1986, 10-14 Permit: 000136525 Shed ' ---- - - - - ------�
' APPLICATION
//7
5|G' 4TUREOF - DATE
OWNER ORAGENT 141
' PR0JECT#
JOB ADDRESS ~ |
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A25
17718 [ COACH DR
"°""~ BUILBIN 131 00
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Hz �N/ WILLIS
""""="' Buildinq Code Fee $1 . 5O
17218 E COACH DR
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, WILLIS
CONTRACTOR:
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^ 8 E CQACH DR
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, FENACRES WA 99016
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PLAT NAME:
GTATES
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^` TORACE SHED =,". PAID BY: CA ," "" °"
WE OF """"'`' $32 .
'= —,",,. "°"""""""" / |"=°" "`^"' DATE:
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Boiluing Gode Fee STRUCTURAL
TOTAL FEE $1 .50
BUILDING TOTAL FEE $31 . 00
Valoatinni Corr 1280 permit Fee 31 . Q0
# of Floors 01 * of Bedrooms 000 # of Rooms 008
PRIMARY STRUCTURE -,
De -Fs ; CAR' -^-- Group . M-1 Type ; VN
-� t Occopancy Load Rate 8 . O0
SECONDARY STRUCTURES :
-
` 0- l4 ~ 6 566.2 375O �OFFICE COPY
19 sz - 4°7'
(THIS IS NOT A 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
1
/ Owner's Name LAST IF1,ST MI
i2Io/3 C 0�I/ 'il% s 9' �-
Project Add s(Street Name&Number) Zip
, /7A/ Co c /i (�' e /1/�c�C S Yt//�J/�
s Applicant I Address
o i ,
s�� /.//L"S ______________ I
City State Zip Phone
Business Phone
Contractor/Agent Address
City State Zip Phone
( )
Contact License Number(Required) Business Phone
( )
Architect/Engineer Address
City State I Zip Phone
I ( )
Contact Business Phone
( )
Lender Address
City State I Zip Phone
(
Describe Work -Res. Comm. II
I0 I '
Subdivision/Plat Name/Short Plat Number
Assessor Parcel Number Lot I I. Block Plat Number
Pertinent File Numbers Zone Rill\ 4 Comp.Plan Census Tract
Number of Dwelling Units Number of Buildings Lot Size(Sq.Ft./Acre) Depth Frontage
Front Setback Left Setback Right Setback Rear Setback R/W Width
Additional Information Square Footage
Z
0
. H
Q
0
z
Z
. r
m Number of Bedrooms
Building Technician Date Group Type
Show on Site Plan: Additional Information:
Lot Dimensions Landscaping
Existing Structures Drainage Plan F
Proposed improvements Hydrants ..._ t.
• Structure Setbacks Topography
Easements Lighting ._
Septic System(s) Signage ;
Water Lines Shorelines
Sewer Lines Highwater Mark
Fences,Wells
Driveway(s) I
Right of Way Width(s)
' flames of
Fronting Street
Flanking Street
Leal Description
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DEPARTMENTAL REVIEW
Cond.
//// lAppproved Approval Hold
Environmental Health Application# (V 6300 ( / 7
W. 1101 College
Room 200
Planning/Zoning
❑ N. 721 Jefferson
Engineers
❑ N.811 Jefferson
Utilities
❑ N.811 Jefferson
Plan Review/Fire Prevention
❑ N.811 Jefferson
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