1983, 08-30 Permit: 83A-8349 GaragePLAN 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. N. IU5 �
PARCEL NO. 15 r
4-1--
2. yQ BLOCK SUSS Nct t-1 NI
OVyNER PHONE
3.
MAj• 1CIDEESS6_-1147)
4.
AD4RESSzt2oB
LICENSE EXPIRES
PHONE
ZIP
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North South 7 {East ia 0 I West
Size ofparpel
Type Cpggt. OFcunncy
DESIGNER
5.
ADDRESS
/PHONE
CHANGE OF USE FROM
6.
ZIP
TO
TYPE Z W ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7. OF WORK BLD. ❑ PLMB. ❑ MECH. ❑ M.H. D POOL ❑OTHER
New Const Valuation
76b0
Main Floor
Cover Deck
No. Battu
Residential OV
Commercial Ill
Sprinklered
❑Yee ❑No ❑Req'd.
Remodel ed Valuation
Upper Floors
Uncv. Deck
No. Floors
GaraIStorag,
Total Bldg. Floor Area
Greenhouse
Fin. Basement
No. Fin. Rooms
Unfin. Basement
No. Dwellings
Certifi. of Exempt.
or Variance
Required Yes Na'`,
Received YesD Norl
Number
DESCRIBE /ORK
VALUATION SOURCE
9 OF
UTILITIES
GAS 1
Shorelines/Flood Hazard
Yes Ll Not Applic. ❑
ELECTRIC
WATER
PUBLIC
PRIVATE 0
SEWAG
SEPTIC
SEWER 0
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 REVERSE SIDE FOR REQUIRED INSPECTIONS
SIGNATURE OF
OWNER OR AGENT
SS -SIAL APPROVALS
PRELIM. FINAL DATE
APPLICATION5 / /tt
DATE3
Plans Required
Received
Env. Health's
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Ger i •
(i* 172-11•1
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
Other (Specify)
TOTAL $
PERMMB
gi.”,
u2* 32.00
*82,006
A *0.00 i;
83&0
08-30-83
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
OATEOISSSUED O — 8 5
PERMIA .4 9
*82.004OOAL
WC,
\)
4-