1983, 06-15 Permit: 83A-5335 GarageIPLAN NUMBER
STREET ADDRESS
1.
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
PARCEL NO. z
LA- 2_ — 0 e503,
LOT 1 BLOCK 1 SUBDIVISION
2.
OWNER
mil, I PHONE
MAILING ADDRESS
oCa
gool./301511'1\
CONTRACTOR
4. V‘A,
ADDRESS
DESIGNER
5.
ADDRESS
CHANGE OF USE FROM 1 TO
6.
1LICENSE EXPIRES
TYPE Evy
7. OF
WORK C;kgr:b*
TEA- 07 o
ZIP
PHONE
LEGAL DESCRIPTION: y
Actual Set Backs in Feet to:
North 41 !South17 East West
Residential
Commercial C
ZIP
PHONE
ZIP
O ALT. 0 AD' N. 0 RPL. 0 MVE.
• PLMB. 0 MECH. 7 M.H. LIPOOL
0 OTHER
Size of Parcel
X. I
1°Irr
Type Const.
1•)
New Const. Valuation
Main Floor
11 Zone classification
Spr nklered
[)Yes CNo DReq'd.
Remodeled Valuation
'Upper Floors 1G
Cover Deck lUncv. Deck
No. Baths
Certif i. of Exempt.
or Variance
INo. Floors
Required
Received
Total Bldg. Floor Area
fe,(0
e/Stora e1 Greenhouse
Fin. Basement
•••••••••••••........
No. Fin. Rooms
8. DET-46CA-f-, DESCRIBE WOr-tA 9---- .2..- •63 tr,
RK
VALUATION SOURCE GAS ELECTRIC WAT SEWAGE
9. UTILITIES
OF PRIVATE E
PUBLIC C SEPTIC
SEWER fl
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 giveau-
thorny to violate or cancel th : 1 rovisions of any other state or local law regulating construction or the perfor ance
of construction. SEE REVE SIDE FOR RE IRED INSPECTIONS
/
Shorelines/ Flood Hazard
tt.
YesEJ Not Applic.
Ownership
Public fl Private
SIGNATURE 0
OWNER OR AG
SPEC?AL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
APPLICATION
DATE
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Unfin. Basement
No. Dwellings
Yes0NOV
YesD No El
Plans Required
--
Received —
Number
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
- C
TOTAL $
PERMIT NUMBER
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
• •
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DATE ISSUED
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PERMIT NO.
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