1984, 04-20 Permit: 84A-3611 Workshop PLAN NUMBERi APPLICATION/PERMIT PERMITNUMBE
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. ioI - - tWlt,13Ur.
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER
3.W tt-u r 1 r J Nf`.lo PHONE '1 4 —034.4
MgILING ADORES Lou PI
, �)/► ZI q"/ (' Actual Set Backs in Feet to:5-#447-r, I
N l ��Q�(�N�i WH • I WG' North I.Cj 1 'South East' )(/ `'West 5
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel ,f Zone Classification Residential
4. — . E _ 7.� !` 14 0 Commercial O
ADDRESS ZIP Ty Clst. •/\a_ncyl ❑Yes Spr❑Nored ❑Req'd.
DESIGNER PHONE New Const.Valuation� Remodeled Valuation Total Bldg.Floor Area p
5.
ADDRESS ZIP Main Floor Upper Floors Garage/ o ge 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 p-NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF WORK BLD. ❑ PLMB. ❑ MECH. O M.H. ❑ POOL ❑ OTHER Certifi.of Exempt. Required Yes❑ No❑ Number
or Variance Received Yes❑ No❑
8. DESCRIBE WORK �� % �t 1 `O,s,, j�, Shorelines/Flood Hazard Plans Required❑
�/`� 1/V Yl-v—Gj'(f Yes❑ NotApplic.❑ Received ❑
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership
9. UTILITIES
OF
PUBLIC❑ SEPTIC
PRIVATE❑ SEWER Public O Private/TA FEES COLLECTED
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 51."
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 REVERSE SIDE FOR REQUIRED
INSPECTIONS Plumbing
SIGNATURE OF \ �� - �L y... /�i;6/,! APPLICATION •
OWNER OR AGENT Y�CC� /3 DATE Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
w•-- Env.Health
l SEPA
Planning
Modular/
Fire MFG.Home >-
Prevent. d
O
Engineer Other(Specify) v
W
J
Utilities 574_ D�
LL
' TOTAL $
SEPA
WPlans / PERMIT IS NONTRANSFERABLE HEIS BECOMES A PERMIT.EN MACHINE TED IN THIS SPACE,
Exam. / 1�10 PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building / � !!!! IN 180 DAYS ((i QQ`r 1 ( (�
Tech. O� DATEYSSUE� O — PERMIT4e. 1 5 * 5 4. v L" IIOIfAL