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1984, 04-06 Permit: 84A-3034 ResidencePLAN NUMBER APPL LCAT ION /PERMIT SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 APPLICANT: COMPLETE NUMBERED SPACES -PRESS HARD TO MAKE 3 COPIES STREETADDRESS PARCEL NO. 5- I� � f J A2_ - ' c �- T BL CK SUBDIVISION _ I LEGAL DESCRIPTION: 2. ZIP Main Floor Upper Floors Garage/ rage Greenhouse OWN R 5 P N (p PHONE 3. Plans CHANGE OF USE FROM o Cover Deck Uncv. Deck Fin. Basement Unfin. Basement MA LING DD ESS 0- j U Actual Set Backs in Feet to: 2 - 0 1 �U No. Fin. Rooms 1 North South East West 40 CONTRA T R L 7 OF 1:1 OTHER LICENSE EXPIRES PHONE Size .f�rcel Zone Cl s'ficat' n Residential Yes❑ No❑ V or Variance Received Yes❑ No❑ r DE IBE WORKShorelines/Flood - Commercial ❑ 4• ADDRESS Yes❑ Not Applic. El Received ❑ ZIP Typest. upancy Sprinklered Ownership FEES COLLECTED 9 UTILITIES PRIVAT ❑ SEWER ❑ Public ❑Private Dyes ❑No ❑Req'd. DESIGNER rF— its work will be complied with whether specified herein or not. The granting of a permit does not presume to give au- PHONE New�n�t. V Iu�Io ll//,, Remodeled Valuation Total Bldg. Floor Area 5. SIGNATURE OF APPLICATION OWNER OR AGENT _ _ - _ DATE Z� DATE Mach. ADDRESS ZIP Main Floor Upper Floors Garage/ rage Greenhouse 1 Plans CHANGE OF USE FROM TO Cover Deck Uncv. Deck Fin. Basement Unfin. Basement 1 rj No. Baths No. Floors No. Fin. Rooms No. Dwellings TYPE ."MW ❑ ALT. ElAD' N. ❑ RPL. E]MVE. 7 OF 1:1 OTHER _F WORK BLD. ElPLMB. ElMECH. 1:1 M. ElPOOL Certifi.ofExempt. Required Yes❑ No❑ Number or Variance Received Yes❑ No❑ DE IBE WORKShorelines/Flood Hazard Plans Required 8• Yes❑ Not Applic. El Received ❑ VALUATION SOURCE GAS ELECTRIC PUBL�ER SEPTIC © Ownership FEES COLLECTED 9 UTILITIES PRIVAT ❑ 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 rF— its work will be complied with whether specified herein or not. The granting of a permit does not presume to give au- Building 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 OWNER OR AGENT _ _ - _ DATE Z� DATE Mach. SPECIAL APPROVALS PRELIM. FINAL D Env. Health t +' 4 Planning Engineer G G �J Utilities SEPA Plans Exam. Zo . Building Tech. 1 rj 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) PERMIT NUMBER , ] MA ' �!0'3 TOTAL $ +7 WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. DATLJS'3Uii 1 6 J CE PERMI�IN. J, 4 z * 4 % (Q, r, (? QQfAL C C L L