1984, 05-04 Permit: 84A-3990 Pole Bldg PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
. - SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAF,ETY-, FdrA —'AC S
NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS ' ` ����� PARCEL NO.
1.`W. ,„26-13s-- .,c.,C.CJ O ,,S-4// .2G//.
Le;), BL i K su>dDIVISlON ��� ® . (� LEGAL DESCRIPTION:
2. n( f'G•ciC.1, �.CI .G
W ,O_A_r"4 e ' PF J O / QPHONE
3. ILING ADDRESS ' ` rn /C/G�/,, Z Actual Set Backs in Feet to: ++
. J V $ l�t_7. ' e North�/ 'South 1' LEast gel I West 3
C•. RACTOR LIC ISE E PILES 0.S:,. / Sizeo Parc�/() Zone Classification Residential
4, ' Q y`-''yy„, �'.�' 7�CO Z Z�(n ��1 Parc/
IIS Commercial❑
ADDRESS/ q ! ZI��� / Type Const. Occupancy Sprinklered �, !;
L}.� s� �/J �Q fCj 7 ❑Yes 0 N ❑Req'd.
DESIGNER PHONE st.Valuation Remodeled Valuation Total B_Idg�oArea
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse
--77.C)
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unfin.Basement
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE EW 0 ALT. ❑ AD'N. 0 RPL. 0 MVE.
7• OF 0 OTHER
WORK BLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL Certifi.of Exempt. Required Yes NoP� �
N" -
or Variance Received Yes Non
DESCRIBE WORKShorelines/Flood Hazard Plans Required❑
8. .3d it
�Q' . i�f'�' Yes Not Applic.❑ Received ❑
VALUATION SOURCE GAS ELECTRIC TER SEWAGE Ownership
9 OF
UTIP LIC❑ SEPTIC❑ Public❑Private FEES COLLECTED
LITIES PRIVATE❑ SEWER❑
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. •II provisions of laws and ordinances governing this type of Cmok., , s .,work will be complied with -ther specified herein oriot. The granting of a permit does not presume to give au- Building
thority to violate or cancel provisions of any oth•r, ate or local law regulating construction or the performance -
of construction.SEER z'II E SIDE FOR REQUIR. a INSPECTIONS Plumbing
SIGNATURE OF -AIWA / - ,k / APPLICATION 3 -,
OWNER OR AGENT ?. ,.1�..: DATE Mech.
SPECIAL APPROVA SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) .
PRELIM. FINAL MATE Plan Check
, Env.Health AA Cj
div" I /7 SEPA
Planning
Modular/
Fire MFG.Home >,
Prevent. a
O
Engineer Other(Specify) v
W
J_
Utilities LL
TOTAL $ 6.>t
SEPA
MACHINE
Plans iJ THISPERMIT IS NONTRANSFERABLE hIS BECOMES A PERM TTED IN THIS SPACE,
O
Exam. 1~ILL` PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Tech.Building IN 180 DAYS '�j G p" , C 9 0 ° *61,U 0it A
03 DATE ISS�UE%c `. PERMIT�O. ' L it)
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