1983, 05-09 Permit: 83A-3778 Garage PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY 602A377s
a ` NORTH 811 JEFFERSON/SPOKANE,V1/ASh'TkI TON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
1 sri 11-04D5Ess I f 6� PARCEL NO. r
�, �A�`'~�6 W vti 'i-- 3 7 4 q- 0 703
LOT BLOCK SUBDI ISIC s I ~ LEGAL DESCRIPTION:
2. I{!� M. - . N) L. I j or -,1/2... ,7r < t/,
OWNSyr J
� ' L ., J�� PHONE {QI4 5-�5 evr- 5 + 1 lc;
3. MAI IN,.G^�ADDRESS V `�,C�- / Actual t sin Feet to:
MAILING
V- X I5I0 I ,,Z-1 North 7 !South East I WestX (` i,i v
CONT T LICENSE EXPIRES ONE Size of Par I Z e I if' ion i % , 'i
Res dentiaL
4. -� �'? ( ,. Commercial❑ _ 7
ADDRESS ZIP TypeCt. OccuRa y Sprinklered —
❑Yes ❑No ❑Req'd.
r i+ 7 n
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
5. I;6 3 .0-
ADDRESS ZIP Main Floor Upper Floors Garage%rage Greenhouse
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
6.
TYPE 112'. .WNo.Baths No.Floors No.Fin.Rooms No.Dwellings
7OF ClALT. 111AD N. CIRPL. ❑ MVE.
WORKBLD. CIPLMB. CIMECH. O M.H. ElPOOL ❑ OTHER Certifi.ofExempt.
or Variance Required Yes❑ No❑ Number
Received Yes❑ No
DESCRIQq WOR cj Shorelines/Flood Hazard Plans Require�Cl
8. /nt I �_�ll v Yes Not Applic.❑ Received j
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE
OF PUBLIC❑ No❑ Ownership FEES COLLECTED
9. UTILITIES PRIVATE❑ SEWER❑ Public 0 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
work will be complied with whether specified herein or not. The grantingof apermit does notpresume to Building
give au-
‘i —.
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction.SEE RE _ 4.0 E FOR RE.,,,a ED INSPECTIONS Plumbing
SIGNATURE OF P I Pr,' /�� � APPLICATION
OWNER OR AGENT Tr, DATE Mech.
SPECIAL APPROVALS SPECIAL C s,''DITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM FINAL DATE Plan Check
Env.Health
Planning �� SEPA
Modular/
Fire MFG.Home
Prevent. C
Engineer C
Other(Specify) V
W
Utilities / ...I. L/� LL
SEPA - TOTAL $
'
WHEN MACHINE VALIDATED IN THIS SPACE,
Plans PERMIT IS NONTRANSFERABLE► t THIS BECOMES A PERMIT.
Exam. O
NII) PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building ' � j� I N 180 DAYS 0 5 -0 9 8 5 7 7, 8 z * 6 8.0 0 a
Tech.
DATE ISSUED PERMIT NO. TOTAL
el"91
i9W21>e9* rd
(*1