1984, 06-19 Permit: 84A-4957 Residence PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY --t DEPARTMENT OF BUILDING &SAFETY 84 —4-q5/
NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
a V
STREET ADDRESS PARCEL NO. '
1. � 44�, 4 X35-1z - clece
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. I g OF a!4-eI'la" PLAT 79 — 110
OWNER PHONE P SONE
3. cz-i+,` cow- i . cab -5N-6
MAILING ADDRESS � ■ ZIP Actual Set Backs in Feet to:
. 52-�(' 5`f,I D IV5 L�I . - cci? z, North I South 30 t East 2,67;.t I West 2,6, t
CONTRACTOR�yy� LICENSE EXPIRES PHONE Size of Parcel I in, Zone Classification Residential
4. "�`.'" ' .4/teQ i sO; ;.r1,-76 ` p H Commercia ❑
ADDRESS ZIP Type nst. Occupancy Sprinklered
�t b
12-3
r3 ❑Yes ❑No ❑Req'd.
DESIGNER PHONEConst.Valuation Remodeled Valuation Total Bldg.Hoar Area
Ill 004.f. --
5. ADDRESS ZIP n Floor' Upper Floors 'Garage/Stora a Greenhouse ^ -
f212 '.�. C? ' 473
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
6. 9 20t'
No.Baths No.Floors No.Fin.Rooms -No.Dwellings
TOFPE NEW CI ALT. CI AD'N. C1 RPL. 111 MVE. ❑ OTHER . 7 I
7. WORK 7y,;BLD. D PLMB. ❑ MECH. ❑ M.H. ❑ POOL Certifi.of Exempt. Required Yes No❑ Number
or Variance Received Yes No CI
DESCRIBE WORK Shorelines/FloodHazard Plans Required❑
8. SI 'ritKIN1 11O_ Ves❑ Not Applic.
❑ Received
VALUATION SOURCE GAS ELECTRIC WATER SEPTI SEWAGE
O ( Ownership FEES COLLECTED
9 UTILITIES PRIVATPUBLlEE LE SEWER LT Public❑PrivateX
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. • provisions of laws and ordinances governing this type of Building Vo. CO
work will be complied with wheth specified herein . no The granting of a permit does not presume to give au-
thority to violate or cancel the p visions of an oth st- e or local law regulating construction or the performance
of construction.SEE REVERS SIDE FOR RE • D 'SPECTION Plumbing
SIGNATURE OF Vie' / APPLICATION .2 I4
OWNER OR AGENTS 4 • •TE Cd`� Mech.
' SPECIAL APPROVALS •ECIA CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
/
VEnv.Health i1 'J'15 i.. IC. 12A 1n-^�C ` I-77,31,3 J e i G
SEPA
Planning
Modular/
Fire MFG.Home >-
Prevent. a
tel i '4 ..1.1 0
j, _Engineer frifik $ :c�J �-yt4A,G (.ty A.n t C� Other(Specify) W
]( f J
Utilities r - /��, t Q Li
// TOTAL $ ✓I�•
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
I PERMIT IS NONTRANSFERABLE
Plans / r / o1 . , THIS BECOMES A PERMIT.
Exam. ',,An, /7/ PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building I !/ / IN 180 DAYS n A�jj ` Q 9 7 d n o -
Tech. DATEISSUEDI 9 -8 't PERMITNO. )• / Z '`316. U 0 fO.AL
fITE PLAN
q 4'
1 701 — —
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--- — — — — — — — .4— — — — -
1 '°'
j 70' _
1:71 —id 000 gaIt.Z taNk A.
1 301
t.
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ni
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30I - I� \
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9" i
, Tt — i 4,1- ,„ 74- .
\ 1
1
g4.78
1441 4,-1-h
TRact- IS, of Ston`Plat 71-11 $
as rl 1Go0 s%, feet
m art -floor 92_0
e44d floor 6$0 SCo.le, I !1 = 2.0'
dra► kt Rke, t So -F,eet
3 bed zooms Z112 bc&ks