1983, 06-15 Permit: 83A-5280 GaragePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT ')F BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1.
we„2.
3.
E /B'jo( P i n .T
BLOCK SUB IVISION
7 & w&ct 4st- 4L
OWNER.PHONE PHONE
�4�Vb CLNASE `12_4.7340
MAILING ADDRESS
4.
ZIP
CONTRAC OR LICENSE EXPIRES PHONE
ADDRESS
DESIGNER
ADDRESS
CHANGE OF USE FROM
ZIP
PHONE
ZIP
TO
TYPE VIEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7. OF WORK -LD. ❑ PLMB. ❑ MECH. ElM.H. ❑ POOL ❑OTHER
PARCEL NO. C� tr'S 5 080Ce
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North % South East [ I West
Size of Parcel
�-? x/
DESCRI E WORK
r-�j C -1 -4(11 -CO
VALUATION
9.
SOURCE
F
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC 0
PRIVATE 0
SEWAGE
SEPTIC
SEWER 0
Main Floor
Cover Deck
No. Baths
Zone gjaslfi =tion
Residential Q'"
Commercial ❑
Spr'nklered
❑Yes 0 N ❑Req'd.
Remodeled Valuation
No. Floors
Total Bldg. Floor Area
5 C
Greenhouse
Fin. Basement
No. Fin. Rooms
Required
Received
Yes LI No
Yes❑ No❑
Shorelines/Flood Hazard
Yes CI NotApplic. ❑
Ownership
Public ❑ Private 8'
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
APPLICATION 6- //Qte/ L
DATE l�J T U
SPECIAL APPROVALS
lkPlanning
Env. Health
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
'1
1siN
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Unfin. Basement
No. Dwellings
Number
Plans Required 0
Received 0
FEES COLLECTED
Building (.t( )
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
PERMIT NUMBER
02* *61.00
*61,006
A *000
527.62
06-15-83
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
n,'
,(
DATE-ISBUUil 5 -8 3
PERMIf5N§.8, 0 5
*61.0 0 aQAL
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