1984, 04-11 Permit: 84A-3247 AdditionPLfr■N 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.
N .'' tic
LOT
2.
BLOCK
SUBDIVISION
OWNER
3. Lc:: iii c3vv\ 'Y1& P-L.. Pr. N
MAILING ADDRESS
4.
•
CONTRACTOR
ADDRESS
J111/4'
DESIGNER
PHONE
LICENSE EXPIRES
PHONE
.2c tc
ZIP
PHONE
ADDRESS
CHANGE OF USE FROM
ZIP
PHONE
ZIP
TO
TYPE ❑ W ❑ ALT. VI/AD' N. ❑ RPL. ❑ MVE.
7. WORK 15 BLD• ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL ❑OTHER
DES RI BE,^WORK
n �
VALUATION
9.
SOURCE GAS ELECTRIC WATER
UTILITIES PUBLIC
ITIES RIVA E ❑
SEWAG
SEPTIC
SEWER ❑
PARCEL NO.
0 7
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North 1South 'East I West
Size of Parcel
scv >< 12c-;
Occupancy
IYl —1
Ty nst.
At
Main Floor
Zone Classification
Cover Deck
No. Baths
Residential
Commercial ❑
Spr'nklered
❑Yes ❑No ❑Req'd.
Remodeled Valuation
Uncv. Deck
No. Floors
Certifi. of Exempt.
or Variance
Total Bldg. Floor Area
Greenhouse
Fin. Basement
No. Fin. Rooms
Required Yes NoL�`
Received Yes No❑
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 L U
DATE
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
/Ps
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Unfin. Basement
No. Dwellings
Number
Plans Required d
Received t'
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
2x
TOTAL $
PERMIT NUMBER
02* *2800
*2n006
A *0.00 8
324.6
04 -11 -84
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
I� ark f• o /�
DATEQSSUED1 1 -8 4
7 d
PERMA4a 2
*28.00
tOIFAL
IIIIIIIIIIIIPMII lopi Illimilr 111111
••••••••••••JE/Ptil 40/1011/0/4i If A olofiUradt A irsa,a7ririfla Ili MN
IIIIIIIIIIIM=2:=1agigiainalainalalll IIM
111111111111111111111111111111111111111111111111111
MEMO Yrrarl•IIIIIIIPWINPIILT IPIE 1111•111•••• ....r• NIONIIMIroirruncnip.
Ems 11 iimcgA IV 11 R.:1%1 II WC 1t O. I•••••••• ' .: ;Di 0 1:11PUN:lre irf.111CILM•
IIMMM MMUMMMIUMM M
MMEWM9WWWW,0
• W7:0WWIPMRIVAPC.1 1
MEM NM MOMMEMEMMOMMEMMUMM
EINE 1110 INNEENNEININEmom
• IN• mummENNEINft•
millipmmEmmummoN
mom AmmEnenwm n lims mommiummummEmmmin
mmemommEmommummEN . ■ I i
4 4
•UNIUMEREMO•MILE•EN 111111111 IIIIII IIIIIIIIIIIIIIIM MEM
ONIMPougmtONCIMmi&La
Implummillosigimagrammaniiimar "
,e.0-4,gccK
4
' i •
Li ppopol
ii7t -i---j LA N6
M mmmm MMMMMMMMM mmmmm mm
===== mmummoommummmumm:::: === mmmmmmmmmmmmmmmmmmllmm
111rWdommommommummimmommimm mmmummummmumm mmumommmoommmummilIMEM
•••"•••• m•Ilmions
MINN
•
•••111111••••••11.111111111
=
i Wilmmimffil•11•1111MIN•
simulisli•dMin.
ININI•••111§11M.
M••••111•••11•MNINNA
• Ifill•NICIal••••111=11111.
- 4 litrMartfltrslrbi Me
IMMUNII••••11111
NEENINNEE 1 mobb
ipmuswormim
............mmmwmgm
ImmozrzummuErmn 1.
IMIUMJILMiiiiiirii lib
111111
I •
m ei
MIL ammkAill:m MO • UM • 3.14mEmumnImms.
•••••••••••••••11 Illel-EL • MM. •• 111.1W
UM MEM 11111•1111•11••••••••■•=1•EmmEgumi
•••••••••
••• m
••iErmtomonmsmummli
•••••••••11••••11111 MENNEN r 11•11m
11•••••••••1111 l
•
•1111•1111•11111•11••••111• suanhom 1 MEM •••••111111E !MI••
iiiiiiiiiiiilial mg' II 11.1111117
111111111111111 .1111111111 =II Illigillige
.........i. N. 1 1
1.111
rti•
r la
........... .
............... . •M'ak MAI
••••••11•111•111•• re A .1'. ' e zim••
mommummommommENNONNimmmumm
••IN11I N1CAw1EMM.OWIMEI rINoIEmVAa•ILA • , 11
E iE mmuaml R I I uII rti 7 ma P44mI rIr
.F................
1 •IIIK•••1111•11ME Illiillprii1E7m1R-
m
s • el••111=1•O Ern • M p
••• iAk11=1rT•
EM7-E N
.477:7-SA
MOMMOMMEM/Fal
• VEILLEgitlINI•11.1111ETA:121
• 211/VONIti MEM% II • I mismi:ilt • 1•11iiir IMINwert:
%MIMI MIME= 1!! • /A '13= ,iii:Alifrtir----ITILii IPIAIrtaliiiiii
• NEENEaNEPENNEENANIIENNI - •d•-t-.11111----- OF i•IMMI•aadr" -rt
ArialliiiLA tilN
•IIINNIPSOIES
••••411PIME ill tarawars "P.m
r
• a
INNEENFEimmorm• on
MIME A 11 taltards ••
MI 4111:1111Mds2 NM ' •• MN plIMI•1114111100111",
• .11 gralL1111 '
EmEmmEreiNumm •
AINIIIIPAVVIIMMEM•••
• ILrNewmIIismE m
••
EI IIII
•ffillr•EMENIPAM•mill•
Pil
gilMIMI' •
..11111
6111111111111
III 'me
t
el
ltdetOW1f20
fi
—I— —4— -