Health ❑ Commercial; ❑ Residential
W. 1101 College ❑ New Construction; ❑ Bldg alteration /addition
Room 200 5V Additional -structure;
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; =-
Q�
N. 811 Jefferson ❑ drainage new access/approach❑ road improvements qConditions/Comments: �N(4 /
Utilities:
N. 811 Jefferson
Conditions/ Comments:
Other:
Plan Exam
Fire Prev.
Conditions/ Comments:
Project Representative
Agencies Performing Special Inspection:
1.
2.
3.
1 Indicate above or attach conditions relative to final as built approval
2 Indicate above or attach reasons for hold
Telephone
Release
Release
w/cond 1
Hold 2
J%
Engineers: ❑ Commercial; ❑ Residential; =-
Q�
N. 811 Jefferson ❑ drainage new access/approach❑ road improvements qConditions/Comments: �N(4 /
Utilities:
N. 811 Jefferson
Conditions/ Comments:
Other:
Plan Exam
Fire Prev.
Conditions/ Comments:
Project Representative
Agencies Performing Special Inspection:
1.
2.
3.
1 Indicate above or attach conditions relative to final as built approval
2 Indicate above or attach reasons for hold
Telephone
U2 A // o',/& "
b'T
AA log
Building wi.l 1 be 16'W X 42
60
3
Building will have cement
a cement floor.
'
i ProPose�.,
Framing will be of 211X4" w
boards running hori zontal l
601
► a►dy
'
-,
purposes.
.
16 X �{2
Exterior will be sheathec
,steel
siding. Roof, wi 11 a -
{
structed of colored' Steel
There will be a 10'X10`
garage door and a 36" pet
1
-
6 µ'X 32'
8%
r
76
S�
,.
..53,
I
Curb Cut Down`-