1984, 04-19 Permit: 84A-3553 Residence PLAN NUMBER APPL ICAT I9N{,PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY 4e31A - 3.5-5
NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
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APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. 5020 H. REES ROAD 35643-1701
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. 1 2 HENDRICKSON SUBDIVISION Lot 1 in Block 2 of HENDRICKSON SUBDIVISION,
OWNER PHONE PHONE as per plat thereof recorded in Volume 15 of
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3 iIMALAYA HOMES, INC. 535-6602 ` . -,
AcppAtiks gia tol0 J -
MAILING ADDRESS ZIP
S. 104 Freya, Suite 104B 99202 North t 5 I [South East I west -Z---1 i . .
CONTRACTOR ) LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑
4. same / _ 8d k ‘ C Commercial❑
ADDRESS ZIP Type Const. Occupancy Sprinklered
fu t-, 3 Oyes ❑No ❑Req'd.
DESIGNER PHONE Const.Valuation '` Remodeled Valuation Total Bldg.Floor Area
5. . 4"7 -
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse
6:15z—
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unfin.BBT t
6. ,� —
/ No.Baths No.Floors No.Fin,Rooms No.Dwellings
TYPE L� NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. 'Z e. `
7• OF ❑ OTHER _
WORK
EI/BLD. ❑ PLMB. ❑ MECH. ❑ M.H. El POOL Certifi.of Exempt. Required Yes Nor' Num�r�
or Variance Received Yes❑ No❑
DESCRIBE WORK Shorelines/Flood Hazard Plans Required f
8. VRCst aCN3C:: Yogi: Not Applic.❑ Received V
VALUATION SOOURCE GAS ELECTRIC PUBLIC WATER SEPTIC Ownership FEES COLLECTED '
9 UTILITIES PRIVATE❑ SEWER❑ Public❑Private❑
I hereby certify that I have read and examined this application and have read the "NOTICE' provisions included on j
reverse side,and know the same to be true and correct. All provisions of laws and ordinances governing this type of Building Z1�`'
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 Plumbing
SIGNATURE OF APPLICATION , G� /
OWNER OR AGENT • . . - !.'" ii s DATE O T Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health A
J f f, 7 I e SEPA
Planning Modular/
MFG.Home
Fire
Prevent. a
Engineer —' 4100AW/4 /{e-/, Other(Specify) W
�rk'F,/ y' J
Utilities `-"(G-CO
TOTAL $
SEPA
PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE,
Plans THIS BECOMES A PERMIT.
Exam. 4P1(ir PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Buildinge ( f �� IN 180 DAYS '^
Tech. �%�� �1 n
Ic/ DATE4StlUER1 y— R 4 PERMIT N6. 5 7 '5. * 2 j�,U, U U �I�4L
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WATER DISTRICT:
• CONSOLIDA'1'hD IRRIGATION
CONTRACTOR:
HIMALAYA HOMES, INC.
a�
1 -
I •
. PROPERTY ADDRESS:
i • N. 5020 Rees Road
LEGAL DESCRIPTION:.
A Lot 1 in Block 2 of
- 4 ' HENDRICKSON SUBDIVISION,
_ .
_'_ t s per: plat-thereof recorded
t9
in Volume 15 of Plats, page 16
. _ ..._... .. ._ _ PARCEL.NUMBER
:_ 35643-1701
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