1984, 05-24 Permit: 84A-4454 ResidencePLAN NUMBER
APPLL ATION%PERMIT
'SPOKANE COUNTY — DEPAAAAAABTMENTOF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COM
PLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
1.
STREET ADDRESS
t:.G 404
1-koL;miss N 120R0
PARCEL NO.
b'544Z-0`503
LOT
2.
BLOCK
SUBDIVISION
JCD4rvstoK.,t &DO i -CC 011
3.
OWNER
--\1M 'N1 Drv'CCaAMtBR-N
PHONE
/PHONE
qzZ- A 50
LEGAL DESCRIPTION:
MAILING ADDRESS
ZIP
4.
5.
CO TRACTOR
qe'4 T—o-r
LICENSE EXPIRES
Pei2A°-aadE3
Actual Set Becks In Feet to: ...
North (South o [�c ' (East 5b' I West e.4
Sized Parcel Zone Classification
1(o$ St‘e5
Residential V
Commercial 0
ADDRESS
S. -sat
0 NE.s
DESIGNER
ZIP
Type Const.
3CrJ
Occupancy
t-
Spr nklered
DYes DNo 0Req'd.
PHONE
Mew Const. Valuation
11Z •
Remodeled Valuation
Total Bldg. Floor Area
ADDRESS
ZIP
Main Floor
ZkSO
Upper Floors
Garage/Storage
Ent
G eenhouse
6.
CHANGE OF USE FROM
TO
Cover Deck
UC 1.0
Fin. Basement
1 1(00
Unfin. Basement
TYPE p EW 0 ALT. 0 AD' N. 0 RPL. 0 MVE.
7. OF
WORK BLD. 0 PLMB. 0 MECH. ❑ M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
2 -
Certlfi. of Exempt.
or Variance
No. Fin. Rooms
CO,
Required YesD Noll
Rselved Yes❑ No❑
No. Dwellings
1
Number
DESCRIBE WORK
8. Cr-1D61vC.G
Shorelines/Flood Hazard
YesD Not AppPic. 0
Plans Requ red
Received 2'
VALUATION
9.
SOURCE
F
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC
PRIVATE 0
SEWAGF�
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 construction or the performance
of construction. SEE RE : SE SIDE FOR REQUIRED INSPECTIONS
SIGNATURE OF
OWNER OR AGENT
APPLICATIO
DATE
Ov. 3,(483
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
aidusia
Planning
Fire
Prevent.
Engineer
?.04
Utilities
SEPA
Plans
Exam.
Building
Tech.
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
Other (Specify)
52$.00
TOTAL y 5Z8 -c
PERMIT N UmBE84�
02* *52800
*`'29006
A *0.00
125.62
11-G3-83
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEQSSU€D2;4 -'8 4 PERMIT44.5. 4'= *5 2 8. 0 n gOTAL
A
COMMENTS:
S
C'
I
1 SET BACKS
2 FTGS & FORMS
3 STEEL
4 PROGRESS
5 BOND BEAMS
6 ROOF DECK
7 FRAMING
�.
8 INSULATION
9 SPECIAL INSP.
10 ASSEMBLY
11 FIREPLACE
12 EXTERIOR FINISH
13 DRYWALL
14 EXT. GRADING
15 FINAL
16 GRD. PLBG.
17 WATER PIPING
18 DWV TEST
19 FIkTURES
20 SEWAGE DISP.
21 SEWER
22 WATER HEATER
23 PROGRESS
24 WATER SERVICE
25 ROOF DRAINS
26 FINAL
38 VENTILATION SYS.
39 PLENUM & DUCT
40 GAS TEST
41 FURNACE
42 DAMPERS
,
43 INLET/OUTLET
44 COMPBUSTION AIR
45 COMPRESSOR
46 APPLIANCE
47 FIRE DAMPER
48 SMOKE DETECTOR
49 HOODS
50 PROGRESS
51 FINAL
52 FINAL INSP.
53 FIRE PREVENT.
54 OCCUPANCY/TEMP.
55 REQUESTED It
56 OCCUPANCY/FINAL
57 OCCUPANCY/OTHER
1
58 COMPLAINT/ZONE
-I
59 COMPLAINT/BLDG. 1_,
t
.
60 COMPLAINT/OTHER
COMMENTS:
S
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