1983, 02-24 Permit: 83A-1276 GaragePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHiNGTCN 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
BLOCK
LOT
2.1 22 3
/�--SIN
3
MitIADDf Ess
t'7007 Sia,
SUBDIVISION
66•11-- S t-r1OKI
CONTTOp
4. V
ADDRESS
P -TONNE °3 —ZEA 1
PHONE
PARCEL NO.
2 - ' 3001
LEGAL DESCRIPTION: 1\11(2_ 1(2
ZIP
2o7
Actual Set Backs in Feet to:
North I South ?7 East
West
LICENSE EXPIRES
PHONE
ZIP
SizeofParcel1
4 7 Zo e las5ification
Ty t. I Sprinklered
❑Yes ❑No ❑Req'd.
Occupancy
MI
Residential
Commercial El
DESIGNER
5.
ADDRESS
PHONE
New Const. Valuation Remodeled Valuation
10 75.7
Total Bldg. Floor Area
ZIP
Main Floor
Upper Floors
Garage/Storage
13�
Greenhouse
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv. Deck f Fin. Basetnent
Unfin. Basement
TYPE 254EW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7. OF BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
WORK
8 DESCRIBE WORK
WATER./
PUBLIC E!
PRIVATE ❑
VALUATIO
9.
SOURCE
F
UTILITIES
GAS
ELECTRIC
❑ OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required Yes❑ No❑
Received 'fest: No
Number
SEWAGE(
SEPTIC
SEWER E
Shorelines/Flood Hazard
Yes❑ Not Applic. E
Plans Required
Received ❑
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 REVEftSESTQE FOR REQUIRED INSPECTIONS
SIGNATURE OF
OWNER OR AGENT
- _ i
SPECIAL APPROVALS / SPECIAL CONDITIONS: 'I REVERSE SIDE FOR NOTICE)
PRELI DKfE
APPLICATION
DATE �-
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
M. FIN L
1at/
•
(L
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building (C)7--
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $ (Q�
PERMIT NUMBER
12 -Te
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE'ISSUEAC? 4_ 8 3 PERMIT]NI. 7' z *10200°J
OO 4O AL
ADOITION
1.1/1cATE0 NL1rY si' of Aiv4
g
CARN A HAQN
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Proposcot
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