1983, 05-18 Permit: 83A-4250 GarageAPPLICATION /PERMIT
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, t%tiHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
LOT BLOCK SUeDI Isl N LEGAL DESCRIPTION:
2.
OWNER PHONE PHONE
3. i✓�t�
MAILING ADDRESS
ZIP
Actual Set Backs in Feet to:
I'll) 13z
X0
North tfS I South'S&> East
I West
CONTRACTOR o LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential }a
E
4.
p
-' 1 fl 11�4
It -By I --t, j
I
Commercial C
AD RESS
ZIP
Type Const.
Occupancy
Sprinklered
-5�
R01 Zai
v
Dyes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
-i ?_- t
I
T
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basem
6.
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
TYPE W ❑ALT. ❑ AD'N. ❑RPL. ❑ MVE.
—
7• OF ❑OTHER
WORK LD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
Certifi. of Exempt.
Required
Yes❑ No
Num er
or Variance
Received
Yes❑ No❑
8 D SCRIBE WORK
4( -f -410
Shorelines/ Flood Hazard /'
Plans Required
IDP_N)'1' 0
Yes❑ Not Applin
Received CR"
VALUATION I SOOURCE
9.
GAS _j___ELECTRIC
pUB IC ❑
SEPTISEWAGE
Ownership
FEES COLLECTED
�0 UTILITIES
PRIVATE ❑
SEWER ❑
Public ❑Priv
I hereby certify that I have read and examined this application and have read the "NOTICE"
cluded on
reverse side, and know the same to be true and correct. All provisions of laws and ordinanceshis type of
Buildingwork
will be complied with whether specified herein or not. The granting of a permit does no give au-
::ate
thority to violate or cancel the provisions of any other state or local law regulating constructirformance
of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
Mach.
SPECIAL APPROVAL'S
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Plan Check
/r Env. Health
SEPA
Planning
Utilities
Plans pPERMIT IS NONTRANSFERABLE
Exam. ` T `I PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
BuilYng .t &- �_ . )n IN 180 DAYS
Modular/
MFG. Home
Other (Specify)
�'i
TOTAL $ `�
WHEN MACHINE VALIDATED
THIS BECOMES A PERMIT.
PERMIT NUMBER
DATEYSSUEJ 8 - 8 3 PERMIAN. 5. 0 6 * 8 2' 0 0 �TAL
D
C
C
u
u
Serving the Inland Empire
-11:11= nef/x is Coaxtity STEEL BUILDING—ST.114C.
__
NORTH 1220 FANCHER WAY SPOKANE, WASHINGTON 99206 r. ,(509)5359016 1-800-5727-5641
,...
GENERAL CONTRACTOR • LICENSED • BONDED • INSURED . . . . . . for your protection
171,-_,`,----;'' '• ,' ,' --_-,:
(Lic. No. TO-WN-CS-B263S9)
Name VENT-, fa-. 9..2g-eo Go,
f\T ry)
Address )
City 5PO 12011,15- State Ceifrck-s-
county nTokt9yvte cfcr,)_e)
Teophcn.
RepreenfltakCtrve t I YS -ii / -0301- 2.
Source of Lead tiO -re fri ik)NOSi 1400 LI G7
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