1984, 02-22 Permit: 84A-1458 Mechanical FixturesPLAN NUMBER
it
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
1.
STREET ADDRESS
E.
13303 C. TAL_7p
PARCEL NO.
LOT
2.
BLOCK
SUBDIVISION
OWNER
3 13E.R.Niko..0
MAILING ADDRESS
E • '1 3c.) -b
PHONE
4eit
PHONE
Q24--4-133
LEGAL DESCRIPTION:
ZIP
Q03.i(o
Actual Set Backs In Feet to:
North ISouth
4.
CONTRACTOR
LICENSE EXPIRES
PHONE
Sim of Parcel
LIZone Classification
East
West
Residential 0
Commercial 0
ADDRESS
ZIP
Type Const.
Occupancy
Sp nklered
Dyes ONo ❑Req.d.
DESIGNER
5.
ADDRESS
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
6.
TYPE 0 NEW
7. OF
WORK 0 BLD.
TO
Cover Deck
Uncv. Deck
Fin. Basement
Untin. Basement
❑ ALT. ❑ V' N. ❑ RPL. 0 MVE.
❑ PLMB.MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Caroti. of Exempt.
or Variance
Required Yes El NoO
Received Yes ❑ No❑
Number
DESCRIBE WORK
8. N£e>TiY,)
Sys tsaN
Shorelines/Flood Haze d
VesD Not Appllc. 0
Flans Required 0
Received 0
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC 0
PRIVATE 0
SEWAGE
SEPTIC 0
SEWER 0
Ownership
Public 0 Private 0
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 REOUIRED I • SPECTIONS
SIGNATURE OF
OWNER OR AGEN
APPLICATION a—a�- t7 ((
DATETEa( 6 7
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: SEE REVERSE SIDE FOR NOTICE)
L2') 404000 t T L-.
tCE4aTea 5
1
so, rico 3z L.L bl zts2
cflS?( t� NCS
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
o.co
TOTAL 590.E
P RMIT NUMBER
4-R - 14-5s
In' a7*3G0'0ED)
02-22-84
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMESA PERMIT.
Uri
•
DATE !Lao- 2 2 - 8 !4'
t •
PERMIT 44 58 tz' *.3.0.0 perm