1984, 01-16 Permit: 84A-440 GaragePLAN NUMBER
APPLICATIOt /PERMIT Ns•
SPOKANE UJUNTY — DEPARTMENT OF BUILDING& SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1. t✓ 107 2aj
k 6ij ( Vi 6tiv ,,A9
PARCEL NO.
075151 — o3v I
LQT
2.
OWNER
3 GL -rte, s jz—
M ING ADDRESS
I2%� v Dim.
LICENSE EXPIRES
BOCK
5 151 N"/IUt'V ,t -FJ nM- Alice -r.
4.
CO rghc700RR
PHONE
PHONE
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North ICP ISouth
Size of Parcel/
tco7C 110
!East I West
Zone Classification
Residential B'
Commercial 0
ADDRESS
ZIP
Type C Inst
OaupaIncy
Sp nklered
❑Yes ONo CAN 'd.
5.
DESIGNER
PHONE
New Co
ist. Val atlon
Remodeled Valuation
Total Bldg. Floor Area
ADDRESS
ZIP
Main Floor
Upper Floors
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv. Deck
Garage/Stoe,
17/
Fin. Basement
Greenhouse
Unfin Basement
TYPE
7. OF
WORK
W 0 ALT. 0 AD' N. 0 RPL. 0 MVE.
0
BLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certih. of Exempt.
or Variance
Required YesO No0
Received Yes No❑
Number
DESCRIBE WO O
8. b
9.
VALUATION SOURCE
OF
UTILITIES
ELECTRIC
PUBLIC s
PRIVATE 0
SEWAGE /
SEPTIC
SEWER D
Shorelines/Flood Hazard
YesO Not Aeolic.❑
Ownership
Public 0 Private
I 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 provisions of any other state or local law regulating construction or the performance
of construction. SEE REVER SIDE FOR INSPECTIONS
SIGNATURE OF nn APPLICATION !�
OWNER OR AGENT d/ir — DATE �� r(
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NO
CE)
PERMIT IS NONTRANSFERABLE
PERMIT 15 NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Ram Required 0
Received 0
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $ 6!
PERMIT NUMBER
12A -f1/4 — 440
02* *61.00
*61.006
A *0.00
43.92
01'-16-84
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0DATE ISSUE U
PERMITNO.Y 0 5
*6100aOTAL
GA~
Lc1I
F\M7ZVV Me:
iki901.-f.