1984, 01-13 Permit: 84A-335 DamperPLAN NUMBER
APPLICATION/PERMIT
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
1. .3 /606 /lactic •
PARCEL NO.
LOT
2.
BLOCK
SUBDIVISION
3 KAiR Aid ti
MAILING ADDRESS
a 00 cp /1064
PHONE
9a7 -g18'/
PHONE
LEGAL DESCRIPTION:
ZIP
Actual Set Backs In Feet to:
North ISouth
East
West
NTRACTOR
4. nepstst PRAIRi c iAmts Cu S/ow yu�y
ADDRESS
€��a7 8 tieloo Ca WI
DESIGNER
5.
LICENSE EXPIRES
.9-8v
PM'
Size of Parcel
1 Zone Classification
Residential 0
Commercial 0
ZIP
9'9.267 —l6 f8
PHONE
Type Const.
Occupancy
Sp nklered
DYes DNo DReq'd.
New Const Valuation
Remodeled Valuation
Total Bldg Floor Area
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
6.
CHANGE OF USE FROM
TO
Gover Deck
Uncv. Deck
liNo Dwellings Unfin.
Basement
Basement
TYPE H'NEW
7. OF
WORK 0 BLD.
D ALT. 0 AD' N. 0 RPL. 0 MVE.
0 PLMB. R'MECH. 0 M.H. 0 POOL
0 OTHER
NO. Baths
No. Floors
No. Fin. Rooms
Certif1. of Exempt.
or Variance
Required Vest Not
Received Yes° No0
Number
8.
SCRIBE WOR
Shorelines/Flood Hazard
Vest Not Apollc.0
Plans Required 0
Received 0
9.
VALUATION SOURCE GAS ELECTRIC vPU9LTE
IC
UTILITIES PRIVATE 0
SEWAGE
SEPTIC 0
SEWER 0
Ownership
Public 0 Private 0
1 hereby certify that I have read and examined this appl cation 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 SIDE FOR REQUIRED INSPECTIONS
SIGNATURE OF
OWNER OR AGENT
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
yi3
APPLICATION
DATE/i_ I
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 $a0-0-0
PERMITNUMBER
LL22JJ�r�rff�IAA�1
04* *2000
*2000
A *000
33.38
01-13-84
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
((jj
11 cof.j.,y.p ,
DATEVSSU
EDc 3� — 4'
PERMIT Na. 3' 5 z * O' 0 O fOYAL