1984, 04-12 Permit: 84A-3309 Residence W/CarportPLAN NUMBER
APPLICA' "" " '� /PERMIT
.1POKANE COUNTY - .RTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456 -3675
STREET ADDRESS
H 7I
LOT BLOCK
2.
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
SUBDIVISION
3.
OWNER
11-
MAILING ADDRESS
2-I 1- (1 dry- a ■l
PHONE
7
PHONE
PARCEL NO. 16,514 —7)
LEGAL DESCRIPTION: 1 1
IP
Z.0
Actual Set Backs in Feet to:
North ISouth ")
East
West
CONT ACT
4. ADDRESS
LICENSE EXPIRES PHONE
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
ZIP
PHONE
ZIP
TO
TYPE ,g NEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7 WORK '-' �'LD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL CI OTHER
Size of Patel
17!7.
Cl
Type ns . I Occupanc
wConst. Valuation
t c)c1 J 9
G
ne Classif' tion
Sprinklered
❑Yes ❑No ❑Req'd.
Residential Cwt'
Commercial ❑
IRemodeled Valuation
o
M in Floc)/ � Upper Floors
v ` 4 i
Cover Deck
Uncv. Deck
Garage /Storage
4th
Fin. Basement
Total Bldg. Floor Area
IGreenhouse
Unfin. Basement
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
DESCRIBE WORK
VALUATION
9.
SOURCE
UTILLIITIES
GAS
ELECTRIC
WATER
PUBLIC
PRIVATE ❑
I Required Yes❑ NO Num r
Received Yes❑ Nor: `
Plans Required g
Received ❑
Shorelines /Flood Hazard
Yes Not Applic. ❑
SEWAG
SEPTIC
SEWER ❑
Ownership /
Public ❑ Prvate.C7
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 REVER E SIDE FOR REQUIRED INSPECTIONS
SIGNATURE OF aA __ , -f/ /_
OWNER OR AGENT �Z�i�
APPLICATION /6 /YJ
SPECIAL APPRO ALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. Fl AL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
12,64210 ,
a - 65--6 * %)yt-1/.4 -V s161.
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
:21.0-60
TOTAL $
'.PERMIT NUMBER
elitt 31
?_* *32600
*326.006
A *0.00 8
330.8g
04 -12 -84
g 6479.
tZ
O
C3
W
J
LL
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
n Q �I r
DATEQSSUED12
4
PERMIT-Li 0. F 'z * 3 L U. U U EO FAL