1983, 09-07 Permit: 83A-8675 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
STREET ADDRESS
1. ( 2� 2_ 14
New Const. Valuation Remodeled
PARCEL NO.
2 -or A'S - 1 O
LOT
I BLOCK
I SUBDIVISION
"ate Co v
LEGAL DESCRIPTION:
1i �_,Z7
5.
OWNER
SS
PHONE
PHONE
(nZ3.. 44S I S
3. ?-
Upper Floors
Garage/Storage
Greenhouse
MAIL G ADDRESS
ZIP
ip
Actual Set Backs in Feet to:
-1—t33-7
iii
Li�_v
8
North S I South East West
Cp TRACTOR
4. V�k
TO
LICENSE EXPIRES
PHONE
—0&q
Size of Parcel
Lkt x ID 5 \Zex-6
ZoneClassificat' n
Residential
Commercial ❑
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered —7
No. Baths
No. Floors
NAFinR-mS
., t
No. Dwellings
❑Yes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation Remodeled
Valuation
Total Bldg. Floor Area
"ate Co v
I
1i �_,Z7
5.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
—
-
Li�_v
CHANGE OF USE FROM
TO
Cover Deck Uncv. Deck
Fin. Basement
Unfin. Bas;—m,
6.
No. Baths
No. Floors
NAFinR-mS
No. Dwellings
TYPE E ❑ALT. ❑ AWN. C1 RPL. ❑ MVE.
7. ❑OTHER
WORK 10.8LD. ❑ PLMB. ❑ MECH. ❑ M. H. ❑ POOL
Certif of fExempt.
Required
Yes❑ No
El
Number
or Variance
Received
Yes❑ No❑
—
8 DESCRIBE WORK /� (\(4y --:s0)
� �P� �� 6A Ip-�— \ �l} y-�
Shorelines/ Flood Hazard
yes Not Applic. t�
Plans
Required ❑
Received ❑
VALUATION
9
SOURCE
OF
GAS
ELECTRIC
WATER
PUBLIC ❑
SEWAGE
SEPTIC
Ownership
FEES COLLECTED
UTILITIES
PRIVATE 1-1SEWER
❑
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 compiled 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. SEER RS SIDE FOR REQUIRED INSPECTIONS
Plumbing
SIGNATURE OF ( APPLICATIO
OWNER OR AGENT DATE_
Mach.
SPECIAL AP VALS 7
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOT CE)
Plan Check
PRELIM. FINAL DATE
v. Health (,x
1
Planning
Utilities t%r ��CO f
PlansPERMIT IS NONTRANSFERABLE
Exam. A&PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building i IN 180 DAYS
SEPA
Modular/
MFG.Home
Other (Specify)
PERMIT NUMBER
3A - SG757
TOTAL $ ---I�_
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT. 5t
O
sUED"ry
DATE PERMITIry' i67ol
D
C
C
U
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