1983, 05-12 Permit: 83A-3962 GaragePLAN NUMBER •
APPLICATION/PERMIT
SPOKANE COUNTY - DEPARTF.:, NT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456.3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
1.
77507
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LOT
2.
OWryER�""ICC�}'�"( Gi Jh M
3.
4.
5.
6.
BLOCK
9
PARCEL NO. �"7 %Z 1003
SUBDIVISION /it
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MAIyyINGADDR
SSn✓CJI1rjf1/440t‘il0
COIMPR MG rzato
LICENSE EXPIRES
ADDf . I I i 4- c. L JMF3tA
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North (South
Siz Orce I yJ r
Type_Cgnst-
West
Ocgapcy
Residential
fa
Commercial D
Spr nklered
DYes DNo DReq'd.
DESIGNER
PHONE
Newnst. Valuaflon Remodeled Valuation
V
Total Bldg. Floor Area
ADDRESS
ZIP
Main Floor
Upper Floors
Gara a/Wor9
Greenhouse
CHANGE OF USE FROM
TO
TYPE W 0 ALT. 0 AD' N. 0 RPL. 0 MVE.
7 OF WORK BLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL 0 OTHER
Cover Deck
No. Baths
Uncv. Deck
No. Floors
11 No. Fin. Rooms
Fin. Basement
Unfin. Basement
No Dwellings
Certif1. of Exempt.
or Variance
Required YesL NoD
DE RIB OR
8.
Shorelines/Flood Haza d
YesO Not Applic.0
Number
Received YesO No0
Plans Requ red LY/
Received
VALUATION
9.
SOURCE
F
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC
PRIVATE 0
SEWAG
SEPTIC
SEWER 0
Ownership
Public 0 Private
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 compiled 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- .(VERSE SIDE FOR R OUIRED INSPECTIONS
SIGNATURE OF ,
0.11: i.{ _26,APPLICATION
OWNER OR AGENT, �- r*'f'°""`— DATE
SPECIAL APPROVALS SP IAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FIN L DATE
I
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
7\\TBulidech.ing
Ul c . (Ft' -1- LcR 3 32 Di)
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)
TOTAL $ —1—
PERMIT NUMBER
63A - 32G2-
02*
2Gz
02* *61.00
*61.006
A *000 8
37532
05-06-83
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DAT�IISSUEP Ii,- 8,�jPERMIX423.6 2 5 * 6 10:0 actAL
•