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1984, 04-05 Permit: 84A-2968 ResidencePLAN NUMBER APPLICATION/PERMIT 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 1. c . 3°1 1 I UJOOP RJJ FF C� PARCEL NO. 323-1 `, S LO,T 2. BLOCK SUBDIVISION L �� ? G SP- AL2 3. OWNER N R . r Ow-. cG PHONE MAILING ADDRESS . 6:01_12f 1 201342 4. CONTRACTOR / F'' r ADDRESS DESIGNER 5. ADDRESS LICENSE EXPIRES CHANGE OF USE FROM 6. PHONE 4+Co4, -031 ZIkt 25 LEGAL DESCRIPTION: PHONE ZIP PHONE ZIP TO TYPE ANEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE. 7. OF ❑OTHER WORK BLD. ❑ PLMB. ❑ MECH. El MECH. ❑ POOL Actual Set Backs in Feet to: North [South 3y [East ZO I1 West Size of Parcel l�5' X 5h 124)46 Type est. OcApanc N Const. V uation sa Iain Flppr O t I Zone=5 . Residential G'S.. Commercial 7 Spr'nklered ❑Yes ❑No Req 'd. Remodeled Valuation UpRer Floors Garage/ S.toragel 7 Total Bldg. Floor Area Cover Deck No. Baths Uncv. Dec 1 No. Floors 2 Fin. Basement Greenhouse No. Fin. Rooms 7 Unfin. Basement 12.31 fl. No. Dwellings Certifi. of Exempt. or Variance Required Yes❑ No❑ Received Yesi_ No: ' Number 8.DESCRIBE WORK / 1 ! CICYVI IVY J nSS1 C7 / ? Tp 2. VALUATION 9. SOURCE OF UTILITIES GAS ELECTRIC Shorelines/Flood Haza d YesL NotApplic. E WATER PUBLIC $ PRIVATE U SEWAG SEPTIC SEWER❑ Ownership Public ❑ Privateg 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 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 SIGNATURE OF / APPLICATION G . OWNER OR AGENT—`�J - DATE SPECIAL CONDITION'SOSEE REVERSE SIDE FOR NOTICE) SPECIAL APPROV/ PRELIM. FINAL DATE Health Planning Fire Prevent. ✓'Engineer Utilities 5E• SEPA Plans Exam. Building Tech. 4_/74t, PERMIT IS NONTRANSFERABLE PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED IN 180 DAYS Plans Required'g Received PC FEES COLLECTED Building Plumbing Mech. Plan Check SEPA Modular/ MFG. Home Other (Specify) TOTAL $ PERMIT NUMBER Q *41800 *418.008 *000 03-22-84 6479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. DATE ISSUEr. 5 — PERMI720.6. 8 z * 4 1 8. D 0 T-0TAL