1983, 10-05 Permit: 83A-9943 GaragePLAN NUMBER
STREET ADDRESS
1.
LOT
2.15 !tic
O
3
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
BLOCK
If)
Q Zn E S.- fiskIs
SUBDIVISION
ER
MAILING ADDR
(Q?0
SS
5± -
HONE
PHONE
Q7.-(0- t?aP,
PARCEL NO. 295 2S OB
LEGAL DESCRIPTION:
4 --
CONTRACTOR
4.
ADDRESS
DESIGNER
5. ADDRESS
ZIP
�ortz
LICENSE EXPIRES
6.
CHANGE OF USE FROM
7.
8. De i-ackAsLci. e(zHxL6' SLAPa
TO
PHONE
ZIP
PHONE
ZIP
TYPE ❑-‘W ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
OF
WORK BLD. ❑ PLMB. ❑ MECH. E M.H. CIPOOL
DESCRIBE WORK
Actual Set Backs in Feet to:
North 7 U 'south 20 East (S l West aS
Size of Parcel Zone Classification Residential
CP C3 K 1-5 0 Commercial 72
Type Const.
Occupancy
_ IAS I
New Const. Valuation
Sprinklered
❑Yes '7 No ❑ Req 'd.
Remode ed Valuation
Main Floor
Upper Floors
Cover Deck
Gara a/Storage
C� D
Total Bldg. Floor Area
Cg 0
Greenhouse
Uncv. Deck 1 Fin. Basement
Unfin. Basement
❑ OTHER
No. Baths
No. Floors
No. Fin. Rooms
Certifi. of Exempt.
or Variance
Required
Received
Yes Noie7
YesC Nor
No. Dwellings
Number
Shorelines/Flood Hazard
Yes ❑ Not Applic.
Plans Required
Received
VALUATION
9.
SOURCE GAS
UTILITIES
ELECTRIC
WATER
PUBLIC ❑
PRIVATE O
SEWAGE/
SEPTIC M
SEWER 0
Ownership
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 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 REVERS IDE FOR REQUIRED INSPECTIONS
SIGNATURE OF
OWNER OR AGENT
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
iyA
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
itkk
N4t
APPLICATION
/O —5_�3
DATE
SP CIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
CrY\ rz£c-. Z -E o f
9LA,Oid-3‘f �,�� R t�\Se
1�w2 4 �0�� ;A 1
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
Z
TOTAL $ 9�
PERMIT NUMBER
b3A 99Li(&
U2*
*82,00
*8200
v0.00 8
9942$
10-0E-83
64.79.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE IgUiD-0 5-8 3
994.3
PERMIT NO.
*82.00°�
TOTAL
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