1984, 01-13 Permit: 84A-362 Remodel GaragePLAN NUMBER APPLIICATIO'k1,/PERMIT
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
STREET ADDRESS
1.
LOT BLOCK
2.
_916NER
11 N
MAILING ADDRESS
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
PARCEL NO.
SUBDIVISION LEGAL DESCRIPTION: +
PHONE PHONE iGXC' Ty
A it v;r a� U _84_e+U Aoj
ZIP Actual Set Backs in Feet to:
SPECIAL APPROVALS
PRELIM. FINAL D,
Env. Health
1Q1A I T
Planning
Engineer
LA (Q t V i5(Z `3.� C -
North I South East
\ 15' 1 West
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential
Building � )/
Tech. `�
�AIIA E
140 X 1411 F\�eb)1
Commercial ❑
4.
ADDRESS
ZIP
Ty st. Occupancy
Sprinklered
� AaV\J
N
1' 1-1
Dyes 0 N ❑Req'd.
DESIGNER
PHONE
New Const. Valuation emodeled Valuation
Total Bldg. Floor Area
J.
ADDRESS
ZIP
Main Floor Upper
Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
s.
TYPE
�• moths No.
Floors
No. Fin. Rooms
No. Dwellings
7
❑NEW ❑ ALT. ®'AD' N. ❑ RPL. ❑ MVE.
OF ❑OTHER
WORK BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
Certifi.ofExempt.
Required
Yes❑ No❑
Number
or Variance
Received
Yes❑ No❑
DESCRIBEWORK f dV�L�T ��
Shorelines/Flood Hazard
Plans Required
8•
6 �� 1C 3C�
Yes❑ Not Applic. ❑
Received ❑
VALUATION
SOOUFCE
GAS
ELECTRIC
PUBLIC-WATEO
SEPTIC
OwnershipT_
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
Oji on
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 SIDE FOR REQUIRED IN PECTIONS
Plumbing
SIGNATURE OF APPLICAT�N
l
OWNER OR AGENT DATE
Mach.
SPECIAL APPROVALS
PRELIM. FINAL D,
Env. Health
1Q1A I T
Planning
Engineer
Utilities
SEPA
Plans
Exam.
i
Building � )/
Tech. `�
SPECIAL CONDIT
i7c)a
(SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
PERMIT NUMBER
;nom
TOTAL $ 42.06 I
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A5, PERMIT. z
DATE l 11 > - u t` PERMIT N1 7 * a
TOTAL
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V ALLEY vJ,4y
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