1984, 04-05 Permit: 84A-3011 Addition GaragePLAN NUMBER APPL ICAT [ON /PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY `-A ' fl
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREETADDRESS PARCEL NO.
1.
l
E Ido IZ-a'ytax->
LOT
BLOCK
SUBDIVISION
LEGAL DESCRIPTION:
2.
'5
I �
V tin.
OWNER
PHONE
PHONE
3.
6 r.x �,
906
MAILING ADDRESS
ZIP
Actual Set Backs in Feet to:
6 ' (C,,—, lZ t, d/JC,
`a V,'
North South
East West
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential
4.
1S-
—74 X V1!-4-
I --!W2
I Commercial ❑
ADDRESS
ZIP
TYR2 (2p nst.
Occupa y
Sprinklered
A yvt-e
❑Yes ❑No
❑Req'd.
DESIGNER
PHONE
Const. Val uatlon
Remodeled Valuation
I
Total Bldg. Floor Area
a t &e3F,
5C_
5.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
3
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
6.
PE
fff�:]
No.
No. Floors
No. Fin. Rooms
—
No. Dwellings
7.
NEW ❑ ALT. 8'AD' N. ❑ RPL. ElMVE.
OF�
❑OTHER
WORK BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL Certif I. of Exempt. Required Yes❑ NoV Number_
or variance Received Yes ❑ No ❑
8 DE IBE WORK_ Shorelines/Flood Hazard Plans Required ,
(nii�� Le -f1\00 Lam(( ON Yes Not Applic. ❑ Received �d
VALUATION I SOURCE GAS ELECTRIC I
OF PUBLIC ❑ SEWAGE Ownership FEES COLLECTED
9. UTILITIES PRIVATE ❑ SEWER ❑ Public ❑ Private ❑
1 hereby cehify that I have read and examined this application and have read the "NOTICE" provisions included on h�}
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 REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
SIGNATURE OF v P' q„� � �, APPLICATION /
OWNER OR AGEN? � •-- p� �/ .T DATE! _�/ �y Mach.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health _TA_T__
Planning
rire
Prevent.
Utilities
Plans ¢ PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS
Tech.
Plan Check
SEPA
Modular/
MFG.Home
Other (Specify)
TOTAL $ !7,,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEIS UED" ` PERMIT-Ikb.
*&AL
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