1984, 04-19 Permit: 84A-3534 Storage BldgPLAN NUMBER
APPLICATION /PERMIT
-POKANE 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 b ° A
LOT
2.
BLOCK SUBDIVISION
C ish Pypp . •fb Gl —t,l (Nal f,
OWNER
3 P , niA*WaL,
PHONE PHONE
MAILING ADDRESS
• i84o imxt Gr-i E-43 1u✓A.
CONTRACTOR LICENSE EXPIRES
4. FQOTT CONU'LE`(F
ADDRESS
( gy 1 1 A1,+c.l GmFAAe(
ZIP
PHONE
ZIP
atc1 U t C>,
PARCEL NO.
105 - 09o3
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
i
North •∎ ISouth 172 [East
Zone C assifiic pion
a ✓i
Size of Parcel
IWest
Type�n�t.
Occup,ancy ,
DESIGNER
N�> 4$ P A yR -IX S
R � F
(�DD73P
2- 1 l! I Sl O NJ q
CHANGE OF USE FROM
PHONE
ZIP
TO
TYPE y1, NEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7 WORK )BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL ❑ OTHER
New Const. Valuation
Main Floor
Cover Deck
No. Baths
Certif1. of Exempt.
or Variance
Residential �.
Commercial ❑
Sprinklered
❑Yes ❑No ❑Req'd.
Remodeled Valuation
Total Bldg. Floor Area
Upper Floors
Garage /Storage
22t7
Greenhouse
Uncv. Deck
No. Floors
Fin. Basement
No. Fin. Rooms
Unfin. Basement
No. Dwellings
Required Yes ❑ No❑ Number
Received Vest: Non
8. DESCRIBE WORK ! •
30 _! ^ 'e 011 5
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER SEWAGE
PUBLIC ❑ SEPTIC *
PRIVATE ❑ SEWER ❑
Shorelines /Flood Hazard
Yes NotApplic. ❑
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 the provisions of any other state or I. :1 la regulating construction or the performance
of construction. SE -3;SE SIDE FOR _ ,• UIRED INSPE� NS
SIGNATURE OF ' / APPLICATION
OWNER OR AGENT ` , J� DATE
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
9r
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plans Required E]
Received ❑
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
9
TOTAL $ 1••
PERMIT NUMBER
- ;4
02* *9600
353.2°
04 -19 -84
6479
*
33
04 -19 -84
6.479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
Wit
DATVI I,NEI1 9 - g'4
PERMIT NO.
353.42
TOTAL
*9600°c2
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)
AP-3 �� f Oe n � `i i L
kpartmeUye Only
' Comm
2 Prot Address (not Mailing Address) co- oad Name Space Zip
(F'L(o7 /LK�
3 C'ty /Community
f e_ e n v1r 2 _ (c, S
State
(,,. -) ii.
Subdivision /Plat Name
C rz" , f\., 64, 0 n \ a c; R.,.,, e c.
4 Assessor Parcel No.
Lot
Block
1 el-33+ '--
5 Sic Code
Cc( 0
* * * DEPARTMENT USE ONLY
Zone Act. #
Zone Project No
6 Dwell #
No. of Building
Sq. Ft. /Acre
Depth
Soc-_-) 1
Frontage
fq O ■
7 Set Back -Front i
i —7 2.
1 (L)S -1
(R1S i2
t
I Rear
Census Tract Module No.
ials
16 Architect Firm NaVek (�
/� { ( �(''�
OQ .�/�.� l?-RI ' /L�J�S
Stre Address �}
I /V 7 3 2 \ Pl`
�'
v�SEnn
Zip.
j)
Cit
State
Phone
( )
ntact Person
n ry no /1: � e ,,2 S
Phone if different than above
( )
Contractor Firm Name
Strut Address k'
Zip ^ Ci ( 1�
1 CI %l e f�/ t�Rt
State
Phone ) 7.2y..-C2 ,2
Phone if different than above
tod.nt7
/
io n /
License No. ,*
8 Owner /Agent (if different than #1 above)
Business Address
9 Zip
City
State
Phone
(
12 Review Required
Plan Check (Y /N)
Other (Y /N)
I SEPA Exempt (Y /N)
Date
15 Type Work Bldg
❑ Fire
❑ MH
❑ Demo
IIIVNew
7 Add /Alter
E Replace
E Move
7 Other
14 Describe Work
-1.b e_PC -s E t ) L. 1 L_. .D4 ti [,
10 Applicant Name
Street Address
11 Zip
City
State
Phone
( )
Lender
Street Address
Zip
City
State
Phone
( )
Contact Person
Phone if different than above
( )
Additional Information
1
Application Type
(Standard unless
otherwise indicated)
Fast Track
Early Start
DEPARTMENT APPROVALS
This is not a Permit
(Indicated approvals required in either "release" or "release with conditions"
space prior to permit issuance.)
Environmental Health ❑ Co ercial; /Residential
W. 1101 College ❑ w Construction; ❑ Bldg alteration /addition
Room 200 Additional structure;
APPLICATION #
Conditions /Comments•
Planning /Zoning: ❑ Commercial; ❑ Cert. of Exemption; ❑ Frontage;
N. 721 Jefferson ❑ Setbacks; ❑ lot w /d; ❑ lot size; ❑ use /zone;
❑ CU, variance, zone change; shoreline; ❑ fence;
❑ Other
Conditions /Comments•
Engineers: ❑ Commercial; ❑ Residential;
N. 811 Jefferson ❑ drainage ❑ new access /approach;
❑ road improvements
Conditions /Comments•
❑ Flood Plain;
❑ fence;
Utilities:
N. 811 Jefferson
Conditions /Comments•
Other:
Plan Exam
Fire Prev.
Conditions /Comments•
Project Representative Telephone
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
Release
Release
w /cond 1
Hold 2
Conditions /Comments•
Planning /Zoning: ❑ Commercial; ❑ Cert. of Exemption; ❑ Frontage;
N. 721 Jefferson ❑ Setbacks; ❑ lot w /d; ❑ lot size; ❑ use /zone;
❑ CU, variance, zone change; shoreline; ❑ fence;
❑ Other
Conditions /Comments•
Engineers: ❑ Commercial; ❑ Residential;
N. 811 Jefferson ❑ drainage ❑ new access /approach;
❑ road improvements
Conditions /Comments•
❑ Flood Plain;
❑ fence;
Utilities:
N. 811 Jefferson
Conditions /Comments•
Other:
Plan Exam
Fire Prev.
Conditions /Comments•
Project Representative Telephone
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