1983, 10-20 Permit: 83B-646 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
1. i✓ . IoZZ
BLOCK SUBDIVISION
LOT
2.
OWNER
A LA
B ION
PHONE
3. titlry ro N h1 Yt�i l ,c =N
MAILING ADDRESS
PHONE
4.
CONTRACTOR
. PAY11.6
ADDRESS
LICENSE EXPIRES
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
ZIP
' albl
PHONE
ZIP
PHONE
ZIP
TO
TYPE O EW ❑ ALT. u AD' N. ❑ RPL. ❑ MVE.
7. WORK '� BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL ❑OTHER
PARCEL NO.
as c - Ca-7O
LEGAL DESCRIPTION:
Actual Set Backs in Feet to
North !South
East a e f I West
Size of Parcel
too 1 i(o
Zone Classification
Residential
Commercial ❑
Type Const.
.s+r _v
Occupancy
Sprinklered
OYes ❑No ❑Req'd.
Const. Valuation Remodeled Valuation
Total BIdg. Floor Area
4&%
Main Floor 'Upper Floors
Cover Deck
No. Baths
Certifi. of Exempt.
or Variance
Uncv. Deck
Garage/Storage
Fin. Basement
No. Floors
Greenhouse
Unfin. Basement
No. Fin. Rooms
No. Dwellings
Required Yes❑ No❑
Received Yes❑ No❑
Number
DESCRIBE WORK
8. - Q 4ArZ AC �i � ( x 1)
Shorelines /Flood Hazard
Yes NotApplic. ❑
VALUATION
9.
SOURCE
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC ❑
PRIVATE ❑
SEWAGE
SEPTIC ❑
SEWER ❑
Ownership
Public ❑ Private ❑
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 th visions of any oth • state or local law regulating construction or the performance
of construction. SEE REV SE D R REQU ; INSPECTIONS o /'
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
SEPA
Plans
Exam.
Building
Tech.
'Y2c,
T� C `lY.v l 4�f &. • a -.� l Velo { is���-- .+�'..�y�t. L�l {2i✓c!' ? /
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plans Required ❑
Received ❑
FEES COLLECTED
Building 64.4t,tJ
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
PERMIT NUMBER
F.33 `'
2* *5400
*54,006
H *0.00
6452
10 -20 -83
o 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEISSUED2 a 8 3
PERMITNC6 4, 6
*54,OOm1AL
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