1984, 01-04 Permit: 84A-063 ResidencePLAN NUMBER APPLICATION /PERMIT
SPOKANE COUN ITY — DIE-PAKI MENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
ADDRESS C
ZIP
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
Occupancy
STREET ADDRESS
Sprinkle ed
PARCEL NO.
1.
-70,3
S® K.0,e&
❑Yes ❑Req'd.
DESIGNER
PHONE
LOT
BLOCK
SUBDIVISION
LEGAL DESCRIPTION:
2.
til
'Ze
12,!0,DiC/
5.
OWNER
3
PHONE
PHONE
MAILIW ADDR SS
ZIP
ZIP
Actual Set Backs in Feet to:
Garage/Storage
Greenhouse
re ^ Z)(
— ,<x
Pte/
North South J^
East ' / West er /
CONTRACTOR
CHANGE OF USE FROM
LICENSE EXPIRES
PHONE
Size of Parcel
Fin. Basement Unfin. Basem,
Zone Classification
Residential Ri"
4.
_�509L41
/ OIC'
,
FloorsNo.
+T
Commercial ❑
ADDRESS C
ZIP
Type�CoVt.
Occupancy
Sprinkle ed
❑Yes ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
1 ®5-
5.
ADDRESS
ZIP
Main Floor, Upper
Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement Unfin. Basem,
6.
!-�
/ OIC'
No. Baths No.
FloorsNo.
Fin. Rooms
No. Dwellings
TYPE i�EW El ALT. ElAD' N. 11 RPL. ❑ MVE.
1.
7. OF ❑ OTHER
WORK 2-6L D. ❑ PLMB. ❑ MECH. ❑ M. H. ❑ POOL
Certifi. of Exempt.
Required
Yes LJ No❑
Number
or Variance
Received
Yes❑ No C1
8 DESCRIBE WORK
Shorelines/ Flood Hazard
Plans Required
/ r�i%0L.��c'4 � 4-f/XW01_
Yes❑ Not Applic. ❑
Received B-'
VALUATION
SODURCE
GAS
EL TRIC
P ATEBLICRs�
SEWAGE SEPTIC ❑
Ownership
FEES COLLECTED
9
UTILITIES
PRIVATE ❑
SEWER
Public ❑ Private H
I hereby certify that 1 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
Building
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 REVE IDE FOR REQUIRED INSPECTIONS
Plumbing
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE /
Mach.
SPECIAL APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE!)
PRELIM. FINAL DATE
Plan Check
Env. Health
SEPA
Planning
Modular/
MFG. Home
Fire
Prevent.
Utilities
Plans0��s PERMIT IS NONTRANSFERABLE
Exam. 3 PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building / (� IN 180 DAYS
Tech.
Other (Specify)
TOTAL $
WHEN MACHINE VALIDAT
THIS BECOMES A PERMIT.
DATE>S9UEDL
PERMIT NUMBER
00
PERMIT NO. -J � ' * 4 Li. L' C11 e fOi-AL
CL
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V
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9a'
'00 01/
Z-7 o 3 SO L 7-71 ADP, C 4.)