1983, 05-12 Permit: 83A-3998 GaragePLAN NUMBER
APPLICATION/PERMIT
'SPOKANE COUNTY - DEPAATMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
1.
STRZT. ADDRESc)S
� 54-
PARCEL NO. a ca,
LOT
2.
BLOCK
SUBDIVISION
6-v,i'C
3.
A \f M C 601-1
MAI ING ADDR�,FSS
' L 4, oedf2 .1
4.
CONTRP�CTQ�1�
(PHONE
I
zl7,7-•°G
LICENSE EXPIRES
PHONE
LEGAL DESCRIPTION:5.k
- 7hr2r'
Actual Set Backs In Feet to:
North 'South t�
ADDRESS
ZIP
Size of cel
�x I
Type 7Ons(. OccuRarlcy
11 Zone Claseilatmon
Sprinklered
❑Yes ❑No ❑Req'd.
East I West
Residential
Commercial 0
DESIGNER
5. ADDRESS
PHONE
Newuation
Remode ed Valuation
Total Bldg. Floor Area
ZIP
Main Floor
Upper Floors
Garage/
Greenhouse
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv. Deck
FI . Basement
Unfin. Basement
TYPE ❑ W
7. OF BLD.
WORK
❑ ALT. 2rAD' N.
❑ PLMB. ❑ MECH.
8.
DESCRIB WORK
VALUATION
9.
SO RCE
UTILITIES
❑ RPL.
❑ M.H.
rJ
(tci1)
ELECTRIC
GAS
❑ MVE.
El POOL ❑ OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required
Received
Yes❑ No❑
Yes❑ No❑
Number
Shorelines/Flood Hazard
Yes Not Applic. ❑
Plans Required 0
Received 0
WATER
PUBLIC
PRIVATE 0
SEWAGE
SEPTIC
SEWER 0
Ownership
Public 0 Privat
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 REQUIRED INSPECTIONS
SIGNATURE OF
OWNER OR AGENT
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
r'
it
APPLICATION 5
DATE �/z
SPECIAL CONDITION- (SEE REVERSE SIDE FOR NOTICE)
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 $
54,
PERMIT NUMBER
134'c 37,5
02* *54.00
*54,006
A *0.0.0 8
399.•72
0.5-12-83
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE9s EDI. 2 - 8 3'
PERMITIc. 9. 8 Z
*5 4.0 0 0
fiotAL