1984, 04-03 Permit: 84A-2883 GaragePLAN NUMBER APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
ADDRESS
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
1•
STREET ADDRESS
`'i 14 i5, _sUNP0WtN 2 Q,
PARCEL NO. r.
3 3Sg 3 Z-O�
2.
LOT
G
I BLOCK
7,
I SUBDIVISION
FCA_& "005
LEGAL DESCRIPTION:
OWNER� � ��
PHONE
PHONE r 60
JIG
PHONE
N Const. Valuation
�%
Total Bldg. Floor Area
MAILING ADDRESS
ZIP
Actual Set Backs in Feet to:
)
5.
J
1°
North , South PA - East (�ji West
CONTRACTOR
...
LICENSE EXPIRES
PHONE
Size of Parcel d 3'
Zone Cl sification
Resld
Comr
4.
Floors
Garagel orage,, 1
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
ADDRESS
ZIP
Ty jCFo t. Occ ncy
Sprinklered
❑Yes ❑No ❑Req'd.
DESIGNER
PHONE
N Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
CU
5.
ADDRESS
ZIP
Main Floor Upper
Floors
Garagel orage,, 1
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 11 ALT. C3AWN.❑RPL.
❑ MVE.
7• WORK JKBLD. El PLMB. ❑ MECH. F] M.H.
❑ POOL El OTHER
Certifi.ofExempt.
Required
yes[] No❑
Number
or Variance
Received
Yes❑ No❑
8 DESCRIBE WORK g ^ I ` J Z ,1 ' &�/ 0 G
G't'' `t
C y,>�� P
Shorelines/ Flood Hazard
Plans Required ❑
%c 111
I�'
Yes El Not Applic. ❑
Received ❑
VALUATION
I SOURCE
GAS
ELECTRIC I
p UBA E D
SEWAGEPTIC
Ownership
FEES COLLECTED
9•
UTILITIES
PRIVATE ❑
SEWER ❑
Public ❑ Private ❑
I hereby certify that I have read and examined this application and have read the "NOTICE"
provi§ions 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-
Building
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction. SEE REVERSE OR REOUIPRD INO&TIONS
Plumbing
SIGNATURE OF
APPLICATION
OWNER OR AGENT -��
DATE
Mach,
SPECIAL APPROVALS SPECIAL C DITI S: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent. �[r ,
Engineer F (�J ,i d { j 0(o "p y�0 IAC_t-i
Utilities
SEPA
Plans PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building
T -h ., IN 180 DAYS
Plan Check
SEPA
Modular/
MFG.Home
Other (Specify)
TOTAL $
PERMIT NUMBER
A - 3
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
//;; 'j �p7
DATEll SSUEC}PERMI419. O, 3 '3 * 5 4 0 0 SAL
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