1984, 02-22 Permit: 82A-1468 GaragePLAN 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
7 9 D 3 AUo rA
LOT BLOCK
2 2cf Cf
OWNER
Pikt VA �-
SUBDIVISION
3.
MAILING ADDRESS
4.
5.
PARCEL NO.
— 0-7
PHONE
CONTRACTOR
‘Y1(Ar, e C11100(1) ft p
ADDRESS ` t q-
DESIGNER
LICENSEE PIRES
1/31/ .0c
•> ``
PHONE
ZIP
ZIP
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North (South
ADDRESS
CHANGE OF USE FROM
6.
PHONE
ZIP
TO
TYPE ;SI, NEW ❑ ALT. ❑ AD' N. El RPL. ❑ MVE.
7. OF ❑ OTHER
WORK k9'BLD. ❑ PLMB. CI MECH. ❑ M.H. ❑ POOL
Size ofpafcel
v-- I
East ✓�
West
Zone Classification
Residential.
Commercial ❑
Type Congt. Occupancy
N +
'nyi Remodeled Valuation Total Bldg. Floor Area
Sprinklered
:Wes OW ❑Req'd.
Const. Valuation
4 326)
ain Floor I Upper Floors
Garage / Storage
Greenhouse
Cover Deck
Uncv. Deck
No. Baths
No. Floors
Certifi. of Exempt.
or Variance
Fin. Basement
No. Fin. Rooms
Required Yes ❑ No❑
Received Yes El No❑
Unfin. Basement
No. Dwellings
Number
8.
DESCRIBE WORK
30 X 174 t a(? Pr&P ofd- -cry
VALUATION
9.
SOURCE
UTILITIES
GAS
ELECTRIC
WATE
PUBLIC
PRIVATE ❑
SEWAGE
SEPTIC
SEWER
Shorelines /Flood Hazard
Yes❑ Not Applic. ❑
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 REQUIRED INSPECTIONS
SIGNATURE OF
OWNER OR AGENT
APPLICATION
DATE
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
/Engineer
Utilities
J< F. z/ 71„. L_.ic • it Sys (Ve G8
L%
SEPA
Plans
Exam.
Building
Tech.
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plans Required ❑
Received ❑
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
PERMIT NUMBER
84- Y� —1
n•-)* *61,00
*61.006
A *0.00 8
1466
02 -22 -84
Zr 64'79.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEYS3UED` 2 -8 4
PERMITNO'. 6` 8 z *614°4
.0 O L
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