1984, 04-12 Permit: 84A-3292 Storage BldgPLAN 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
STREET ADDRESS
1.
LOT
2.
'Tit I CAht,pO
D.
BLOCK SUBDIVISIONON G ^t00 tv G ErJ
OWNERS S!-1-EPu EtzD
3. �
MAILING ADDRESS
— Stcni E
PHONE
P ONE
PARCEL NO.
05r2 -IS -
LEGAL DESCRIPTION:
4.
5.
CDMOFI B (WS. sl riT�l. 9"N�V.
LICENSE EXPIRES
RD.r E t BOX 55-3 t3 OTIy bt2Cl-MArlos
DESIGNER
ZI P
90 0140
PHONE
Actual Set Backs in Feet to:
North 461 I I !South 70
11 East 5)(191.1 West
Size of Parcel
(001' Si (a2-
Tyr kst.
ADDRESS
ZIP
Occupancy
M I
NiTons7Val�uatIo Do
Main Floor
Zone CI$Ification
r^.
3'
Residential%
Commercial C
Sprinklered
CYes CNo Reg' d.
Remodeled Valuation
Total Bldg. Floor Area
Upper Floors
Garai e/S_ forage
Greenhouse
6.
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck 1 Fin. Basement
Unfin. Basement
TYPE ;(NEW ❑ ALT. 0 AD' N. 0 RPL. 0 MVE.
7• OF
WORK 'BLD. 0 PLMB. ❑ MECH. ❑ M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certif1. of Exempt.
or Variance
Required Yes No0
Received Yes O NnD
Number
DESCRIBE WORK
8.
VALUATION
Gjt12ACcE BUtWIPJG ?o' )'4O
Shorelines/Flood Hazard
Yesf Not Aeolic. 0
Flans Requ red 0
Received 0
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC 0
PRIVATE 0
SEWAG
SEPTIC
SEWER
Ownership
Public 0 Private 0
I hereby certliy 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 taws and ordinances governing this type of
work will betcomplied 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 R ER IDE FOR REQUIRED INSP. IONS
SIGNATURE OF / APPLICATION
OWNER OR AGE T / _ DATE 7"
SPECIAL APPR a VALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
JkP. 41/) -
ON
Ft
/JP'
PERMIT IS NONTRANSFERABLE
PERMIT 15 NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
132'
82
TOTAL $
PERMIT NUMBER
—L�z
02* *P2,00
*82006
A *0.00 8
329.12
04-12-84
2 6479.
>-
O
U
W
J
LL
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
n///jj "w°jjV r{P±,7
DATEQS#UEDLi'2 1."R`f
PERMIT42.'. 2 2 .* 8 2.0 0 ILOfrAL