1984, 03-15 Permit: 84A-2261 GaragePLAN NUMOMM I mr'P'LIVA I IVIS/ r c mI11I1
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NOA`TH 811 JEFFERSON/ SPOKANE, WASHINGTON 99260 / (509) 456-3675
1. • it
7_F0_T__T BLOCK
2.
OWNER
3. C I d(If
MAILING ADDRESS
CONTRACTOR
4. ADDRESS
DESIGNER
5.
ADDRESS
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
I
Poe AtKV 1ST / 1 PARCEL NO. QLD g q Z— i I 1 1 1 /
CHANGE OF U6. SE FROM
P4f_=PLA-T 00 . -Z--
PHONE
PHONE PHONE
ZIP
19, ;06
LICENSE EXPIRES PHONE
ZIP
PHONE
TO
TYPE ;.NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7 OF WOR ;4BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL ❑OTHER
t'tHMll NUMbtH
North r'► South East -7 L & v West I✓ X f7T.
or Variance
Size of Parcel (
(
Zone Classification
n
{ �•- -'
Residential
Commercia ❑
Type Conpt.
Occupancy,
M - I
Sprinklered
Dyes ❑No ❑Req'd.
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
k4ain Floor
Upper Floors
GaragelStorage t
8�0�T �
Greenhouse
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
Required Yes No El
Number
K
or Variance
Received Yes❑ No❑
DESCRIBE WORK�/ i .- (` 1
8• CO ?
Shorelines/Flood Hazard
Yes Not Applic. ❑
Plans Required ❑
Received ❑
VALUATION
9•
I SOURCE
UTILITIES
GAS
ELECTRIC
PUBLIC,
PRIVATE ❑
SEP AIC-
SIM El 0
Ownership
Public ❑ Private
FEES COLLECTED
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-
Building Gr 00
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction. SEE REVERIE SIDE FOR REQUIRED INSPECTIONS
Plumbing
SIGNATURE OF APPLICATION
OWNER OR AGENTDATE
Mech.
SPECIAL
APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Plan Check
Env. Health
SEPA
Planning
Modular/
MFG. Home
Fire
Prevent.
Engineer
�
Other (Specify)
Utilities
G �Q
TOTAL $ '
SEPA
pianss�
Exam.
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
WHEN MACHINE VALIDAT
THIS BECOMES A PERMIT.
/
✓ /�
Building
Tech.
�'�
IN 180 DAYS
DATE ISSUED - `i 4
PERMITYI( 6' z * 7 5' *tAL
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