1984, 01-25 Permit: 84A-694 Reroof PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
- ) SPOKANE COUNTY - DEPARTMENT OF BUILDING &SAFETY 8¢ ��g
V NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. C. . 1 .c _ c'.'' ,2- 5 4 I, — •%3 j _
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER PHONE PHONE
3. AL _t✓ry T{-k-ca yv-.6s 4i2s `3-1 3G,
MAILING ADDRESS ZIP Actual Set Backs in Feet to: t K t -T 1 NC\
C. iZD ?_t Cv rt-) Gt1(2C.. North 'SouthEaat I West
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential 11/
4. r'.,E Commercial❑
ADDRESS ZIP T Const. Occupancy Sprinklered
aryl6 !N 12_ ❑Yes ❑No ❑Req'd.
DESIGNER PHONE New Const.Valuation Remodeled 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 0 NEW 0 ALT. 0 AD'N. 1'1 RPL. 0 MVE.
7. OF
0 OTHER
WORK
0 BLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL Certifi.of Exempt. Required Yes No❑ Number
or Variance Received Yes❑ No❑
DESCRIBE WORK Shorelines/Flood Hazard Plans Required❑
8"RC. ftc4:0,pervCS; Yes CI Not Applic.❑ Received ❑
VALUATION SOOURCE GAS ELECTRIC WATPUBLIEO SEWIC CIOwnership FEES COLLECTED
9 i , C>C�C' UTILITIES PRIVATE❑ SEWER❑ Public❑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 Building Ze.>.or)
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 i
OWNER OR AGENT �i�-"a 't ti " .. DATE I-�S J Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:(SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health
SEPA
Planning
Modular/
Fire MFG.Home ).-
Prevent. d
O
Engineer Other(Specify) v
W
_1
Utilities U.
TOTAL $ �C �
SEPA
PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE,
Plans THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS Ql � _ Q n o * O. OOO J
Tech. ' / DATEEPERMIT NO ' ' 2
ft AL