1985, 03-29 Permit: No # Awningr L/11• nvmvui
Mr -r1 -11/4.h 1 l Jl4 f f .P11Y11 1
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
S REET ADDRESS
1 /t Iil/�[ vri t
LOT BLOCK SUBDIVIVe„Nd 4 , 7
l `dl�u_L1K!
2. 5
W ER
3. AY IA E
MAILING ADDR S
N
It/ 4, k9 nl N4 ry 'Roo d
CONTRACTOR
4. ADDRESS
E /3/c /1c el Seek diE
DESIGNER
5.
PHONE
90-11,23
PHONE
PARCEL NO.
LEGAL DESCRIPTION:
ZIP
LICENSE EXPIRES
ix.:_?
PHONE
ZIP
62
Actual Set Backs in Feet to:
North I South I East
Size of Parcel
IWest
Zone Classification
Residential ❑
Commercial
Type Const.
Occupancy
Sprinklered
❑Yes DNo Req 'd.
ADDRESS
CHANGE OF USE FROM
6.
TO
PHONE
ZIP
New Const. Valuation
Main Floor
Cover Deck
Remode ed Valuation
Upper Floors
Uncv. Deck
Garage/Storage
Fin. Basement
Total Bldg. Floor Area
Greenhouse
Unfin. Basement
TYPE $NEW ALT. ❑ AD' N. ❑ RPL.
7• OF
WORK ❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required Yes❑ No❑
Received Yes ❑ No ❑
Number
DESCRIBE WORK
8.
GAS
i0ts?/IiD ( 'A)(Ai r)J . )L.K.Z. 4 x 33 x Y'' 2gd
VALUATION
9.3 yp5 0
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 R REOUI ONS
SIGNATURE OF APPLICATION'
OWNER OR AGENT �-� DATE
SOURCE
UTILLIITIES
ELECTRIC
WATER
PUBLIC ❑
PRIVATE ❑
Shorelines/Flood Hazard
Yes C, Not Apollo. ❑
Plans Required C
Received E
SEWAGE
SEPTIC ❑
SEWER 0
Ownership
Public IT Private C
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL TE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
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. Horne
Other (Specify)
TOTAL $
f'tHMII NUMI3tH
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED
PERMIT NO. TOTAL