1983, 04-04 Permit: 83A-2578 Demolish 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
1.
2.
3
STREET ADDRESS
N. 13c %Nc:?
LOT 13i( BLOCK ( SUBDI ION
OWNER
PARCEL NO.
PHONE PHONE
-nrrterrn y w ! --..soN
t ,
MAILING ADDRESS ZIP
13/ Rvl�i►�14_
CONTRACTOR
4.
ADDRESS
LICENSE EXPIRES
LEGAL DESCRIPTION:
PHONE
ZIP
DESIGNER PHONE
5.
ADDRESS
CHANGE OF USE FROM
6.
ZIP
TO
TYPE ❑ NEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7. OF f2 OTHER
WORK ❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. 12POOL
Actual Set Backs in Feet to:
North [South {East 1 West
Size of Parcel I Zone Classification
Residential ❑
Commercial 0
Type Const.
Occupancy
Sprinklered
OYes ONo ❑Req 'd.
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
Main Floor
Upper Floors
Cover Deck
Uncv. Deck
Garage/Storage
Fin. Basement
Greenhouse
Unfin. Basement
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certif1. of Exempt.
or Variance
Required Yes No
Received Yes No❑
Number
DESCRIBE WORK I�
8. Pev7eN Peep I �'-3�
1 n 20' -Sz
SEWAGE
SEPTIC ❑
SEWER ❑
VALUATION
9.
Shorelines/ Flood Hazard
Yes Not Applic. ❑
SOURCE
UTILITIES
GAS ELECTR
WATER
PUBLIC 0
PRIVATE 0
Ownership
Public 0 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 SID FO EOU ED INSPECTIONS
SIGNATURE OF
OWNER OR AGEN
SPECIAL APPR
VALS
PRELIM. FINAL DATE
Env. Health I
M
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
APPLICATION
DATE q%44/1c3
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 0
Received 0
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
oc
PERMIT NUMBER
33A-2573
CST72 *“10068
04-04-83
z 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE f6$Q ED 0 4 -8 3:
PERMIT 1:15 7. 8 5
*10,00TOTAL