1983, 06-03 Permit: 83A-4777 GaragePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WA$HINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES —PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
Lq� BLOCK SUBDIVISION LEGAL DESCRIPTION:
2
E� �- �S- J1L�
�OWNER . .C,. ; � J 1: PHONE PHONE
3. � J
SPECIAL APPROVALS j SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Env. Health I I ��0 lo'
Planning
Fire
Prevent.
Engineer
Utilities
Plans PERMIT IS NONTRANSFERABLE
ExamPERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building
Tech. IN 180 DAYS
Plan Check
SEPA
Modular/
MFG.Home
Other (Specify)
PERMIT NUMBER
_ 0-3 i'l+
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATETSSUEDo 3 - 3 3 PERMIT NO. 7. 7 z
*61.00°
TOTAL
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MAILING ADDRESS
ZIP
Actual Set Backs in Feet to:
C_ ' : e?-% � =� iZV t
gckb7-7
North Z6 4- South East
CD` West
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential
4.
1 mPA
Q ''���lU
0-AYMx
l 3�o
'RM4�r
Commercial ❑
ADDRESS
ZIP
Type Const. Occupancy
Sprinklered
.�(a7FL?a -iZiffZ- i C, aei
fv
F1i-(
❑Yes ❑No ❑Req'd.
DESIGNER
PHONE
Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
ADDRESSZIP
Main Floor Upper
Floors
Garage/Storage
Greenhouse
57G
—�
CHANGE OF USE FROM
TO
Cover Deck
Uncv. DeckFin.
Basement
Unfin. Basement
6.
_._
TYPE
No. Baths No.
Floors
No. Fin. Rooms
No. wellings
D��
NEW 1:1 ALT. ElAD'N. ❑ RPL. ElMVE.
1
7.
OFElOTHER
VBLD.
WORK ❑ PLMB. ❑ MECH. ❑ M. H. ❑ POOL
Certifi. of Exempt.
Required
Yes El No
Number r
or Variance
Received
Yes❑ No F-1
✓
8
DESCRIBE WORK
Shorelines/Flood Hazard
Plans Required 1:1$
v ilk Cl(� 2
Yes❑ Not Applic. El
Received El
9
VALUATION I SOURCE GAS
ELECTRIC
EV
I PUBLIC
I PTIC &
SEW
Ownership
FEES COLLECTED
UTILITIES
PRIVATE ❑
SEWER ❑
Public ❑ Private
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
�_m[r
work will be complied with whether specified herein or not. The granting of a permit
does not presume to give au-
Building
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction. SEE REVE SE F R REQUIRED INSPECTIONS
Plumbing
SIGNATURE OFAPPLICATION '-�
A
OWNER OR AGENT.- - DATE
— ,
Mech.
SPECIAL APPROVALS j SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Env. Health I I ��0 lo'
Planning
Fire
Prevent.
Engineer
Utilities
Plans PERMIT IS NONTRANSFERABLE
ExamPERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building
Tech. IN 180 DAYS
Plan Check
SEPA
Modular/
MFG.Home
Other (Specify)
PERMIT NUMBER
_ 0-3 i'l+
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATETSSUEDo 3 - 3 3 PERMIT NO. 7. 7 z
*61.00°
TOTAL
CL
O
V
W
J
IL
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