1983, 04-19 Permit: 83A-3043 GarageOwnership
Public 0 Private 2/
PLAN NUMBER
APPLICATIORj%PERMIT
SPOKANE COUNTY - DEPARTMENT 4:F BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
1.
STREET ADDRESS
N 4- k, 0
LOT
2. 0.1
BLOCK
SUBDIVISION
I� s`{ ArJ J CoJE,2ya0ac.E
H7C
OWNER
3.—17av.� i�P.LAC.rCK
MAILING ADDRESS
jV 14{D FEST
PHONE
PHONE
CQa..°2--,-0X018
PARCEL NO.
1464 —7- (
LEGAL DESCRIPTION:
4.
5.
CONTRACTOR
ADDRESS
DESIGNER
LICENSE EXPIRES
ADDRESS
CHANGE OF USE FROM
6.
ZIP
.D.A. ti<
PHONE
ZIP
PHONE
ZIP
TO
TYPE (.q NEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7 WORK L9 BLD. ❑ PLMB. ❑ MECH. ❑ M.H. CIPOOL ❑ OTHER
Actual Set Backs In Feet to:
North 3"- !South
Size of Parcel
122.cc,
[East
I West
Zone Classification
CZ -1
Residential L
Commercial 0'
Type Const.
Occupancy
Sprnklered
❑Yes ❑No ❑ Reg 'd.
NgiConst. Valuation
4.7x4
Remodeled Valuation
Total Bldg. Floor Area
wog
Main Floor
Upper Floors
Garage/Storage
Cover Deck
No. Baths
Certifl. of Exempt.
or Variance
Uncv. Deck
No. Floors
Fin. Basement
Greenhouse
No. Fin. Rooms
Required Yes❑ No El
Received Yes Non
Untin. Basement
No. Dwellings
Number
DESCRIBE WORK
8. -r A_ A `a A-VL-►4CZE
9.
VALUATION SOURCE
UTILLIITIES
GAS
ELECTRIC
WATER
PUBLIC ❑
PRIVATE 0
SEWAGE
SEPTIC U.
SEWER 0
Shorelines/Flood Hazard
Yes❑ Not Applic. ❑
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
SPECIAL APPROVALS
APPLICATION
DATE
PRE2IM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
it*
9'1-411115
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plans Required ❑
Received ❑
FEES COLLECTED
Building Q 1
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL
PERMIT NUMBER
02*
304.2-2
04-19-83
2 6479.
*61.00
*61.006
*000
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
4-19-83
DATE ISSUED
PERMITU. 4 3 z
*6L00AL
SPOKANE
COU�ti
NTY ALTH DISTRICT
E. 0. PLOEGER, M. D., M.P.H., HEALTH OFFICER
N. 819 Jsffsrson Stmt,
Spokons, Washington 99201
DATE
c `!
ArAfl
Ne. A 16269:.
'APPLICATION FOR PERMIT TO INSTALL OR RKONSTRUCT SEWAGE DISPOSAL.FAOLiTIES%
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