Montgomery E 9107 Drever, McIntosh & Co
ArrL it►A i iuN / rtKM I i PERMIT NUN
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 111 JEFFERSON I BPOKANE, WA4HINOTON Ol60 1 (W9) 4W3d16
APPLICANT. COMPLETE NUMBEAED SPACES - PRESS HARD TO MAKE 3 COPIES
sTRMAoDREss PARCEt, NO
~ East 9107-9321 Montgomery 08542-1814 ► ~
LoT eLocK sueoivIsioN _ LEGAL OESCRIPTION, IWesg 1g' ex~- 2. 11-12 Wazren's 5 Acre Tract cept East 165 o West o Sout 1 0,
owNeAgrever,McTntosh & Co. PN°"E PHONE Tract 12 exeegt West 15' Warrens .5-Acre Tract
3. :Nain Street Frep,gr'ipC (415) 433-1773
MAILING AOORpS ZIP AdLW Set BscM Irt Fed to
110 Sut,ter Street 5.F., Ca..ifaruia ,~,4 ~ ~
caNrAacroR uc,E+SE avIREs arroNE stma PrM xonec~t~ua~ ~
ZIP TyPeoona omvow
4 ADOFtM `
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OE$ItiNER PMONE NeWaDnet IhIWtIOn Remod~tedVaIlatl0fl TOt9181dg FIOOtAteg
5. Larrv Rasmussen (208Q 661-0361
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CHANtiE OF USE FROM 1'0 dMa Qsdi Uncv Dedk Fln. Bemanent Un}ln 8aoeneent
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No. Boft No Floon No Fln Roaro No Qrmillnp
TYPE D NE1IV 0 Alt 0 AO' N 0 RPL 0 MVE
1. WORK 0 BLD 0 PLMB 0 MECH 0 M H 0 POOL ❑ 0~~ ownfnr~+ ~a~ee Yeea raa ~
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VAIUATlON ~F~ GAS ELECTNIC liCpE1 %AC~Ef ~p fEE8 COLLECTED
9. uriLiriEs PRIvATE o SEWrc.a+ ❑ waic n P►wae
I hereby certify Mat 1 heve read and examined lhis appltcetlon and heve resd the "NOTICE' provlelone IncluOed on
reverse aide, and know ihe eame to De true ana correcl All provieions of lewa and ardinanaes gaverning thl9 type ot ~lkUng
work will be complied wilh whether specilled herein or not The granting of a prermit does not presume to glve au-
thorily to vfolale or cancellhe provielons o} any otfier state or local law regulating construction or the perbrmence
of canetruction SEE pEVERBE SIqE FOR REOUIpEq INSPECTiON8 Plurntd^o
SIGNATURE OF K L!CE & HAG00 ,gent APPUCATION
OWNER OR AGENT ~ DATE August 23. 1983 Meen
SOECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE 91DE FOR NOTICE)
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~~0 IN 180 DAY$
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' "PLANN~~n@~~ APPLICATIONIPERMII 'PEAM~T NJM@ER
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY -
NORTH 811 JEFFERSON I 6POKANE, WASHINOTON 89280 !(5d9) 456-3875
APPLICANT• COMPLETE NUMBERED SPACES - PRESS HARDTO MAKE 3 COPIES
srREEr AonaEss` PARCEL NO ~ S- ~
1 2. 91t~7 ~!vntaomery, Spokane, s~1A. 'p~ '
2 LoT eLxK sue01wsIoN - LEGAlOESCRIPTION
OWNER PHONE PHONE
3 Drever-"cIntosh & Co. _
kiAiLINC aoaRess - ja~,Frmisco, CA , ziP ~ s~ eeM +n r~ to
l1l~ Sutter 5t., ute 94104 Nonn Iswin lEin ~we+
CONTRACTQp LICENP-E P 3izeo1 PO~oel ~ne Claseifltatfon q~~ p 4.1 Qath Vorthwest 12~ ~RES ~~~-8666 _~G
P.°OR~1l SvraRue, 5Pokane~ 'lA. aP TrMoWer o~► - sp~~~o O,
o 99202 ore~ or~ r~o d
OESI6NER - PHONE New Lanet Veluellon RBfItOdAlBd VeluBtlOn --tOtg) Bldg FtOOr Area
5Same- S12r00026 3 sq. ft. 4
AODRESS ZIP NtWnFloa UpperFloaa GeragerbYmage dreenlrouse
Ch1AN(3E OF USE fROM TO QNer Oed1 Una► Oecc Fln Baeement Unfln Basirnertt
8 3usiness _ _
TYPE :'*S NEW 0 ALT p AD' N 0 RPL 0 MVE N0 Fl0°rs N° Fln R°°'"e ko Owelllnps
' WORK 0 8L0 r PLMB 0 MECH 7 M H 0 FOOL 0 OTHER ~ired yesD NoC ►+unmer
DE6CRI8EWOAK S ilo Construction n~3 - Ye80 ko ~
Y snodnmiFlooaHozra rWM Paquirea ❑
8"acc Installatian Only r~O No„polic o Recitve ~
-IaLuariprv soQ~ ~ Gas ~CtRiC p~e~ p gE~ C p ~hlo FEES COlLEC1ED
9 3~ Z ,n ~ J UTiIITIES PRIVATE Q SEINER C I FUalc 0 Rivate C
i hereby certify that I nave read and examined thls application and heve read the "NOTICE• provleiona Included on
reverse slde and know the same to be Vue and correct All prnvisions of laws and ord(nancea governing tMs typa of Bullding _
wark iviu be complled w3tR whelher specified herein or not Tne granting of a permit Qoea not preaume to give au• - ~
thorily to violete ur canoel the provisions of any olAer stale or local !aw regutating constructton or the Qerformanae 4
of con9truction SEE REVERSE SIDE FOR RECUIREO IN8PECTIONS P►umbing 014t
SIGNATURE OF APPLICATION
dWPJER OA AGENT OATE Mooh
SPECIA! APPROVAIS SPECIAL CONDITION8••(6EE REVERSE SIDE FOR NOTICE)
PNELIM FINAL OATE ~
:Iv kfidlln
SEPA
P+anm pg
Modularl
~ire MFG Me" _ a
?rav8n1 0
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Ertpirreer Olhsr (SpWty) c
Ufilil3es • 4
SEPA ToTaL $
PERMIT IS PIONTRANSFERABIE M~HEN MACMINE VALiDATED IN TMIS SPACE"
THlS BECOMES A PERMIT
Exam PERMIT IS NULL ANO VOID IF WORK HA8 NOT COMMENCED
13ui1°'"q ( IN 180 DAYS
~:)rn I
I~ _ OATEIS8UE0 PEAMRNO TOTAt