1984, 03-23 Permit: 84a-2579 DuplexIMAN NUM r-ri I _ ; ArrL11L;A 11UN/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY ,
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES —PRESS HARD TO MAKE 3 COPIES
STREETADDRESS A PARCEL NO. ,
�. • .32 3 �2 � L�,1S C�. 33 � Z - t l 1.3
LOTBLOCK SUBDIVISION LEGAL DESCRIPTION:
2. 13 2 CiASTI., "D I TI O Iii
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Uwrve
so) EH
PHONE
HON
�I 2-s-�I18o
Planning
3.
.
F re
Prevent.
Engineer
MAILIN ADDRE+gS /� j �-, n
Z'1 Z + s a
ZIP 7
Actual Set Backs in Feet to:
) I
I
ZS ,
f`�`� �✓�Y
w
North South East
West ��
CONTRACTOR LICENSE EXPIRES
�^ '
PHONE
Size of Parcel I
1
'3ot
Zonfication
Commea4.
Building
Tech.
3a
merca ❑
ADDRESS
ZIP
Type Co t.
Occ ncy
Sprinklered
❑Yes ❑No ❑Req'd.
DESIGNER
PHONEsLValuation
0S o—
Remodeled Valuation
Total Bldg. Floor Area
7 Z
5.
.
ADDRESS
ZIP
Main FI
Q I Upper
o
Floors
Garage/St rage I I
l{
Greenhouse
6.
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. ment
Unfin. Basement
13
7
TYPE 'NEW ❑ ALT. ❑ AD'N. ❑ RPL. 1:1MVE.
No. Ba No.
FloorsNo.
Fin. Rooms
D
No. Dwellings
Z
OF ❑OTHER
WORK 'BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
Certifi.ofExempt.
Required
Yes❑ No❑
Number
or Variance
Received
Yes❑ No❑
8
DESCRIBE WORK 3 Bp A -„_ pue� w/ �� ^'. �r
a�/vl'` /�► �+[O
Shorelines/ Flood Hazard
Plans Required
Yes❑ Not Applic. ❑
Received
9•
VALUATION
SOOUFCE
GAS
ELECTRIC
PUB IWATC,t3[
SEPTIAC
Ownership
Public ❑ Private
FEES COLLECTED
UTILITIES
PRIVATES ❑
SEWERR'❑
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
'461.0-0,
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 REVERSE SIDE FOR REQUIRED INS ECTIONS
Plumbing
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE 710
Mach.
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
F re
Prevent.
Engineer
t
"�
Utilities
SEPA
Plans
Exam.
Building
Tech.
3 k�
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plan Check
SEPA
Modular/
MFG.Home
PERMIT NUMBER
Other (Specify)
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
3w
DATE ISSUED J 0 `� PERMIT NO. L Q o * TOTAL
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