1984, 02-15 Permit: 84A-1284 Addition PLAN NUMBER • ' APPLICATION/PERMITPERMIT NUMBER
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 PARCEL NO.
1. s.le,\4' ki 1✓t2+a GCZ =`L- '7
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION: Y' 0 U ?-
2. 2 -0_ .TC�t:. n-•c,.vC CC- ri. -t c 4*
OWNER PHONE PHONE ,
�k 14.- Tt2-l�r J-C(._ : a-22-6 784- 1 r_" .!
3. MAILING ADDRESS ZIP Actual Set Backs in Feet to:
%e.--,kc-t. 0 F-Q C..-- c,i CZGtd-7 North t....7 SouthEast I West _ -• ? - L+
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential le....."--
e./ ,1
` L
4. K.Ara . lL,A.k , 024,--( X£ tC t 70 +'>1 eg c>'c �.--1 Commercial❑
ADDRESS ZIP Type Const. Occupancy Sprinklered
E. . 1-.12161 :.2..a r1 C�...e-) --2.z. ❑Yes ❑No ❑Req'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
5. €i' i Gcl szs'
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
6.
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE 0 yEW O ALT. liAD'N. El RPL. El MVE.
7. OF ❑ OTHER
WORK BLD. ❑ C7 PLMB. ❑ MECH. ❑ M.H. ❑ POOL Certifi.ofExempt. Required Yes❑ NoNumber_
or Variance Received Yes❑ No❑
DESCRIBE WORK Shorelines/Flood Hazard Plans Required
8.t .TL c.;.,e,...1 'C'c, ;c— IN.) c..�t Yes❑ Not Applic.❑ Received
VALUATION SOURCE GAS ELECTRIC WATER) SEWAGE Ownership ir FEES COLLECTED
9. OF
UTILITIES PUBLIC SEPTIC D/
PRIVATE❑ SEWER t� 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 'QV
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 REV RSE SIDE FOR REQUIRED INSPECTIONS Plumbing
SIGNATURE OF APPLICATIQNN// .. /`u,J Mech.
OWNER OR AGENT Q DATE //�\
SPECIAL APPROVALS IAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env.Health
N)
SEPA
Planning
Modular/
Fire MFG.Home a
Prevent. p
Engineer Other(Specify) W
J_
Utilities
TOTAL $ 'c7
SEPA
PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE,
Plans THIS BECOMES A PERMIT.
Exam. 2� PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS u. n * OO QTO 1 J
Tech. P /I5 DATE iiSED 1 5 —8 q PERMIT #c2
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