1984, 04-06 Permit: 84A-3039 Finish Basement PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY S4 - -3o3c>t
NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. E. . i 1C;��� ' ?i V v €w , ' 4 -- to 1 s---
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. 1-6 I v S)LV V t cw -Ac .`7
OWNER PHONE PHONE
0 tkN AN 1Z:5.0 f•••1 q3-. 4'i
MAILING ADDRESS ZIP Actual Set Backs in Feet to: l e•--T
%Z. 1(et-Ls-et-Ls- ¶_ Ie-'/ U 1 E vA\ 1 North (South East I West �
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Baal❑1/
coryyvE, _ _
4. ADD $S ZIP TyiaLcconst. Occupancy Sprinklered
Mt 31-N 2- DYes ❑No ❑Req'd.
DESIGNER PHONE New Const.Valuation Rsinodeled Valuation Total Bldg.Floor Area
Z 8Cac) ----70-
5. ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
6. / `76`3
TYPE 0 EW [�ALT. 0 AD'N. 0 RPL. 0 MVE. No.Baths No.Floors No.Fin.Rooms No.Dwellings
7. OF 0 OTHER
WORK BLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL Certifi.of Exempt. Required Yes NoD Number
or Variance Received Yes❑ No El
DESCRIBE WORK Shorelines/Flood Hazard Plans Required❑
8. IF i N `,.k --" BSc Yti c/V r Yes❑ Not Applic.❑ Received ❑
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
PUBLIC CI SEPTIC 0
7--iap UTILITIESLIPRIVATE❑ SEWER❑ Public D Private I
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 4:7(CC
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au- Building
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction.SEE RE RSE �IDEJFOR REQUIRED INSPECTIONS
NS C� Q� Plumbing
SIGNATURE OFOWNER OR AGENT r✓� )• ct 'ld / v' DATECATION / � — U y Mech.
SPECIAL APPROV SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health
so SEPA
Planning Modular/
MFG.Home )-
Fire a.
Prevent. O
Engineer Other(Specify) W
9 J
Utilities
TOTAL $ _ L
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 �� 9 n
BuildingS)5) DATE(
4/s IN 180 DAYS � "1-17 .—t' 1
Tech. PERMIT NO. 0 3. z * `t 7 0 TAS