HomeMy WebLinkAbout1983, 06-09 Permit: 83A-5093 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
STREFT ADDRESS
1. I 1 19
PARCEL NO. 14-54-1
Lcrr
2.
BLOCK
2_
SUBDIVISION -r
IvAvt,rL}` tj-g, Aoo'r'
OWNER
3.
4.
11,7 guts, `, A• r2
LICENSE EXPIRES
CONTRACTOR -
ADDRESS)._
DESIGNER
PHONE
ZjP
5.
ADDRESS
-15'7
PHONE
LEGAL DESCRIPTION:
X 6/15/ ,-J-4
MAI ING ADDRESS N
� • i
Actual Set ks in Feet to: ((��,,�
North 'South Z/N East 1 West
Residential
Commercial ❑
Si7eo?Parcell neClassifigatlonr
TypeTst
Occypfiiy
New Const. Valuation
3 2 C
Spr'nklered
❑Yes 0 N ❑ Req 'd.
Remode ed Valuation
Total Bldg. Floor Area
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
6.
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE g NEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7. OF
J_�/
WORK BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
8. DES
I E !/ 4 i .,) ‘...vsc i (2,4
?t.
VALUATION
9.
SOURCE
F
UTILLIITIES
GAS
ELECTRIC
PUB IC(
PRIVATE ❑
0 OTHER
SEPWTIC..
SEWER ❑
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certif 1. of Exempt.
or Variance
Shorelines/Flood Haze d
Yes❑ NotApplic. ❑
Ownership
Public ❑ Private
Required Yes❑ No❑
Received Yes No❑
I hereby certify that I have read and examined this appl'cation 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 RE , RSA IDE FOR EQUIRED INSPECTIONS
SIGNATURE OF
OWNER OR AG
APPLICATIOly p S3
DATE /r+
SPECIAL APP ' LS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
c4
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Number
Plans Required ❑
Received ❑
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
PERMIT NUMBER
0'3A- q�
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
5n d
DATE�bL SSUEDO 9 - 8 3 PERMIT „,,Q 7'
*61.MIAL
COOK BROTHERS CONTRACTING
Route 2 Box 853 B
OTIS ORCHARDS, WA 99027
(509) 924-1557
JOB
SHEET NO
AI -11/ :et/nI. fr i,
CALCULATED BY "I" A
OF
%/7,-cf.77
/` t, x.:,)1/1/,
DATE
CHECKED BY DATE
SCALE
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or &N'EtN clti Ywc cF !Idol V
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FORM 204 Available from I EHSJINc Townsend, Mass 01470