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1984, 02-08 Permit: 84A-1079 Residence
PLAN NUMBER APPLICATV .N/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 STREET ADDRESS PARCEL NO. LOT I BLOCKSUBDIVISION LEGAL DESCRIPTION: 2. -:7--> 1-1 OWNER I PHONE I PHONE 3. C� rz-c M'4 I IN C:., MAILING ADDRESS �• 10�©W �k-��~t CONTRACTOR 4. `�-P-rnr_ ADDRESS ZIP ue QCT ZEANorth LICENSE EXPIRES PHONE Size lA 6 rj' I South 'Z I East I West Parcel Zone Classif ication Residential e Commercial C onst. Occupancy Sprinklered /v Dyes ❑No ❑Req'd. DESIGNER PHONE--- towConst. Valuation Remodeled Valuation��g. Floor Area 5. 1 om- ADDRESS ZIP Main Floor Upper Floors Garage/ Storage Greenhouse ,�sz — 4_t 6. CHANGE OF USE FROM TO Cover Deck Uncv. Deck Fin. Basement Unfin. Basement / No. Baths No. Floors No. Fin. Rooms No. Dwellings TYPE P( NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. ; 7. OF ❑ OTHER WORK V BLD. ❑ PLMB. ❑ MECH. ❑ M. H. ❑ POOL Certifi.ofExempt. Required Yes❑ No Number or Variance Received Yes ❑ No ❑ 8 DESCRIBE WORK Shorelines/Flood Hazard Plans Required �tNr✓E: Yes❑ Not Applic. ❑ Received VALUATION I SOOURCE GAS ELECTRIC PUBLT, CE V SEPTIC WAGE 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 reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this type of Building �•� 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 REVERSt S^ FOR REQUIRED INSPECTIONS Plumbing SIGNATURE OF ' APPLICATION OWNER OR AG DATE Mach. SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) PRELIM. FINAL DATE Plan Check Env. Health SEPA Planning Modular/ MFG.Home Engineer' Other (Specify) Utilities �� TOTAL $ G' f.,C./ SEPA Pians ! PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATE ( THIS BECOMES A PERMIT. Exam PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED BuiTech mg IN 180 DAYS o �' DATE ITC �� 0 — C 4 PERMIT NUMBER 84-A - % O-1 PERMIT N� U 7' 9 z * 3 8 6. O T d A O C C U U IVa�ZTt-� 33S4� - :aaa -k! 1 0 11 et,� oZuD t�l>P G R t -r M i/-t-