1984, 04-18 Permit: 84A-3485 ShedPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY -- DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE,i/ASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1 LOT BLOCK C•
K
2./4 2 -
(92-19 0'1r14
PARCEL NO. O5$-2_ _ 04-5-7
SUBDIVISION
1 t J ,# lv fiG 5Ni --&.
OWNER
3 LA-(L(L/ • 6.oNt�tz-/
PHONE PHONE
MAILING ADDRESS
�if�l,l1✓
CONTRACTOR
4. 130N504 0
ADDRESS
LICENSE EXPIRES
ZIP
PHONE
ZIP
DESIGNER PHONE
5.
ADDRESS
CHANGE OF USE FROM
6.
ZIP
TO
TYPE *NEW ❑ ALT. ❑ AD' N. C RPL. n MVE.
7. WOE OTHER
RK BLD. ❑ PLMB. C MECH. h M.H. C POOL
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North 1South
[East '" 1 West ltz I
Size of Parcel
Zone Classification
Residentia.
Commercial
Type Cgnst.. Occupancy
Sprinklered
OYes 0 N Req 'd.
NConst. Valuation
en
4OO
1 Remode ed Valuation Total Bldg. Floor Area
Main Floor
Upper Floors I Garag /Storage
U.00
Greenhouse
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required YesO No0
Received YesL Non
Number
DESCRIBE WORK
8. 301
Shorelines/Flood Hazard
Yes NotApplic.
VALUATION
9.
SOURCE
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC
PRIVATE 0
SEWAGE
SEPTIC
SEWER'__
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 JI /
OWNER OR AGENT, -� //
APPLICATION
DATE
Plans Required ' 1
Received
SPECIAL APPROVALS /SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
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 $
f1 G.
PERMIT NUMBER
02* *6800
*68006
A *0.00 8
34&4z
04-1£-84
f 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE 'fSSU of 8 8 4
PERMITN n 0. 5 z
*68.0U1OAL