1984, 04-09 Permit: 84A-3101 GaragePLAN NUMBER APPLICATION/PERMIT
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
Utilities
SEPA
Plans
Exam.
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
,ir `1 IN 180 DAYS
PERMIT NUMBER
zJ�A - 3 I C, I
+ tJ �
TOTAL $ l ` `�
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE1&4I EDr / PERMITW. i'. 11 `.
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APPLICANT: COMPLETE NUMBERED SPACES -PRESS HARD TO MAKE 3 COPIES
Received Yes❑ No❑
,.
STREET ADDRESS
-1-7.1C
Shorelines/ Flood Hazard
PARCEL NO.
G7 5-4,t - 61:3 34
Z4/plnn'F_ ,4-X�P4a:.
Yes❑ Not Applic. ❑
LOT
BLOCK
SUBDIVISION
GAS
LEGAL DESCRIPTION:
PUBLIC ❑
2.
1Z_3
E t,kMX-Y "0
UTILITIES
OWNER
PHONE
Public ❑ Private ❑
PHONE
1 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
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work will be complied with whether specified herein or not. The granting of a permit does not presume to give au-
24 -5, Z
of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
3
SIGNATURE OF / APPLICATION
OWNER OR AGENT DATE
Mech.
SPECIAL APPROVALS
SPECT CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
MAILING ADDRESS
Plan Check
ZIP{
Actual Set Backs n Feet to:
f
A" r_ —
( �.�+
North -� South (( East '49 I West
SEPA
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel )
Zone Classification
Res Identialgg
4.
Modular/
i75Commercial0
ADDRESS
Fire
ZIP
Typ�Const.
T
VConst.
Occu ncy
Sprinklered
❑Yes ❑No
❑Req'd.
DESIGNER
PHONE
N Valuation
Remodeled Valuation
Total Bldg. Floor Area
Other (Specify)
Engineer
C, 6
Zf Z :/
�J.
�.�•
ADDRESS
ZIP
Mam Floor
Upper Floors
Garage/Storage p�
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
6.
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
TYPE NEW ❑ ALT. ❑ AD' N. ❑ RPL.
ElMVE.
7
❑OTHER
O K BLD. ❑ PLMB. ElMECH. ElM.H.
WR
11 POOL
Certifi. of Exempt.
Required Yes❑ No❑
Number
Utilities
SEPA
Plans
Exam.
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
,ir `1 IN 180 DAYS
PERMIT NUMBER
zJ�A - 3 I C, I
+ tJ �
TOTAL $ l ` `�
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE1&4I EDr / PERMITW. i'. 11 `.
dr 0 i, MITAL
O
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or Variance
Received Yes❑ No❑
DESCRIBE WORK
8 ZV A
0'y CON
Shorelines/ Flood Hazard
Plans Required ❑
Z4/plnn'F_ ,4-X�P4a:.
Yes❑ Not Applic. ❑
Received ❑
VALUATION
SOOURCE
GAS
ELECTRIC
PUBLIC ❑
SEPT CWATER
G❑
Ownership _F
FEES COLLECTED
9•
I
UTILITIES
PRIVATE ❑
I SEWER ❑
Public ❑ Private ❑
1 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 REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
SIGNATURE OF / APPLICATION
OWNER OR AGENT DATE
Mech.
SPECIAL APPROVALS
SPECT CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Plan Check
Env. Health
f
J&
SEPA
Planning
Modular/
MFG. Home
Fire
Prevent.
Other (Specify)
Engineer
�.�•
Utilities
SEPA
Plans
Exam.
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
,ir `1 IN 180 DAYS
PERMIT NUMBER
zJ�A - 3 I C, I
+ tJ �
TOTAL $ l ` `�
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE1&4I EDr / PERMITW. i'. 11 `.
dr 0 i, MITAL
O
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