1984, 02-22 Permit: 84A-1449 AdditionPLAN NUMBER
~ APPLICATION/PERMIT
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAi7ETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1.
LOT
2.
s�7;o -r r)
S Npsl0v
BLOCK
3.
4.
5.
OWNER
+4= --rte_ �1 • A
Opp sc4•1
MAILING ADDR
z
CONTRACTOR
ADDRESS
I9i
E;I `�'
DESIGNER
LICENSE EXPIRES
PHONE
ZIP
PHO
NE1.2�`
/ZIP
fjo2-7
PARCEL NO.
2-(09+3 _O7 -C
LEGAL DESCRIPTION:
or
Iz5 of Cs<ZpUI
Actual Set Backs in Feet to:
North ]South +0
11 East [West
ADDRESS
CHANGE OF USE FROM
6.
TO
PHONE
ZIP
Size of Parcel
Tree Occupancy
New . V81uat on�
Co1J� r7 w
Main Floc
'2 -7
ne Classification r
I'ING .
Sprinklered
❑Yee ONo DReq'd.
1 Remode ed Valuation
upper Floors
Residential f:
Commercial i7
Total Bldg. Floor Area
Garage I Storage
Greenhouse
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE ❑ NEW ❑ ALT. LAD`N.
7. OF
WORK ALD.
0 PLMB. ❑ MECH.
0 RPL.
❑ M.H.
8. DESCRIB i'^ AVb1116�
VALUATION
9.
SOURCE
F
UTILLIITIES
GAS
ELECTRIC
❑ MVE.
❑ POOL
WATER
PUBLIC
PRIVATE ❑
❑ OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required
Received
YesC No0
Yee❑ Nof
Number
Shorelines /Flood Hazard
Yes❑ Not Applic.
SEWAGE/ Ownership
SE Public O Private -0
SEWERER C
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 REV SE SIDE FORFjEQUIRED INSPECTIONS
SIGNATURE OF
OWNER OR AGENT
1/
APPLICATIOISIL,
DATE • S - 1
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
J ,5. 2/3
Fir e
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
7-O "c . C�4 C Zq (p lam)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plans Required C :'
Received C!
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $ •L_
PERMIT NUMBER
C144-141
02*
*89.00
*89.00
*000 n
86.7f
02—C 1-84
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
•
DATE 16SUED2-84t
PERMITLC4 4 9 Z
*89.00-g „L