1983, 05-03 Permit: 83A-3579 GaragePLAN NUMBER
APPLICATION/PERM IT
SPOKANE COUNTY — DEPA'RTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT:
COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1.
E .134x-2.
u,ra.av
PARCEL NO.
0?s''s4l - 4001
2.
3.
LOT
BLOCK.
3
SUBDIVISION
OWNER
Ks '-v cit )Vew., ; -z-
MAILING
MAILING ADDRESS
E. 134-1- 44e&oa
PHONE
PHONE
Qba-80i 1
LEGAL DESCRIPTION:
ZIP
a�lz.�
Actual Set Backs In Feet to:
North 3 1
South
[East Cot I Went
4.
CONTRACTOR
Saves
LICENSE EXPIRES
PHONE
Size of Parcel
ECK 15.6
Zone Classification
liMO r4'
Residential
Commercial 0
ADDRESS
a MCS
ZIP
5.
DESIGNER
PHONE
T at. Occupancy
N§y Const. Valuation
'6feyr-'n..C)
Spr nklered
❑res ONo ❑Rev'd.
Remodeled Valuation
Total Blddg.Fi000�r Area
S4 V
ADDRESS
'ZIP
Main Floor
Upper Floors
Gars eg /Storage
G eenhouse
6.
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE i NEW 0 ALT. VAD' N.
7. OF �/
WORK e4 BLD. ❑ PLMB. 0 MECH.
❑ RPL.
O M.H.
❑ MVE.
❑ POOL
0 OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. j Wellings
Corti! I. of Exempt.
or Variance
DESCRIBE WORK
8. AntGanAOt
�2Q.Kao�
Shorelines/Flood Hazard
Yes0 Not Apollc.0
Number
Required YesD No0
Received Yes❑ No❑ /`
Mans Requ red NTT/
Received PY
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
PUBLIC WATER
Cr
PRIVATE 0
SEWAGE
SEPTIC
SEWER 0
Ownership
Public 0 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
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 constiuctlon or the performance
of construction. SEE REVERSE SIDE FOR REOUIRED INSPECTIONS
SIGNATURE OFT) APPLICA I N
OWNER OR AGENIC-P-/(/'J%?T� DATE �'3
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire '
Prevent.
Engineer
Utilities
SEPA
Mans
Exam.
Building
Tech.
f
CA.- SE -T
T6 44N CNC- 14Coetri M r -r • 43PaoeA k-
�3
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
15 ..(9:1
Other (Specify)
TOTAL $ is' -`x'
PERMIT NUMBER
02* *75.00
*75006
A 1+0.00 8
31488
04.-21-83
2 6479.
WHEN
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
jja�i (� .i4, 7q _ G
DATE'ISSUE[Y'/I ! 813! PERMr4 .7' 9 5 * 7 5. 0 0 tTAL
1