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1986, 05-20 Permit App: 00011495 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 I i Owner's Name AST FIRST MI 2.,.. Project Address(Street Name&Numbed Zip EAST ,1glI 3O7ff AVE. CY-S2O V Applicant Address ,r 7 /eze -- A) _ // .2- ,`- -:" City State Zip Phone L___51,0 A-. &/ s 4 9 y ,,_ a,^ (meg' ��V 6d fr Business P( one �T Contractor/Agent Address City State Zip Phone ( ) Contact License Number(Required Business Phone A" I- ( I Architect/Engineer ' 5 67 Address City State Zip Phone ) Contact J Business Phone Lender ' Address �"u City State r Zip Phone O t Describe Work - Res.✓� Comm. #. ,f ou(l U) / -A ?4c Subdivision/Plat Name/Short Plat Number 24.,-1)/<'0 Pa I poi&I5 t Tt Assessor Parcel Number , (7 Lot Block Plat Number se5 -- , , .._ a/ ao,�-a),, `1- Pertinent File Numbers ` Zone Comp.Plan Census Tract �' .,. .5.1.--eV. t ) �45t,c8 Number of Dwelling Units Number of Buildings Lot Size(Sq.Ft./Acre) Depth Frontage I Front SetbackLeft Setback Right Setback Rear Setback R/W Width ... (0 g 7Q Additional Information Square Footage sfoge As -, /1. l = Hp' z 11_l =tire 0 LL z_ o z 0 J 7 m Number of Bedrooms Building Technician Date Group Type 5'lb-8t, r s v'U . r r DEPARTMENTAL REVIEW Cond. �J Approved Approval Hold Q`C ' Environmental Health Application# C� t233 1% ,0426 ❑ W. 1101 College +1 NiL Room 200 , 1 ct� �. f i- - Planning/Zoning ❑ N.721 Jefferson M;Zel Engineers �l�o�J t'/ IDN.811 Jefferson , % Utilities I El N.811 Jefferson Plan Review/Fire Prevention N.811 Jefferson ,tjataet. (1?'"e-ov cio c y > Other(SEPA/Critical Material/etc.) 0 o 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 , . "1 y . . '-,. .• . • ,..' 1 / .. / , .. • .- . ; . . i- • ?Pixel:.4.2.14 k...i...I G.• . . . . : . . I I . ' . 144 I• . . . • . • .• . .. - . • .. .. ---.1- ./ / / / / • / ' I / . 1 .. ) • 5 e / ./'.// ,- // /, /• „,- , • 4- t., . ' .' / , / / / / ' . - / I— t c3 — 1 i 1° i 1 I 1 -I P i 1 • I p . / / _Also' /// ' .- / • . - •• s•• / • . / • /-1....7:1— I__ °. — ___ ____ _ 53-° 1---'. t , I i 2 s - --" / / .- / :1 I 2 ' I 0 r at . 4/ - / ,,'" .,,,-- , -. / • / • 1.., p. - . • . _ . _ .. . . • 1,,, , . • .. • . / // ar: ' / / r 0 c r I a, / ... 0. —3 'q0 • / / / i i: g L;) . / / 72.,,-1 . . , z . . //,/// // ,„/ ...- ,/ /,' . - Fq. _. • ' / / ./ / r - n.i z r— z- - la / • / / „, _y6 rri ::.:. ;ii . / - Itii, g 5(tugi - • . • - /,, .,- //. . _ 1. trr . , , • • - . z - . . . . . . . . 11 111.,,,, • • . , 4 , I