1983, 02-23 Permit: 83A-1251 GaragePLAN NUMBEPF
�l
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
STREET ADDRESS
1. 6, 132..4E, "7 T4.
LOT SUBDI'/ISION
1 ONE�51J PHONE
2. t
BLOCK
OWNER
3 MAILINGADDRESI � .� �
�32
CONTCRAATOI
4. ADDRESS
DESIGNER
5. ADDRESS
6.
PARCEL NO.
LEGAL DESCRIPTION:
LICENSE EXPIRES PHONE
CHANGE OF USE FROM
TYPE W
7. OF
WORK BLD.
DESCRIBE WORK
8.
VALUATIO OURGE F
GAS
UTJLITIES
9.
ZIP
PHONE
ZIP
TO
❑ ALT. 0 AD' N. 0 RPL. 0 MVE.
❑ PLMB. 0 MECH. 0 M.H. 0 POOL
0 OTHER
Actual Set Backs in Feet to:
North 'South East I West . /
Residential Clg
Commercial 0
Size of ParcelneClassification
X 13 0 Zone
G
yPe Sprinklered
❑Yes ONo ❑Req'd.
T CSS
Occupancycc
I 1
New L Valuation
Remode ed Valuation
Total Bldg. Floor Area
Main Floor
Upper Floors
Garage/Storage
O
Greenhouse
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required Yes❑ No❑
Received Yes❑ No❑
Number
Shorelines/Flood Hazard
Yes❑ Not Applic. 0
Plans Required
Received 0
ELECTRIC PUBLICRC/ SEPTI / SEWCGfd'
PRIVATE 0 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 REVERSE SIDE FOR REQUIRED INSPECTIONS
SIGNATURE OF (7 APPLICATION
OWNER OR AGENT �2� ` r - _�� L DATE
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE RERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
1103
716
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)
TOTAL $ 614-
PERMIT NUMBER
02* *54.00
*54.006
A *0,00 8
1 1 9.3%
02-18-83
2 6.479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE 1552ED 2 3 — 8 3
PERMIT l c2 5.1 5
* 5 4.0 0 , ,t„L
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