1983, 06-21 Permit: 83A-5575 GaragePLAN NUMBER APPLICATION/PERMIT
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE,' WAStUNGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL N0.
(o'�.0 k�-C7cZIL"vN -Oct l3
Lo F�jK
cSUBDIVISION LEGAL DESCRIPTION:
2. 1
OWNER PHONE PHONE
3. Q. W Ecz.rv+6rz.. S'SS-4-3
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
(0--)' 0 r V Q;w:—' North South 3t East ®/ West
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of rceX
Zone Classification
Residential
4.
J Z,� C
al ❑
ADDRESS 1
ZIPOccupancy
11Const.
Sprinklered
'SA YV16-
I
M-1
❑Yes ❑No ❑Req'd.
DESIGNER
PHONE
Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
Nq 4 G o'b I
_
1 15'7 4
5.
ADDRESS
ZIP
Main Fla"Upper
Floors
Garage/Storage
Greenhouse
�,
57<. 1
CHANGE CIF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
In
TYPE
No. Baths No.
Floors
No. Fin. Rooms
No. Owel�ings
❑ALT. ❑ AD'N. ❑RPL. ❑ MVE.
`
7. OF El
ElOTHER
WORK BLD. ❑ PLMB. ❑ MECH. ❑ M. H. ❑ POOL
Certifi.ofExempt.
Required
Yes El NoVT
NuTbor�—
or Variance
Received
Yes❑ No❑
I
DESCRIBE WORK
8•; (`Z'}) _-;L
Shore] Ines IFlood Hazard
0C
Plans Required Nf
C,i�LQ iPr t0.( .
Yes❑ Not Applic. ❑
Received Q7
VALUATION
SOURCE
PUBLIC
GAS
ELECTRIC
g
6
/
SEWAGSEPTIC (3
�h�p
FEES COLLECTED
9•
UTILITIES
PRIVATE ❑
SEWER ❑
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 to be true and correct. All provisions of laws and ordinances governing this type of
691 ,m0
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
Plumbing
SIGNATURE OF APPLICATION ice/ r `
OWNER OR AGENT DATE a /�
Mach.
SPECIAL APPROVALS I SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Env. Health I ON
• I t^h/
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building_ IN 180 DAYS
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
PERMIT NUMBER
'_?r7
TOTAL $ =}__
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE I3 46-2 1 — 8 5 PERMIT N�.5 7. 5 z * 6 1. 0 �Wo A -L
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