1983, 09-13 Permit: 83A-8977 Addition GaragePLAN NUMBER APPLICATION/PERMIT PERMITNUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY' 93A ecF? 7
r
NORTH 811 JEFFERSON / SPOKANE, -WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL N0.
1 8 -A -v, -Z:54;S I—c 1p
LOT
BLOCK
SUBDIVISION
LEGAL DESCRIPTION:
2• 3
I 1�
6c�cWc�fl�i'�co v
OWNER
PHONE
PHONE
3. ►�ttcwa�i Kvu-_C 5
534--G n 5�
MAILING ADDRESS
ZIP
Actual Set Backs in Feet to:
tL01�►�!
Q 2(2—
North South-+ East West '
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classif ication
Residential
4
7211C 2
Commercial ❑
ADDRESS
ZIP
T Con t.
Oceupancy
Sprinklered
,r —
Dyes ❑No ❑Req'd.
DESIGNER
PHONE
Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
5.
ADDRESSZIP
Main Floor Upper
Floors
Garage/Storage
Greenhouse
SSi
CHANGE OF USE FROM
s.
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE NEW El ALT. f1
/AD' N. El RPL. 11 MVE.
No. Baths 7No.
Floors
No. Fin. Rooms
No. Dwellings
7. OF ❑OTHER
Certifi.ofExempt.
Required Yes❑ No❑
Number
WORK ® BLD. ElPLMB. 1:1MECH. ❑ M.H. ❑ POOL
or Variance
Received Yes❑ No❑
8 D SCRIBE WORK
—rd
Shorelines/ Flood Hazard
Plans Required ly
/iCc," 'CIA)CLP,yt7 ` X -2A
Yes❑ NotApplic.❑
Received Ld
VALUATION
9
I SOURCE
OF
GAS
ELECTRIC
I WATER
PUBLIC ❑
SEWAGE
SEPTIC
Ownership
FEES COLLECTED
UTILITIES
PRIVATE ❑
SEWER El
Public ❑ 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 o be true and correct. All provisions of laws and ordinances governing this type of
�I
work will be complied with wheth r specified herein or not. The granting of a permit does not presume to give au-
Building •�
thority to violate or cancelt pr isions of any other state or local law regulating construction or the performance
of construction. SEE REVERSE DE FOR REQUIRE SPETIO S
Plumbing
SIGNATURE OF APPLICATION
OWNER OR AGENTL�bz,DATE
Mech.
SPECIAL APPROVALS
SPECIAL coITI (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
,kK-f Gt,y f!t . /�3�� i, Ae
Plan Check
�
SEPA
Planning
Modular/
Fire
MFG. Home
>_
Prevent.
dC
Engineer
Other (Specify)
V
W
J
Utilities
f�
TOTAL
SEPA
$
WHEN MACHINE VALIDATED IN
THIS SPACE,
Plans
PERMIT IS NONTRANSFERABLE
THIS BECOMES A PERMIT.
Exam_
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building
Tech. (
IN 180 DAYS
((�� 9' 1
9UED` 3 - 8 3
R 9 7 O J
/' z * 6 1. O O f0l�AL
DATEY PERMITYVO.