1983, 09-26 Permit: 83A-9491 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
STREET ADDRESS
LOT
2. S
N
BLOCK
SUBDIVISION
' flt ?tTI.
OWNER
3 -1at -try
PHONE
ADDRESS coa
CONTRACTOR
4. f�2 TiSt`�C �x,,vSC.
ADDRESS
k4"71tS". t-7�tF
DESIGNER
5.
ADDRESS
LICENSE EXPIRES
PHONE
u _z4
ZIP
PHONE
PARCEL NO.
t BSSa —
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North 'South ■ J
East
Size of Parcel
t S S
IWest C,
Residential
Commercial ❑
Zone Classification
a-Q.11(v\ lA
CHANGE OF USE FROM
ZIP
cj4o3'7
PHONE
ZIP
TO
TYPE /NEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER
WORK ( /BLD. ❑ PLMB. ❑ MECH. ❑ M.H. El POOL
Type Const.
-a.
NeWConst. Valuation
irP,(3D-C!'
Occupancy
Sprinklered
❑Yes ❑No ❑Req'd.
Remodeled Valuation
Total Bldg. Floor Area
Main Floor
Upper Floors
Garage /Storage
1.04'0
Greenhouse
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certif1. of Exempt.
or Variance
Required
Received
Yes❑ No❑
Yes No
DESCRIBE WORK
8. c C� 4 c.t
VALUATION
9.
SOURCE
UTILITIES
GAS
I hereby certify that I have read and
reverse side, and know the same to
work will be complied with whether
thority to violate or cancel the prov
of construction. SEE REVERSE
SIGNATURE OF
OWNER OR AGEN
ELECTRIC
WATER __,/ SEWAGE/
PUBLIC IC SEPTIC
PRIVATE ❑ SEWER ❑
Shorelines /Flood Hazard
Yes❑ Not Applic. ❑
Ownership
Public ❑ Private.d
examined this application and have read the "NOTICE" provisions included on
be true and correct. I provisions of laws and ordinances governing this type of
specified he orjjat. The granting of a permit does not presume to give au-
ions of any s er4l to or local law regulating construction or the performance
APPLICATION Z gC,? DAATE
Number
Plans Required
Received bill
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Yr-al&
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)
TOTAL $'Q?
PERMIT NUMBER
g5A -4441
02* *89.00
A 8006`3
949.02
1479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE nS2IED2 6 - 8 7)
PERMIT Nat 9.1
* 8 9. 0 041FAIL
•
t) c_ C-0 OcT; 0 u4
lq 7 vs-- [Th,
R Pk 0 A -
43■•
Pit■Porr\I
Y%4kj
e 10 •-•