1984, 03-01 Permit: 84A-1730 Exterior Door To BasementPLAN NUMBER
APPLICATION /PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456 -3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
1.
STREET ADDRESS I I � K. I
L
BLOCK SUBDIVISION
opparzroNrr
LOT
2.
3.DMIR -rl- rne_
MAILING ADDRESS
— s7]C1 / ► -
PARCEL NO. 1 c 7' 3 0744 cveminow op
PHONE aigJ
CONTRACTOR
4.
ADDRESS
DESIGNER
LICENSE EXPIRES
ADDRESS
CHANGE OF USE FROM
IOc
ZIP
PHONE
ZIP
PHONE
ZIP
TO
TYPE ❑ NEW P.ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7 WORK BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL ❑ OTHER
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North 1South
East
West
Size of Parcel
Type Cogst. Occupancy
NewConst. Valuation
Main Floor
No. Baths
Certifi. of Exempt.
or Variance
Zone Classification
Residential ❑
Commercial ❑
Spr'nklered
❑Yes No ❑Req'd.
Remodeled Valuation
Upper Floors
Total Bldg. Floor Area
Garage /Storage
Uncv. Deck
No. Floors
DESCRIBE WORK poop M � ri
t A��
VALUATION
9!_
SOURCE
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC ❑
PRIVATE ❑
Greenhouse
Fin. Basement
No. Fin. Rooms
Required Yes❑ No❑
Received Yes No❑
Shorelines /Flood Hazard
Yes❑ Not Applic. ❑
SEWAGE
SEPTIC ❑
SEWER ❑
Ownership
Public ❑ Private ❑
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included on
reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this type of
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au-
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction. SEE REVERSE SIDE FOR REOUJ tD INSPECTIONS
SIGNATURE OF
OWNER OR AGEN
APPLICATION
DATE __
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
P -mlt slA -03i53
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Unfin. Basement
No. Dwellings
Number
Plans Required ❑
Received ❑
FEES COLLECTED
Building !v%
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
Qi
TOTAL $ `
PERMIT NUMBER
5341A— 17 0
02* *4000
172.9g
03 -01 -84
E 6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
1I11 jj t.
DATESSUED' 1 8 4
PERMITINO.l, 0 5
*4a0OROAL