1984, 04-20 Permit: 84A-3632 Residence AdditionPLAN NUMBER
APPLIICATION‘PERMIT
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
1.
STREET ADDRESS
E. /SO/6
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
•
RI VER.tay
PARCEL NO.
of (S1) ` D1ia
LOT
2.
BLOCK
SUBDIVISION
3.
OWNER
.iot}N
f2. H N? -y
PHONE
`728-5-3"33
PHONE
LEGAL DESCRIPTION:
MAILING ADDRESS
E./Bn/(a RadUPY
ZIP
Actual Set Backs in Feet to:
North !South
4.
CONTRACT R
. P. Tre
LICENSE EXPIRES
-0773
Size of Parcel
ADDRESS
zl N . ,i,r41,M10114
17/0
Iciu
TypaV 1"
Occyjia ncy,
ilZone Classification
East
1 West
Residential
Commercial ❑
Spr'nklered
❑Yes ❑No ❑Req'd.
5.
DESIGNER
PHONE
ADDRESS
ZIP
N Confit{/P_. Va� 4on
rr.'J ao
Main 2F10
Remode ed Valuation
Total Bldg. Floor Area
Upper Floors
GarageISt ee
Greenhouse
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE ❑ NEW ❑ ALT. AD'N.
7• OF
WORK KBLD. ❑ PLMB. ❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required Yes❑ No❑
Received Yes El No E]
Number
8.
9.
DESCRIBE WORK
ADDrflON "r EKISTitcr RESIDENCE
VALUATION
SOURCE GAS
F
UTILITIES
— R.Ec: Rooth DiNUJQ
ELECTRIC
/WATER SEWAGE
PUBLIC ❑ SEPTIC ❑
PRIVATE ❑ SEWER ❑
Shorelines/Flood Hazard
Yes Not Applic. ❑
Plans Required ❑
Received ❑
Ownership
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
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 REQUIRE i ISPECTIONS
SIGNATURE OF '1 APPLICATION /�/
OWNER OR AGENT '�-- �`..�� („<" DATE "7
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
PRELIM. FINAL DAT
VIZ
P2.
440
Part
'Abe I
7//W
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building 00
°'-)
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
PERNUMBER
lr* —
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
014
DATE E
PERMIT'NO. ' c z
*89.0OO1AL