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1984, 03-07 Permit: 84A-1911 AdditionQLArJ 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 1. LOT BLOCK SU DIVISION 2. 7 — bi y,t.,& } 2-7\10 OWNER i I PHONE 3 �. �.�LJ I N MAILING ADDRESS e 1e7 SI STRET ADDRESS PARCEL NO. LEGAL DESCRIPTION: PHONE CONTRACTOR 4. HJ' Ni lt< * 5 - ADDRESS I r, )c- 71 DESIGNER 5. ADDRESS LICENSE EXPIRES ZIP �l�J l� PHONE 72-6zip 415 7)x23 CHANGE OF USE FROM 6. PHONE Actual Set Backs In Feet to: North I South I e [East I West Size of Parcel Zone Classification Residential L3 Commercial ❑ Type Occupancy Sprinklered [Wes ENo EReg 'd. ZIP TO TYPE E NEW ❑ ALT. ,ErAD' N. r RPL. 7. OF WORK BLD. E PLMB. ❑ MECH. C M.H. DESCRIBE WORK 8. N Ih& I22ol1 9. VALUATION SODUFCE UTILITIES i1/449+9iTi4\l GAS ELECTRIC E MVE. ❑ POOL WATER PUBLIC PRIVATE 0 ❑ OTHER New Const. Valuation Re mode ed Valuation Total Bldg. Floor Area Main Floor (aC Upper Floors Garage/Storage Greenhouse Cover Deck Uncv. Deck Fin. Basement Unfin. Basement No. Baths No. Floors No. Fin. Rooms No. Dwellings Certifi. of Exempt. or Variance Required Yes❑ No❑ Received Yes Nof7 Number SEWAG SEPTIC SEWER 0 Shorelines/Flood Hazard Yes Not Applic. Ownership Public ❑ Private 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 . any other state or local law regulating construction or the performance of construction. SEE REVERSE SID • EOUIRED INSPECTIONS SIGNATURE OF OWNER OR AGENT . e SPECIAL APPROVALS S PRELIM. FINAL DATE Env. Health Planning Fire Prevent. Engineer Utilities SEPA Plans Exam. Building Tech. 77 APPLICATION DATE A.j IAL CONDITIONS: (SEE REVERSE SIDE FOR NOTI PL11 I -T .b 6'* - CiN� �,jo-ft N" l:v4 -t'viA L. -54, pr,ut\LA A -1I( 11315° -= 41 - Sk-2-(44-A- -13°4) PERMIT IS NONTRANSFERABLE PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED IN 180 DAYS Plans Required Received '1 FEES COLLECTED Building Plumbing Mech. Plan Check SEPA Modular / MFG. Home Ot r (Specify) 2"--2/ TOTAL $ PERMIT NUMBER 02* * 22.00 * 22.00, *0.00 El 191.0 03-07-84 479 WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 03-07-84 DATE ISSUED 191.12 *22.00,9AL PERMIT NO. ROLLING DOORS & GRILLS HOLLOW METAL DOORS TOILET PARTITIONS PANIC HARDWARE Mel's MAINTENANCE & CONSTRUCTION GENERAL. CONTRACTOR License No. MELS-MC-221LR RT. 1, BOX 71 • MICA, WASHINGTON 99023 (509) 9264195 a0 r R/ 4 e S/E 440A'Die/ Rcc ; AcQl,T,co cvs7 X975 ao 1(1 PP /c0c�t r &DC'AGE- Cdr1, n L 1.4 v a N j3eSs/4"