1984, 01-10 Permit: 84A-240 Damper PLAN NUMBER APPLICATION/PERMIT P RMITNUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY KA- - o
NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES— PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. ,;'C;41 f ,i l
LOT I BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
J / PHONE _P_HONE
ILING ADDRESS ZIP Actual Set Backs in Feet to:
L` r 9. C' North [South East I West
CON ACTOR LICENSE EYYYP ,ES PHONE � Size of Parcel Zone Classification Residential❑
f / 5 / Commercial❑
/'�{"�,','.�` ( rl,�, `.�-E:,r✓:'Z�LZ-iZ:.,,' � ��.-.0 7'�Z T _
4. ADDRES' ZIP Type Const. Occupancy Sprinklered q V.
'1 1.-i--e –e'r' 72' � i � er ❑Yes 0 N ❑Req'd.
R i/ PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
5 - REYNnI r)SRIRNAC.P CO. _ _ -.-
ADD N. 630303 SUTHERLIN
ERLIN ZIP Main Floor tipper Floors 'Garage/Storage Greenhouse
SPOKANE WA 99208 - 4
CHAt. E OF USE FROM Ph: 327-1924 TO Cover Deck Uncv.Deck Fin.Basement Unfin.Basement
6. ' ` ' '
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE ❑ NEWALT. El AD'N. CI RPL. ❑ MVE.
7. OF IIOTHER
WORK ElBLD. ElPLMB. ❑ MECH. ❑ M.H. ❑ POOL CertiVarianceempt. Required Yes❑ No❑ Number
or Received Yes Non
DESCRIBE WORK ) "j� Shorelines/Flood Hazard Plans Required❑
8. L-�' t"''' CL- � 1Q 41-`-J "� l' CC 71 ...t;f 14,2,444,-.C- -.Yes❑ Not Applic.❑ Received ❑
VALUATION SOURCE GAS,� / ELECTRIC WATER / SEWAGE Ownership FEES COLLECTED
LI v PUBLIC❑ 6 SEPTIC❑ Public❑Private❑
9. / / 6 UTILITIES PRIVATE❑ SEWER❑
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 REVERS SIDE FOR REQUIRED INSPECTIONS Plumbing
APPLICATION C c`
SIGNATURE OF / / 1 . -• /-- j ---- _� Mech. Ir --�
OWNER OR AGENT ti __C-6_;.:. r � ��'1 F,� -l'LCt-,,.� DATE
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env.Health
SEPA
Planning Modular/
MFG.Home d
Fire
Prevent. OC)
Other(Specify) I.1.1Engineer J
Utilities
TOTAL $
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
Plans PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Budding IN 180 DAYS ELis§u of 0 —8 1 4 0 z * 1 4, 0 0 °
Tech. i 0 DAT E PERMIT N . TAL
f / /