1983, 08-17 Permit: 83A-7882 Storage BldgIr LAN NUMI:itH
MrFL I.A 1 IV IV / I -LK IYi 1 1
et SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, Wa tSHIN pTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
1.
2.
STREET ADDRESS
.i0f3ti3
PARCEL NO.
cAs41 -
LOT
BLOCK
SUBDIVISION
OWNER
3. SRAPOL. --ef.'1T►al2.tv00v
MAILING ADDRESS
6 't C.YZN e -A Mk.) L: i E
PHONE
PHONE
LEGAL DESCRIPTION: . f tv i,So= o
'$ r= A t 12 Pc.tP-..CS
ZIP
Actual Set Backs in Feet to:
North 7° 'South
4.
5.
6.
CONTRACTOR
ADDRESS
v LL.e
DESIGNER
LICENSE EXPIRES
PHONE
Size of Parcel
'East
(West
Zone Classification
Residential Id
Commercial 0
ZIP
Type Const.
Occupancy
VIA
Spr nklered
❑Yes ❑No ❑Req'd.
PHONE
ADDRESS
ZIP
New Const. Valuation
*IPA°
Main Floor
Remode ed Valuation
Total Bldg. Floor Area
Upper Floors
Garage/Storage
t40
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE LJ NEW 0 ALT. 0 AD' N. 0 RPL. 0 MVE.
7 WORK 13t/BLD. 0 PLMB. 0 MECH. ❑ M.H. 0 POOL 1=1 OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required Yes ❑ No Li
Received Yes ❑ No ❑
Number
8.
DESCRIBE WORK
'ia i? "--' LS) c, — ?°420 - r -Ka c.
f
4)
VALUATION SOURCED
9 UTIF
LITIES
GAS
ELECTRIC
WATER SEWAGEZ
PUBLIC 0 SEPTIC Q
PRIVATE ❑ SEWER ❑
Shorelines/Flood Hazard
Yes❑ Not Applic. ❑
Ownership I/
Public 0 Private
Plans Requ red ❑
Received 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 REQUIRED INSPECTIONS
SIGNATURE OF
OWNER OR AGENT
APPLICATION
DATE /
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
S EPA
Plans
Exam.
Building
Tech.
kL
oNn
4;0-•
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 $
PERMIT NUMBER
f .22A X71 ()2
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE'iSSUEDL 7 - 8 PERMIT/N9. 8' 2
z *20,OO,4AL
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