1984, 02-02 Permit: 84A-938 GaragePLAN NUMBER APPL ICAT ION /PERMIT PERMIT NUMBER
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 PARCEL NO.
1. NI). Z.�i 7 ��t�z:1`�
LOT I BLOCK I SUBDIVISION LEGAL DESCRIPTION:
2. 2 4 -
OWNER
OWNER PHONE PHONE
3. --1 i..ro.ly ��.� d' —
MAILING ADDRESSIP
Actual Set Backs in Feet to:
k ' `r_>S
CIO l
North C.' I South East
4t i , West -Ar,-A'
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential
-qQNTRACTOR
f�fv`aE sv /V "tom
4.
Z _ —ZZ -7i...
IZ2 5 LtL� .�
Commercial ❑
ADDRESS
ZIP
Type t. Occupancy
Sprinklered
�V�-tr
Dyes ❑No ❑Req'd.
DESIGNER
PHONE
lkow Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
ADDRESS
ZIP
Main Floor Upper
Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
6.
. _..
•_- _
—
TYPE
110' No.
Floors
No. Fin. Rooms
No. Dwellings
& EW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7. OF ❑OTHER
WORK BLD. ❑ PLMB. ElMECH. ❑ M.H. ❑ POOL
Certifi.ofExempt.
Required
Yes❑ NoW
Number
or Variance
Received
Yes❑ No❑
DESCRIBE WORK
8•
Shorelines/ Flood Hazard
Plans Required gel
�C_occ> <5:: - �C i<ii� Ox��C?,
Yes Not Applic. ❑
Received
VALUATIONSOOUFCE
OF
GAS
ELECTRIC
pWAUBLICR
SEPTIAC
U"nership
FEES COLLECTED
9
PRIVATE ❑
SEWER ❑
Public ❑Private19/
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions incl]udedn
reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing thiBuilding
054,
work will &a complied with whether specified herein or not. The granting of a permit does not presume to
thority to violate or cancel the provisions of any other state or local law regulating construction or the perfof
construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
SIGNATURE OF ° APPLICATI wOWNER
OR AGENT DATE
Mach.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR N
PRELIM. FINAL DATE
Env. Health 2
Planning
Fire
Prevent.
Utilities
Plans thv iPERMIT IS NONTRANSFERABLE
Exam. k t� PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS
Tech. 4� Y36
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
O�
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATS�UE6 2 0' 4 PERMIT Nd . 3, 8 6 * 5 4 0 0
E'iTOTAL
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30�
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20'7 Nope=s
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