1984, 02-06 Permit: 84A-1002 ResidencePLAN NUMBER
APPL ICAcT ION /PERMIT
PERM T NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING
& SAFETY b4A
-10,02,
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES -PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
,. s, •Ion ITA PPV V� 20513 -
f 72,E
LOTBLOCK
SUBDIVISION
LEGAL DESCRIPTION:
2.25
,
I m i ccs
PSK 0 or,3
OWNER
PHONE
PHONE
- L
3.
MAILINGADDRESS
ZIP
9 C,
Actual Set ks rn Feet to:
1 I i
Z
11bi V
(?
North 5 South East
West
CONTRACTORLICENSE
r
EXPIRES
PHONE
Size of Parcel r
f 20.00
ZoneClassification
� ��
Residential
�
Commarcia ❑
4.
( L b
ZIP
Typte imi .
Occupancy
Sprinklered
ADDRESS
Dyes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
ADDRESS
ZIPn
lour
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck Uncv. Deck
Fin. Basement
Unti��as ment
6.
et�J1�
TYPE
TY .NEW ❑ ALT.
No. Baths No. Floors No. Fin. Rooms No. Dwellings
❑ AD'N. ❑ RPL. ❑ MVE.
7 11 OTHER
WORK J!4.BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL Certif I. of Exempt. Required
Yes❑ No❑ Number
or Variance Received
Yes❑ No❑
DESCRIBE WORK��.r
8•
Yes0ines/Flood Hazard
I �1��-� Yes❑ Not Applic. ❑
flans Required
Received ❑
AGF Ownership
VALUATION SOOUFCE GAS ELECTRIC PUBLIC ❑ SEWATER PTic
9•
FEES COLLECTED
UTILITIES
PRIVATE ❑ SEWERR''❑❑ Public ❑ Private ❑
I 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
Building 2% d�
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
FO REQUIRED INSPECTIONS
Plumbing
SIGNATURE OF
APPLICATION ,�//
- / -c�'T"
Mech.
OWNER OR AGENT
DATE �?
SPECIAL APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Plan Check
inv. Health
Sr z
SEPA
'fanning
Modular/
MFG. Home
y,
-ire
prevent.
CL.
C
Engineer
Ole
Other (Specify)
C3
LU
Utilities
U.
TOTAL $
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
V/ Plans �/�
PERMIT IS NONTRANSFERABLE
THIS BECOMES A PERMIT.
Exam. 1
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building+
Tech.
r5l
IN 180 DAYS
((�� " Q
DATAZiD0 6— S 4 PERMIT�(Cl 0, 2 z
* 9 6. 0 r 1na�L
PLo7 PL 4 N w
L o -F ZS &Lock I /P//`C.4 1`49 R c,gct: Ion
ti
l Zo.00
i
P �1%
MICA 1,
I �^
I J i 1
j
1