1984, 05-29 Permit: 84A-4491 ResidencePLAN NUMBER
APPLICATIO!`:/P,ERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3875
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
1.
STREET ADDRESS
E I o 1 o 8 {-11-o amps pa°
L
2. fOT
OWNER PHONE
3. f.IKN P:TLE T14 CO NST i IJ t •
MAILING ADDRESS
BLOCK
.4
SUBDIVISION
PARCEL NO. 051.41 — 12_0
h 13 it
PHONE
2ss-ro83de
LEGAL DESCRIPTION:
fitt"Ci oP S/kVK't n 3 -234
s.4f sl )eta ►e wE.. ucfarr
ZIP
Actual Set Backs In Feet to.
I South 4?.I East est
North
I 2_o � 6J I W
} ZoneClassification
CONTRACTOR
4.
Sri?-wI E —
LICENSE EXPIRES
PHONE
Size of Parcel
�j• 3
Residential
Commercial 0
ADDRESS
ZIP
Type
Oupancy
to
Spr'nklered
DYes ❑No ❑Req'd
DESIGNER
5.
ADDRESS
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
ict&Z
ZIP
CHANGE OF USE FROM
6.
TYPE %ANEW
,7. OF
WORK J&BLD.
TO
Main Floor pl
14
Ck
Upper Floors
411'2-
Garage/Storage
❑ ALT. 0 AD' N. 0 RPL. 0 MVE.
❑ PLMB. 0 MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
Uncv. Deck
j7Co
No. Floors
FM..BBasement
Greenhouse
Unfin. Basement
Iii 2
No Fin. Rooms
No. Dwellings
(
Certlh. of Exempt.
or Variance
Required YesO No❑
Received YesO NoD
Number
8.DESCRIBE WORK /, 1190 tkr / r `
VALUATION
SOURCE
OF
UTILITIES
GAS
ELECTRIC
I( PUBLIC WATE
PRIVAT 0
Shorelines/Flood Hazard
YesO Not Applic. 0
Plans Required
Received JIIIC
SEWAGE
SEPTIC
SEWER
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 REVERSE -S 9.ROR RR flUIRED INSPECTIONS ////
GNATURE OF
O JQlfjrj(//.jj,�£�� APPLICATION 3_%6-5%`
OWNER OR AGENT J iv
SPECIAL APPROVALS
PRELIM FOAL DATE
Env. Health
Planning
Fire
/Prevent.
/ Engineer
VVV Utilities
terteSEPA
Plans
Exam.
Building
Tech.
4
7aJ
yip
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
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)
TOTAL $
124 °°
PERMIT NUMBER
atiM `1$ ?!
02* *424.'00
t* 424.006
A '°20,00 8
232.42
03-19-84
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE 11_462 9- 84
11_462 4 PERMIT A A 1. 5
424.0OZD+AL
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150
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