1988, 12-02 Permit App: 00014496 Residence(THIS IS NOTA 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 tL L
Owner's Name
LAST
FIRST
MI
W.R.S. &
Associates, Inc.
Project Address (Street Name 8 Number)
Zip
14317 E.
2.1st
Spokane, WA
99216
Applicant
Address
Same
City
State
Zip
Phone
(
)
Business Phone
Contractor/ Agent
Address
W.R.S &
Associates,
Inc.
P.O. Box
14034
City
State
Zip
Phone
Spokane,
FIA
99214
(509)
922-0732
Contact
License Number (Required)
Business Phone
Bill Smith
IWRSAS-245MG
(
)
Architect/ Engineer
Address
City
State
Zip
Phone
Contact
Business Phone
Lender
Address
City
State
1 Zip
Phone
Describe Work
Res,
Comm.
Single family
residence with double attached
aarage
Subdivision/ Plat Name/Short Plat Number
Karma Addition
Assessor Parcel Number
Lot
Block
Plat Number
Portion of #26541-0917
3
1
Pertinent File Numbers
Zone
Comp. Plan
Census Tract
!&FTZ-
Number of Dwelling Units
Number of Buildings
Lot Size (Sq. Ft./ Acre)
Depth
Frontage
1
1 1
140
100
Front Setback
Left Setback
Right Setback
Rear Setback
R/ W Width
30'
1 20
35'
72'
-So
Additional Information
Square Footage
Main -1343'
ower- in
Bsm't-640'unfin
Z
o
_
a
0
_z
0
Z
0
J_
Co
Number of Bedrooms
3
g Tech r,i nr
. ?l
:
Date
t�, Zlw
Group
_
Type
sem,•
imp
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IJ
7
Fol
DEPARTMENTAL REVIEW
I certify that I have examined this application and state that the information contained in it and submitted
by me or my agent to compile said application is true and correct.
Signature
Date
Approved
Cond.
Approval
Hold
Environmental Health Application #
W. 1101 College
Room 200
Planning/Zoning
N. 721 Jefferson
Engineers
N. 811 Jefferson , �2
Utilities
N. 811 Jefferson
Plan Review/ Fire Prevention
N. 811 Jefferson
i
T
Other (SEPA/ Critical Material/etc.)
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 my agent to compile said application is true and correct.
Signature
Date