HomeMy WebLinkAbout1986, 07-24 Permit App: 00012354 Garage(TH!5 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 /i C
Owner's Name LAST
FIRST
MI
A / i
Project Address (Street Name & Nu(nber)
Zip
=5 91U J
Applicant
Address
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City
State
Zip
Phone
Business Phone
Contractor/ Agent
2RAISISC)O4 S:Frp RI 11 IP
Address
City E. ►1524 'PRAGU AVF—
Zip
Phone
SPO NE,
(
)
Contact
Licejnse Nump��err) (Required)
Business Phone
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Architect/ Engineer.
Address
City
State
Zip
Phone
Contact
Business Phone
1 (
)
Lender
Address
City
State
Zip
Phone
(
)
i
Describe WorkRes.
Comm.
`X
' h
Subdivision) Plat Name/ Short Plat Number
Assessor Parcel Number
Lot
Block
Plat Number
Pertinent File Numbers
Zone
Comp. Plan
Census Tract
Number of Dwelling Units
Number of Buildings
Lot Size (Sq. Ft./Acre)
Depth
Frontage
2
Front Setback
Left Setback
Right Setback
Rear Setback
R/ W Width
Additional Information
Square Footage
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Number of Bedrooms
BulldingTechniciDate
Group Type
TAX SEGREGATION APPLICATION FORM
(Applicable to the division of one or more parcels of real property into
two or more parcels under different ownerships, also applies to
aggregation of parcel/s.)
NAME �j�//r' %!' /(/�N14 ,•
ADDRESS
PHONENUMBER 7i 5I—IZz' DATE Z— <�
DELINQUENT
TAXES
PARCEL NO(S)
I. Enter legal descriptions of all portions to be segregated. Also
include legal description of portions remaining (use supplemental
sheet if needed).
H. Make drawing of entire property. Indicate approximate dimensions
of all property lines. Indicate on which portions of property any
buildings should remain. If a copy of a survey is available, please
attach to this form.
III. This application is to be completed in its entirety before processing.
NOTE: The approval of this application by the County Assessor or his
appointee shall not be construed as authorizing the division of lands for
the purposes of sale or subdivision in violation of RCW 58.17 (Plat and
Subdivision Act). The taxpayer is hereby advised that no segregation
will take place until this form is completed.
Applicant Signature
THIS AREA FOR USE BY APPLICANT FOR LEGAL
DESCRIPTIONS AND DRAWINGS. USE REVERSE SIDE IF
NEEDED.
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