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1985, 10-23 Permit App 00008263 Storage
BUILDING PERMIT APPLICATION WORKSHEET PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND (Please return this original and your building plans to the Department of Building and Safety) 1 Owner's Name (last) (first) (m) Department Use Only Jf% LLB eE .dos Ras. Comm I 2 Project Address (not Mailing Address) or Road Name Space Zip l -.5-0 AEL 7.-S /e . 3 City/Community ‘...5,22 Kee State I GC41 Subdivision/Plat Name 24,7 C,‹ c_,.?iv0.,Igd'f 4 Assessor Parcel No. 17 L?44 — 0!_(C / f sAct. Lot /D Block * * * DEPARTMENT USE ONLY * * * 5 Sic Code Zone ## Zone A&SU.6 Project No. 6 Dwell # No. of Buildings Sq. Ft./Acre Depth Frontage 7 Set Bads -Front I I (L)S-1 (R)S-2 !Rear Census Tract I Module No. Initials * 16 Architect Firm Name Street Address Zip City State Phone ( ) Contact Person Phone if different than above ( ) Contractor Firm Name (OD/ r�6S Str t Address 3x449S-3/B Zip 99oa 7 City ori5 G.BC'H-fi "---4"-S State I CeL9 Phone cSzrr) Y.257_%s 7 Contact Person \Jor7'N License No. e.40e,,"G'a-27J�� Phone if different than above ( ) 8 Owner/Agent (if different than #1 above) ......... Business Address 9 Zip City State Phone ( ) 12 Review Required Plan Check (Y/N) Other (YIN) SEPA Exempt (Y/N) Date 15 Type Work ❑ Bldg ❑ Fire ❑ MH ❑ Demo ❑ New ❑ Add/Alter ❑ Replace ❑ Move ❑ Other 14 Describe Work `574,,ef}G£ %cC gLDG 24)(10' '- SLffe 10 Applicant Name Street Address 11 Zip City State - Phone ( 1 Lender Street Address * Zip City State Phone ( ) Contact Person Phone if different than above ( ) Additional Information 1 DEPARTMENT APPROVALS • Application Type (Standard unless otherwise indicated) Fast Track Early Start 1 nis is nut a Permit (Indicated approvals required In either "release" or "release with conditions" space prior to permit issuance.) r Release Release w/cond 1 Hold 2 • Environmental Health ❑ Commercial; ❑ Residential W.1101 College ❑ New Construction; D Bldg alteration/addition Room 200 ❑ Additional It A}�F P structure; APPLICATION # Conditions/Comments. ❑ Planning/Zoning: ❑ Commercial; ❑ Cert. of Exemption; ❑ Frontage; 721 Jefferson D Setbacks; ❑ lot wld; ❑ lot size; ❑ use/zone;_i N. ❑ CU, variance, zone change; shoreline; ❑ fence; ❑ Other Conditions/Comments • Engineers: ❑ Commercial; ❑ Residential; 0 Flood Plain; I N. 811 Jefferson 0 drainage 0 new access/approach; 0 fence; ❑ road improvements Conditions/Comments' • Utilities: N. 811 Jefferson Conditions/Comments. • Other: ❑ Plan Exam Fire Prev. Conditions / Comments • Information ❑I Representative Telephone Project Agencies Performing Special Inspection: 1 2 3 1 Indicate above or attach conditions relative to final as built approval 2 indicate above or attach reasons for hold JOB SHEET NO CALCULATED BY =4//L 4'Q / DATE CHECKED BY DATE SCALE COOK BROTHERS CONTRACTING Route 2 Box 853 B OTIS ORCHARDS, WA 99027 (509) 924-1557 LcT:_/D_ ©F C I/A.G .... s CoNn..__.. ?c�, • a s5�..JoeR 3'731 VI' FOAM 204 Ava,yble from MgBS wC Town$4n0. Mass 01470 1