1983, 10-25 Permit: 83B-835 GaragePLAN NUMBER
OM!
APPLICATION/PERMIT
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKAN.E, WA;:HINGTON 99260 / (509) 456-3675
1.
STREET ADDRESS
LOT BLOCK
2.
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
•
SUBDIVISION
OWNER
3. 01\1 1/4_ G�%f�.��.
MAILING ADDRESS
7 IA- GiA,ot.1 iP I-.
CONTRACTOR I _
4.
ADDRESS
PHON
LICENSE EXPIRES
PHONE
ZIP
O1CP
PHONE52
PARCEL NO. Z .7 541 _ - 14c
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North t.„' 'South
Size of Parcel
East I West
Residential
Commercial E
Zone Classification
�-2-
ZIP
Tye V IY
Occupancy
I
Sprinklered
EYes ❑No ❑Req'd.
DESIGNER
5. ADDRESS
PHONE
ZIP
New Const. Valuation
12'
Main FI
Remode ed Valuation
Total Bldg. Floor Area
Lipper Floors
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv. Deck
Garage/Storage et-
rnn. Bnt
Greenhouse
Unfin. Basement
TYPE <NEW
7. OF
WORK ❑ BLD.
❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
❑ OTHER
❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certif1. of Exempt.
or Variance
Required Yes ❑ No❑
Received YesE No❑
Number
DESCRIBE 8.WO
VALUATION
9.
SOURCE
UTILLIITI ES
GAS
ELECTRIC
WATER
PUBLIC ❑
PRIVATE ❑
SEWAGE
SEPTIC ❑
SEWER ❑
Shorelines/Flood Hazard
YesC Not Applic.
Ownership
Public ❑ Private Fl
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 ER ' DE FOR REQUIRED NSPECTI •_ S
SIGNATURE OF
OWNER OR AG
SPECIAL APPR • VALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
77
APPLICATION
DATE /0 //
IAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plans Required ❑
Received
FEES COLLECTED
I Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $ `
PERMIT NUMBER
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE isiitED2 5 - 8 3
PERMIT NW 3. 5 z
* 7 5.O O,t'AL