1984, 03-05 Permit: 84A-1835 GaragePLAN NUMBER
APPLICATIGN/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFE`rY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1. •r • ( ° -7 � 11-4 N+'E' ,
PARCEL NO.
2 Z.4t l - 0103
LQT
2.
3. OAR' L ; (� n"i 1✓f.1 ��
MAILING ADDRESS
(J-
CONTRACTOR
ONTR CT R Jp Silly (AAIB?
BLOCK SUBDIVISION
A c op.
4.
PION� PHONE
LEGAL DESCRIPTION:
LI cE r{S SEX FjI ij E�S�
�+ J/ ;� D!/�i
ADDRESSl ✓7-. F KG
5.
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
ZIP
PHONE
ZIP C\ Ze-2
PHONE
ZIP
TO
TYPE J NEW ❑ ALT. ❑ AD' N. ❑ RPL. VE_
7 OF ❑ OTHER
WORK BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
Actual Set Backs in Feet to: _
North el 1. ' 'South viw�. lEast
0 ,1 1 4,'-
[ West
Zone
Classification
Residentia
Commercial
Type til.
Occup9ncy
ti)
Spr'nklered
❑Yes ❑No Reg' d.
TNew�vr>st. Valuation
14
Mai Floor
Remodeled Valuation
Total Bldg. Floor Area
Upper Floors
Garage/Storage
Greenhouse
Cover Deck
No. Baths
Certifi. of Exempt.
or Variance
Uncv. Deck
No. Floors
Fin. Basement
No. Fin. Rooms
Required Yes❑ Not
Received Yes Nott_
Unfin. Basement
No. Dwellings
Number
DESCRIBE WORK
8.
Shorelines/Flood Hazard
Yes❑ Not Applic. ❑
1(ALUATION
SOURCE
F
UTILITIES
GAS ELECTRIC
WATER .
PUBLIC
PRIVATE 0
SEWAGE,
SEPTIC
SEWS ❑
Ownership
Public 0 Privateer
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 EQUII ED INSPECTIONS
SIGNATURE OF
OWNER OR AGENT
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
APPLICATION —7 (--
DATE DATE
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
P zAv t -r 00, - 4°1
*A )r11 i P Oti p4F4,0 iixanO1\J
Aviwe t' 111718 1
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plans Required ;El
Received 2.
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL
C
O
PERMIT NUMBER
041A,-re31
02* *3000
*30006
A *000 8
183,42
03-0-84
6479. 6,4%9.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE0S0UfdJ 5 - 8 4
PERMIT1N8. 3. 5 5
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