1983, 03-24 Permit: 83A-2197 GaragePLAN NUMtStH
HrrL1llL.#► 11VN/ rLKMI 1
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
STREET ADDRESS 1PARCELNO.
� .
to %,-Do ti 1�-!%
North 5' 1
South
LOT
BLOCK
SUBDIVISION
i
2.
4
I
M/a¢►N ASO oT�c
Required Yes❑ No❑
V, --2—
OWNER
Type Const.
PHONE
PHONE
3.
t--,
Ar'ry
New Const. Valuation
Q
Bldg. Floor Area
MAILING ADDRESS
VALUATION
ZIP
GAS
I sc�l% G=' Ljto
4ai
Main Floor
CONTRACTOR
Garage/ Storage
LICENSE EXPIRES
PHONE
UTILITIES
F'
Cover Deck
Uncv. Deck
4.
ADDRESS
Unfin. Basement
ZIP
reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this type of
E
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
DESIGNER
of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
PHONE
SIGNATURE OF APPLICATIO
�% — �.
OWNER OR AGENT DATE
Mach.
5.
ADDRESS
PRELIM. FINAL DATE
ZIP
Plan Check
CHANGE OF USE FROM
TO
s.
3-7
SEPA
iCos�. - i 304
AL DESCRIPTION:
Actual Set Backs in Feet to:
No. Baths
North 5' 1
South
East West 3
Size of Parcel
�—
i
Zone Classification
1
Residential
P>Src t4b
Cartifi.ofExempt.
-T
Required Yes❑ No❑
V, --2—
Commercial ❑
Type Const.
Occupancy
Sprinklered
N
t--,
Dyes ❑No ❑Req'd.
New Const. Valuation
Remodeled ValuationTotal
Bldg. Floor Area
Received
VALUATION
SOURCE
GAS
ELECTRIC
C�'
Main Floor
Upper Floors
Garage/ Storage
Greenhouse
9•
UTILITIES
Cover Deck
Uncv. Deck
JFin.
Basement
Unfin. Basement
TYPE
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
�—
i
I
k
7. OF ❑ OTHER
Cartifi.ofExempt.
-T
Required Yes❑ No❑
Number
WORK IeBLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
or Variance
Received Yes ❑ No ❑
DESCRIBE WORK {
8• --u)-z'
Shorelines/ Flood Hazard
Plans Required
- CSA Uj �.' c' X44)
Yes Not Applic. ❑
Received
VALUATION
SOURCE
GAS
ELECTRIC
PUBIC WATER
/
SEPTIC Fd
Ownership
FEES COLLECTED
9•
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
Building u�
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
Plumbing
SIGNATURE OF APPLICATIO
�% — �.
OWNER OR AGENT DATE
Mach.
SPECIAL APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Plan Check
Env. Health
DL Myl
3-7
SEPA
Planning
Modular/
MFG. Home
Fire
Engineer
Utilities
SEPA
Pians PERMIT IS NONTRANSFERABLE
Exam. 57 PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building 31-11— IN 180 DAYS
Other (Specify)
TOTAL $ Q(`(DU I
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE"ED24-8 J PERMIT4I 9. 7 0 * 9 6, 0 0 0 -'
d.
O
v
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2,
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rn(d
MAR 2 � 1983
BUILDING CODES
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