1984, 04-20 Permit: 84A-3601 Foundation PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY - Hca
NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. E .?cOe� --2./ -Z-4-6--i - 1-10
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER PHONE PHONE
WT% CP.c•�.czWN Q7-F -me q
3. MAILING ADDRESS ZIP Actual Set Backs in Feet to: E)4 t '"r t 6.)c, ,
tr. i i'1‘C) £- ic>iZ<C-k--- CAC(.2-C North 'South East I West
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone ClassificationI
Residential[f�
4. r.A.> Commercial❑
•
ADDRESS ZIP Tune Const. Occupancy Sprinklered
G411110 - R." ❑Yes ❑No ❑Req'd.
DESIGNER PHONE New Const.Valuation modeled Valuation Total Bldg.Floor Area
5. ADDRESS ZIP Main Floor Upper Floors -
Garage/Storage Greenhouse
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
6.
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE ❑ NEW ❑ ALT. ❑ AD'N. VKIIPL. ❑ MVE.
OF 7 WORK ElBLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL ❑ OTHER Certifi.of Exempt. Required Yes Noel/
Number
or Variance Received Yes Non
DESCRIBE WORK Shorelines/Flood Hazard Plans Required ID8. `RE PC--4f t —F[yCA N D AstL %!J Yes❑ Not Applic.❑ Received ❑
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE/ Ownership
PUBLIC 0 SEPTI
9.4 wo UTILITIESLIPRIVATE❑ SEWER L0 Public 0 Private 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 2/°�
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 APPLICATIONet
OWNER OR AGENTA . C- DATE �% -- 20 g Mach.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health
SEPA
Planning
Modular/
Fire MFG.Home y,
Prevent. a
O
C-5
Engineer
Other(Specify) W
Utilities
TOTAL $
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
Plans PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
BBucking ¢ )'��{ IN 180 DAYS /� 0 6 �. 1 0 * 2 0.0 0 0 i
/,GV DATE liS4ED 2 0 U 4 PERMIT t.0. Tb1rAL