1984, 02-27 Permit: 84A-1618 GaragePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - DEPARTMENT OF BUILDING &SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT- COMPI ETE NUMBERED SPACES DRESS HARD TO MAKE 3 COPIES
STREET ADIRADDRESS L
tZ,p. Utz
PARCEL NO. .7-t154— 4 _ 1Zl 5
Lo -T-
2.5
OWNER
BLOCK
I2
SK.I I�/I&kJ frc- Aodt
3. `foN SKANIN1
MAILING ADDRESS
IIs. IZZ�3
CONTRACT9R
4. SAM 0 -
ADDRESS
PHONE
7zz-t 191
LICENSE EXPIRES
PHONE
PHONE
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North !J I South
2 X Igo
11 Zoon C;assificat
East
West
Residential g
Commercial 0
ZIP
Tyjoirs
Occupancy
Spr nklered
❑Yes ONo OReq'd.
DESIGNER
5. ADDRESS
PHONE
New Const Valuation I Remode ed Valuation
7sob° 5760
Total Bldg. Floor Area
ZIP
Main Floor
Upper Floors
Garage/Storage
/76
Greenhouse
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unf In Basement
TYPE 14,EW ❑ ALT. ❑ AD.N.
7. OF
WORK BLD. O PLMB. 0 MECH.
O RPL.
O M.H.
❑ MVE.
❑ POOL
0 OTHER
NO. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifl. of Exempt.
or Variance
Required Yes❑ No❑
Received VesO No❑
8.
9.
DESCRIBE
VALUATION
SOURCE
F
UTILITIES
e 1\10 cwt
SE AGE
SEPTIC
SEWER 0
ECTRIC
WATER)
PUBLIC 9
PRIVATE 0
Shorelines/Flood Hazard
Yes❑ Not Appnc.0
Ownership J
Public 0 Private Id
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 pr visions of any other state or local law regulating construction or the performance
of construction. SEE REVERS $ E EOUIRED INSPECTIONS
SIGNATURE OF APPLICATION�7. �a- J t
OWNER OR AGENT ( DATE d -r
SPECIAL APPROVALS
PRELIM. FN��AL DATE
INn9 Q%g0/
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Rare
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Number
fd
Plans Required
Received
m
FEES COLLECTED
Building
Plumbing
Mech
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
PERMIT NUMBER
224-A- ((oI e
02*
A
14692
00
2006
0.00
2-22-
2 6479.
02* *6800
*6800
*000 8
A
1 47.02
02-22-84
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
• . h : .• H,
0 �2 - 2 7 T8"4
1618z
DATE ISSUED I' PERMIT NO.
•
*68.00.-:
TOTAL
99-
L
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AO
&A.(
C
19
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