1984, 02-09 Permit: 84A-1134 Residence PLAN NUMBER ' APPLICATION/PERMITPERMIT NUMBER
SPOKANE COUNTY — DEPARDIVANT OF BUILDING & SAFETY t'+A - •113
NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET DDR PARCEL NO.
1.
4 c2r 2Cci\I Z4 1 — O , 0 F
LOT BL�K s DIVISION LEGAL DESCRIPTION:
OWNER Kot.. -.1- HONE PHONE
1.
3. MAILING ADDRESS ZIP Actual Set Backs in Feet to: ..
North 19 ISouth i East '. 0 'West /
Ct14T.RACTpR _� LICENSE EXPIRES P ONE_ Size of Par ZoneClass fs j icistipn Residential P
�J�''�Gp ,..._41\1.5,1;
'C? l 1 ���� �t� 7 `2' ,- t _(I ‘ Commercial❑ (,
4. ,
AD�RESS�� 1�� Com ' TYpe gt Occupant Sprinklered
I��JJ (JA•? � //Y�riA ] ❑Yes ❑No ❑Reg'd.
DESIGNER PHONE New Const.V luat n (Remodeled Valuation " Total Bldg.Floor Area
.��gt
5. �J ���/ y
ADDRESS ZIP Mary UpperF rs GaragelStgra Greenhouse
CHANGE OF USE FROM TO Cover Deck Uncv.Deck [[F��in`/l''f1lfBaasement n.Basement
6. U 2-c)
No.7 TYPE ❑ ALT. 0 AD'N. ❑ RPL. ❑ MVE. ❑ OTHER Bath, No.Floors No.Fin ms No. Rings
WORK "IBLD. ❑ PLMB. ❑ MECH. ❑ M.H. 0 POOL Certifi.of Exempt. Required Yes❑ No❑ Number
or Variance Received Yes❑ No❑
DESCRIBE WORK /// Shorelines/Flood Hazard Plans Required/
8. �� � (/�//I C'1 Yes Not Applic.❑ Received
VALUATION SOURCE 9AS f ELECTRIC WATE SEWAGE Ownership FEES COLLECTED
9 OF
UTILITIES PUBLIC SEPTIC
PRIVATE❑ SEWER❑ 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 •e true and correct. All provisions of laws and ordinances governing this type of Building r7C )
work will be complied with whet'-r specified herein or not. - .ranting of a permit does not presume to give au-
thority to violate or cancel the •rovisions of any ot•er st or .cal law regulating construction or the performance
of construction.SEE REVE- -E SIDE FOR REOUI• TIONS Plumbing
SIGNATURE OF ` /'�/ / �� • .. , • �j'
OWNER OR AGENT ���� DATE .011t...... �f/ Mech.
SPECIAL APPRO • S S• -CIAL ONDITIONS:(SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE / Plan Check
Env.Health G<�" ' - LyI�> (r & . i �JNI)I ��l�� SEPA
Planning �/
Modular/
Fire MFG.Home -
>-
Prevent. d
O
Engineer \\'4„''giv 9, Other(Specify) W
l J
Utilities d
4:7-- 0 "-
_ TOTAL $
SEPA
��a7/ PERMIT IS NONTRANSFERABLE WHEN MACHINEA VALIDATEDRIN THIS SPACE,
Plans rTHIS BECOMES A PERMIT.
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Buuding IN 180 DAYSn n l 1 o °a {-
Tech. `� g DATEgS UED' 9 —8 4 PERMITTIQ.3 4 z *3 5 0.0 0 TOTAL
q J
3TE PLA- N
90 '
I
70'
N ; 7a' --,2j , N
70'
moo! _ _.__---- --
_� t 1,000 ga(loi-F�Kk
i I-
Nj 30'
I
m
22) MI
j
F-- i9V4`', -- X91---'.
,N
4O ' j5 � 12'x"
Q
o !
I
9 o' kJk�
G �t
S l ?Olardsot.1 Scale 0=261
Lot- sal x,k. 3 1-1-ea r Pani Addifia i
I GOO •s F Z. s- ozY
mans - (oor- `12.4
Z►i ei -c1oor' 40,60
3 bed rooms 2.112. b441n5