Argonne N 708 ALLSTATE Pole Sign
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(THIS IS NOT A PERMIT)
BUILDING PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YQU UNDERSTAND
COMPI.ETE IN INK
(Ptease return this orlginat and your building plans to the Oepartment af Building and Safety)
SHAOEO AREAS ARE FOR DEPARTMENTAL USE pnged NunEbw Ownor's Name LAST FIRST Mi A LLSTA? E
FroJect AQdrese (Street Natne 8 Number) ={p
{1OORTH 708 RRGONNE
Addresa
Appltcant
City 8fate ZiP Phone
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8us➢ms Phone
Contractpr! AgPnf Addiess
BALOW IN S tONS dr D tSPLAYSP I NC. NORTH 3502 MARKET
ctry state Zlp Pt,one
SPOKANE IIrA. 99207 1 1 489-9191
Contad Lftem Numbef (Rsqutred) Businesa Phone
O tANNA L INau 1sT BA-LD-WS-0166D1
Afchileati"(tt8er Address
Cily Stete Zlp Phone
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Cantast ' . - Busirtess Phane
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ThtO S/F31x8# POLE SIGN3 r
8ubdiWabn/Ptei Name/8hort Plat Number
Ataeaw Pwroel Numbw Lo! Btaclc Plat Number
17543-0523
Hertinsnt Fite Numbers C011a pl°"
Number ot O"11ns Unlts Number d Bulldtnp 7tAt 8t i 4~Sq Ft lAare) Oepih fror+tags
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AddliloW Mfoeatlon Squar° FOO"o
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#34 143-363 Fl PTN OF W3/5 OP Si oF
1VJ OF 8100 1.Y0 W OF CRp 8A OPPORTUNITY O
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DEPARTMENTAL AEVIEW ~
Cond Approved Approval' Hold
Environmental Heelth Appilcatlon N ❑ W 1101 Collepe
Room 200 ~
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❑ N. 721 Jeiferson' ,
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❑ N 811 JeHerson
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~ N 811 Jefferson 2 M~ y1,?~t.~l~ ' '
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ProJect Representatlve Phone
Addresa
I certiiy that I heve examined this appl(catlon and stete,that the information contained In it and submitted
by me or my agent to complle safd applicatlon ia true and correct~
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