Broadway E 9107 Circle K Store - Pole Sign
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(THIS IS NOT A PERMIT)
6UILDtNG PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOD UNDEASTAND
COMPLETE IN INK
(Please return this original and your building plans to the Department o18uiiding and Safety)
SHADEO AREAS ARE FOR OEPAATMENTAL USE PMIM Nwnbw ,
~ OwW~s Meme LAST fIR3T MI
C i re 1 e K Stor,e
R'ojeet Addt+ea (Street Name & Number) I,p
East 9107 Bropdwav
Appltcartt 1 Address
City Siate 1 Zip Phone
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Busmess Prate
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Oontractor/Apent Address
Baldwin Siqns & Oisplays, Inc. North 3502 Market Street
alY State ~ Zip Phone
Spokane WA 99207 ~ j489-9191
con1am UCense NumQw (Requtred) Business Ptronp
Dianna LinQuist BALDWSD16601
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DEPARTMEN7AL REVf EW
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Approved q p Cond oval Hold
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Envlronmentol Neellh Appllcatlon N
❑ W 1101 College
Room Z00 < <
Plenning/Zoning
❑ N. 721 Jefferson
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❑ N. 811 JeNerson ST ~--r,
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❑ N. 811 Jefferson
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N. 811 Jetterson ,
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❑ ❑ -~Fast TnqclSpecisl Inspwllon Inbrmetlon Prqect Representative Phone
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' 1 certify that I have examtned thls appllcation and state that the Informatton aontalned in it and submitted
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