1984, 04-16 Permit: 84A-3390 GaragePLAN NUMBER APPLICATION/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.
1. C . - Z. �Lc�C. c r 0- - Z_-
LOT I BLOCK I SUBDIVISION LEGAL DESCRIPTION:
2. 4 1 1 3 �-rmi na_ k b n
WNER
PHONE
PHONE
MAILING ADDRESS
p
Actual Set Backs in Feet to:
. I . hZCC-(--
North South East
West
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel
�C r
Zone �CGsiffi cation
Residential 01,
Commercial ❑
4
` ►,J
Id
ADDRESS
��
ZIP
T Ct.
Occupa=r�
Sprinklered
❑Yes ONO ❑Req'd.
DESIGNER
PHONE
bibw Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
ADDRESS
ZIP
Main Floor Upper
FloorsGarage
Storage
761 1
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
6.
/
TYPE
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
❑ EW E] ALT. f� AD' N. 1:1 RPL. ❑ MVE.
7 ❑OTHER
/BLD.
WORK ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
Certifi.ofExempt.
Required
Yes El No
Nexnber
or Variance
Received
Yes❑ No❑
8 D SCRIBE WORK
Shorelines/ Flood Hazard
Plans Required
L,L+C-A tZ.+ r,115
Yes❑ Not Applic. ❑
Received
VALUATION
9•
I SOURCE
GAS
ELECTRIC
PUBLIC WATED
SEPTIC
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
(01,60
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
OWNER OR AGENT DATE
_---IMach.
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
W O 4 l6
Planning
Utilities
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plans ], / PERMIT IS NONTRANSFERABLE
Exam. f ( PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS
Tech.
Plan Check
SEPA
Modular/
MFG.Home
Other (Specify)
PERMIT NUMBED
TOTAL $ &�,' . a I
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE AeD1 6 8 4 PERMIT716, 9 n * A I () ()'%�bj-AL
Ll