1984, 04-18 Permit: 84A-3508 GaragePLAN NUMBER APPLICATION/PERMIT PERMITNUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY �-� ' --5s; 8
NORTH 811 JEFFERSON / SPOKANE"WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES —PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
_
(f L(( � �l
LOT
BLOCK
SUBDIVISION
LEGAL DESCRIPTION:
2.
- ,
OWNER
PHONE
ON E
3� i�.0 .� M z-2 s
i(o Z
MAILING ADDRESS
ZIP
Actualt Backs In Feet to:
v
• 5� I -2 7
/,
`tel 2-2
North South East West
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential
4.—�,AC-1 �i t` �(S ry G�
�T J _
Commercial ❑
ADDRESS
ZIPT
Const.
Occupancy
Sprinklered
Dyes ❑No ❑Req'd.
�j r 1005 6�
--I
DESIGNER
PHONE
New Const. Valuation
Remodeled ValuationTotaldg.
Floor Area
roCy8
b
5.
C
ADDRESS
ZIP
Main FloorTUn
Floors
Gareorage
Greenhouse
.
CHANGE OF USE FROM
TO
Cover Deck
. Deck
Fin. Basement Unf in. Basement
s.
TYPE';?BL
No. Battu No.
Floors
No. Fin. Rooms
No. Dwellings
EW ❑ ALT. 11AWN. ❑ RPL. ❑ MVE.
7. ❑OTHER
CertifI.ofExempt .
Required Yes❑ Nok---
Numberi
WORKD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
/
or Variance
Received Yes❑ No❑
DE CRIBE WORK
8•
Shorelines/ Flood Hazard
Plans Required
�4Q
Yes❑ Not Applic. ❑
Received
VALUATION
I SOURCE
of
GAS I
ELECTRIC
I WATER
PUBLIC
SEWAGE
SEPTIC
Ownership
FEES COLLECTED
9 UTILITIES PRIVATE ❑ SEWER ❑ Public ❑ Private ❑
1 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
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
SIGNATURE OF fe APPLICATION
OWNER OR AGENT DATE
SPECIAL APPROVALS SPECIAL CONDITI S: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health �y
Planning
tngmeer
Utilities
Plans a PERMIT IS NONTRANSFERABLE
Exam. (( PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS
Tech.
Building <�2i .Gla;,
Plumbing
Mach.
Plan Check
SEPA
Modular/
MFG.Home
Other (Specify)
TOTAL
WHEN MACHINE VALIDATED IN
THIS BECOMES A PERMIT.
W;
DATEYS#UWo- 8 — 8 4 ?ERMA4. 0. 8 60 * 6 1. 0 0 QOrAL
CL
c
c:
LL
LL