1984, 04-12 Permit: 84A-3294 Garage, CarportPLAN 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.
2.
S . 27 7-0 T 12 -0A -D
LOT BLOCK SUBD JIS1QN
CLA
PARCEL NO.
2543 -a7
3.
OWNER
141 OJ4A2 & • bN MON
PHONE
MAILING ADDRESS
4.
5.
›A-r)/)-
1/L--
dj)/►-VC— C l nM6117' W
LICENSE EXPIRES
PHONE
ZIP
PHONE
ADDRESSe r r.)Cmiu-ISP rzo. b1(� o - �0 ZIP (16
DESIGNER
ADDRESS
CHANGE OF USE FROM
•
1 -
PHONE
ZIP
TO
TYPE ' NEW C7 ALT. ❑ AD' N. ❑ RPL. 0 MVE.
% OF WORK `-BLD. 0 PLMB. 0 MECH. 0 M.H. ❑ POOL LI OTHER
LEGAL DESCRIPTION:
S I f Zoo' of (37;24
Actual Set Backs In Feet to:
North �x(GJ1 South L) i
Size of
o' 7 I Z 3 1
Type Const.
New Const. Valu tion
620 rt2-.1
1,1
East Vv ')f .I West
Zone Classification
• Ho' }
Spri nklered
❑Yee ❑No ❑Req'd.
Remode ed Valuation
Total Bldg. Ftoor Area
Main Floor
Upper Floors
Garage/Storage Greenhouse
Cover Deck Uncv. Deck
No. Baths
8.
DESCRIBE WORK
C.4%
A
VALUATION
9.
SOURCE
UTILITIES
-a C 'ORIT
GAS 1ELECTRIC WATER
PUBLIC ❑
PRIVATE 0
SEWAGE.
SEPTIC
SEWER
Certifi. of Exempt.
or Variance
No. Floors
Fin. Basement
No. Fin. Rooms
Required Yes' Not
Received Yes❑ No^
Shorelines/Flood Hazard
Yes El 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 REVE,JISE SIDE�FpR : • RED INSPECTIONS
SIGNATURE OF
OWNER OR AGENT
SPECIAL APPROVALS
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
PRELIM. FINAL DAT
�L
APPLICATION
DATE
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
EN1(fSTIN(O Dljw�
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Unfln. Basement
No. Dwellings
Number
Plans Required ❑
Received 1i
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
61,
PERMIT NUMBER
&M - 32 ..4
02* *61.00
*61.006
A *000
329,3
0/!-12-84
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATA tia2 - 8 4
PERM1131%.9. 4 z
*6100 AL