1983, 06-21 Permit: 83A-5654 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. E• F57 3 ,t 3C
LOT
2.
BLOCK SUBDIVISION
PARCEL NO.
3.
OWNER
PHONE
P_LIONE
i43 .4-t -c �v1
LEGAL DESCRIPTION:
MAILINGADDRESS
• C!)
ZIP
Actual Set Backs in Feet to:
North (40 6 (South
4.
CONTRACTOR
N
LICENSE EXPIRES
PHONE
Size of Parcel
East C}rZa I West t /
Residential �5"
Commercial ❑
Zone Classification
ADDRESS
E 11611
ZIP
Type Const.
Occupancy
inti —t
Spr'nklered
❑Yes ❑No Req 'd.
5.
DESIGNER
PHONE
Mew Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
ADDRESS
CHANGE OF USE FROM
6.
ZIP
TO
TYPE KpEw ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7. OF WORK / BLD. ❑ PLMB. ❑ MECH. TIM.H. ❑ POOL ❑ OTHER
Main Floor
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
Received
Yes❑ NoS[(
Yes 17 Norl
Number
DESCRIBE WORK
8. rA E.n
VALUATION
9.
C
SOURCE GAS
UTILLIITIES
ELECTRIC
WATER
PUBLIC E
PRIVATE ❑
SEWAG
SEPTIC
SEWER ❑
Shorelines/Flood Hazard
Yes ❑ NotApplic. E
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
SIGNATURs OF APPLICATION-. -3
OWNER OR AGENT ✓���`��-.'� DATE
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Env. Health
PRELIM. FE�IN L DATE
Planning
6A2
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Ott
Building
Tech.
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plans Required �1
Received �/
FEES COLLECTED
Building 101.649
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $ )C],
PERMIT NUMBER
E34 5&>5
02* *102.00
*102008
A *0,00
559.08
06-21-83
g 6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE IoSUED 2 1 — 8
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