1983, 05-12 Permit: 83A-3966 GaragePLAN NUMBER
Inc' 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
1.
2.
ST EETADDpESS
LOT D��
BL K
IzoAcc
PARCEL NO.
Z4)2-
3.
4.
5.
SUED VIIISSIId'4
I�7 "' g°fib C,016-7267
72.6t ONE
1244,4, M -GiY
MpLING,QDD $
CONyIAF$QC'T�-C•�'
REQ_
. c l
LICENSE EXPIRES
ADDRESS
_ 2— Wx 9 /'l 1J
DESIGNER
LEGAL DESCRIPTION: I15
r-1- mF to
-1-tZ% j54 iCo
57o-7
Actual Set Backs in Feet to:
North (South
East 3 1 West
99"41-15s2
PHONE
_n
Size of Parcel
13o x 5o
a Classificapon
,
Residential.
Commercial 0
TyPM
Orr
New Const. Valuation
t.Ce 22S
Spr nklered
0Yes 0No ❑Req'd.
Remodeled Valuation
Total Bldg. Floor Area
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv. Deck
Fln. Basement
Unfin. Basement
TYPE A�/NEW 0 ALT. 0 AD' N. 0 RPL. 0 MVE.
WORK (}BLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL 0 OTHER
8.
VALUATION
RK O. (14-x w� o c d )
SOURCE GAS ELECT IC WATER
DESCRIBE WO
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certlfi. of Exempt.
or Variance
Shorelines/ Flood Hazard
YesD Not Apollc.0
Number
Required Yes0 No❑
Received Yes❑ No❑
Plans Requred$
Received 0
SEWAGE
SEPTIC 0
SEWER 0
Ownership
Public 0 Private
9• UTILLIITIES PRIVATEPUBLIC
❑
I hereby certify that I have read and examined this appl cation 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 RE -.i. SIDE FOR REQUIRED INSP TIONS
SIGNATURE OF4
OWNER OR AGENT , ��-/ DATECATION_//_ 83
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
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
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Horne
4-7
Other (Specify)
01-7
TOTAL $
PERMIT Num BfFj
02'* *47,00
*47.00
A *0.00
39652
05-12-83
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
6'
DATE ISSSUEQ" � ' ���, O. U V C5 * 4 7. O �O AL
PERMIT
COOK BROTHERS CONTRACTING
Route 2 Box 853 B
OTIS ORCHARDS, WA 99027
(509) 924-1557 CALCULATED BY DATE
CHECKED BY DATE
SCALE PAL SO sa.5-1
131 17/707144)PR 1591idekSH ralf Cite
ail :or 7ki5I. FMT or e
•
JOB A/01ThiA M.-sEcky 956 -70266 -
SHEET NON- 41/lla BEST MI OF /611,241/15.
IA
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150
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7:7r
'75-0
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FORM 204 Avollable from E95/1NC. Townsend Man 01470