1983, 05-11 Permit: 83A-3913 GaragePLAN NUMBER APPLICATION/PERMIT
SPOKANE COUNTY - DEPARTMENTOF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
1.STREET ADDRESS PARCEL NO.
LOT BLOCK SUBDIVISION 11 FC,A1 r1FSr.PIPTION-
2. 2— 3 V
OWNER
MAILJNG ADDRESS
PHONE 1.PHONE
ZIP
Actual Set Backs in Feet to:
SPECIAL
DATE
Env. Health
Planning
Prevent
Engineer
Utilities
SEPA
Plans
Exam.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $ Vo I
WHEN MACHINE VALIDATED IN THI
THIS BECOMES A PERMIT.
PERMIT NUMBER
DATEUSSUERL I— 6 3 PERMITNO. 13 6 & S A n n WMAL
0
C
C
U
U
QC�i oz �
North " South East ...�%�'+� West ?-Z:
CONTRACTOR
'
LICENSE EXPIRES
PHONE
Size of oel
�>
Zon Classification
Residential
tC 1217 �kacy�2S
4.
q I �Z
" I
Commercial ❑
ADDRESS
Z P
Type st. Oocupanc
Sprinklered
�QCSs�_�
❑Yes ❑No ❑Req'd.
DESIGNER
PHONE
Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
-const.
y-^
ADDRESS
ZIP
Main Floor Upper
Floors Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck Fin. Basement
Unfin. Basement
6.
--•
--
TYPE i2fNEW E3 ALT. C3 AWN. El RPL. ElMVE.
No. Baths No.
Floors
l
No. Fin. Rooms
No. Dwellings
I
7. OF❑ OTHER
WORK 1� BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
Certif I. of Exempt.
Required Yes❑ N01'Number
or Variance
Received Yes❑ No❑
DESCRIBE WORKShorelines/Flood
8 l 4,C.1 64TZ_taCt(-_G ���
Hazard
Plans Required
-I,,-_"3
yes Not Applic. ❑
Received P/
VALUA aON
9
SOOU�CE
GAS
ELECTRIC
PUBIC WATER
SEPTIC L%1
Ownership
FEES COLLECTED
UTILITIES
PRIVATE ❑
SEWER ❑
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
.6•o5
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 REV ASEAIDE FOR REOUIRED INSPECTIONS
Plumbing
SIGNATURE OF APPLICATION 4 s
q ' �c
OWNER OR AGEN DATE
t_'32
Mach. _
SPECIAL
DATE
Env. Health
Planning
Prevent
Engineer
Utilities
SEPA
Plans
Exam.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $ Vo I
WHEN MACHINE VALIDATED IN THI
THIS BECOMES A PERMIT.
PERMIT NUMBER
DATEUSSUERL I— 6 3 PERMITNO. 13 6 & S A n n WMAL
0
C
C
U
U
COOK BROTHERS CONTRACTING
Route 2 Box 853 B
OTIS ORCHARDS, WA 99027
(509) 924-1557
JOB V5 R -CA//
SHEET NO.
CALCULATED BY DATE
CHECKED BY DATE
SCALE
FORM 204 Available fromERS INC. Towneentl, Mass 07 70