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1986, 06-30 Permit App: 00011974 Residence (THIS IS NOT A 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 Owner's NameBAST FIRST MI resit-1 ��r ` ` Project Address(Street Name Number)1 V Zip r ( 4g34c D � • // Applicant Address City State Zip Phone ( ) Business Phone ( ) Contractor/Agent Address 1(C'Sl (-11':.(it'l ' k o E.- 111 'l;n Iry a' . J. City State Zip Phone 5cv w 99 2-,72S ( ) '1(•(..,--. 13 Contact License Number(Required) Business Phone t ` \(c is 1. 41 I�U A ( ) Architect/Engineer Address — City State Zip Phone ( ) Contact Business Phone ( ) Lender Address iti-Ft City S��" State Zip ���� ( Phone ( ) 4 309--c: Describe Work * - 11(15 W y.:CA V Res.Comm. I.0 Subdivision/Plat Name/Short Plat Number 14' 1sf p4Pt.tioNA _- _ Assessor Parcel Number Lot Block , Plat Number 2__fp g4 Z 1 8013 0! (rois� t Pertinent File Numbers Zone Comp.Plan Census Tract' Number of Dwelling Units Number of Buildings Lot Size(Sq.Ft./Acre) Depth Frontage (. i $A.,‘ '01: 2,2... Front Setback i Left Setback i Right Setback I Rear Setback Rt W Width ;Z IS 20 Additional Information Square Footage IIF .- {2612. ff z U$ = 12.6,o 0 Ft 6Aer, . 52-e)% 2 cc0 u. z o z 0 0 LCI Number of.Bedrooms Buildi g Technician Date Group Type uiYl 6� � 63 . DEPARTMENTAL REVIEW Cond. A.pr• ii` ' Approval Hold �/ Environmental Health Application# d v 0 1 (,60 ❑ W.1101 College I/�1 Room 200 �� --'.'74-11.1-17 etttlArldlid r/ ‘,/— ,%ii ' Planning/Zoning ❑ N.721 Jefferson Engineers �/ 44 /�, 3O ❑ N.811 Jefferson 4 Utilities I ❑ N.811 Jefferson Plan Review/Fire Prevention 7--(--s ❑ N.811 Jefferson g(11 Other(SEPA/Critical Material/etc.) LI ❑ Fast Track/Special Inspection Information Project Representative Phone Address I certify that I have examined this application and state that the information contained in it and submitted by me or m agent to compile said application is true and correct. Signature ane Date L-3cd-- " t... il t 1 r 1 • , 1 1 f ___4___F..__..._ il • - ,-, --•14--->- 1 : ; I 1.1 • I I . 4 ..I I I I I f I t I I I • i I I ' • >"".1 : I . • 1 I 1 : .1.•-', 1 , de! I 1 1 24: C ! ' I I I ! . I I I I I I I I t I ; • • ; : : • 1 ' ' ri i ''''.1 , • .41 "...' ' 1 ./11 . , - 1 1 . , ! 1 ! ..6, ,47' 4frt.' I IF----- - ,...( I Om\I I 1 r I - . I / 111 111 ili ..i 1 .1.. ....... ' I 1 I I I , • I i I I ' I . . , 1 , : ! ! 1 , , I . ,, , , , . , 1. 1 1 , , . 1 , ! I i \ 1-- I 't , 1 , ..c. ;• ! ' 1 ' D '. ii I N I I • 1 i '--" • 1 li i i i 1 1 • .i- • i ,I 1 . , •\ .I 1 ' s 1 \ 1 '• • : .. 1 t '1111 ; it, 1 '; ', 111 ii.N. 1 Ili 1111 \ 4 1 1 If -.. . 7..' ''...J1I1 I - ;- ; : ii • I 1 t ../ tl , 1 \ 1 \! .. 11 .•1 ' lilt ill 1 : I ' 11i ! 11\ III i ' 1 • '111. ‘‘. 1i1Ili , ' IIIiit : a' It. . , , N 1 I I i . I I\ 1 i I I \ I I I 1. I 1., ' i • , i ! 1 I • , \I , D ..w4r711 ! '•,,I I :, i i i : 1 7 i I el:' i ! ' .1-Cs.--'1' \ i i I 1, I. i f;As,.. L-f--cr I i I t* . :i ! , 1 ! „4,,.., N 1 . I I I i i- i. I . . -4..,. I ?ssl., \ I )`` I i, . , , _ : ; , ., 4 - 1\ i , I 1 i , , I , ! ....ei I . . , 1 . ; . i 1 , • v , , 1 , i ! I , i I ! i 1 i• , : . r , Z"!., 21,--I : i ' II —1-1: 1 1 1 I I 1 1 I I I 1 : ' : I ! i ': i '.-1 i -4 \ ! ! 61 1 I !! 0,_ __!. f i .0k 2.. i I : i i ,(------ z : : <" • 1 ! ..),_ i : , iecoe : I I i i: I 1-- ; • ; ! ! I ' : " , i ; I 1 T--i 11. ' ' 1 ' : . 1 ij , I - II1LOPI ; . ...,‘ ' 11 ' ' : 11 : I 11 . )/)-' 11 SrSe_ iii . • ' 1 ; I ! I ' il i' 1 III 11 ' 11 1 1111111 11 ii , , Iliri III , I1 ' 111. ! 1. 1 •• 111 111 ill 11 $ ' i 1 I ! • I t I. I !: i I !' I ' 1 1 i r -i- --- II , , 1 I I I . i i 1 1 ' Ili . i ,' 1 ! : III 1 I I I I I H' , • ! , . , I I I i : .1 --I 4:41"12--I Goitre( dersoet.:, jouvoel e0601;1044;al, I I , I • r _. ; • • I - ....,:• .,.:r - ' I : 1 ; 1 I ' I . 1 : 1 If i i • 1 • 1 1 • I 1 ' , --e- I • ...--:. Hi / 1 , ' i 1 ! • i i . • . ' , 1.re ..4 ! • /11/.:::,- — -,....--wi,.il%;:".i.:; i..;']-..i.:::::;;;•:,1—"e',,':e.1-..-,:-:::"4:- -