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1984, 03-08 Permit: 84A-1949 ResidencePLAN NUMBER APPLICATION/PERMIT SPOKANE COUNTY - DEfMPTMENT 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. ,.•i �� ! /7 suf-� ^ ` gp{ clt_.`� 7 A c.1Zr>7 3 /-t cJa J'; a e PHONE LOT BLOCK 2.12 j OWNER 3.\XtS ,pis cam. MAILING ADDRESS /(). rA //6P>L CONTRACTOR 4. Sim ADDRESS 1LYC PHONE %z C y} ZIP -q7 PARCEL NO. r*i 1 LEGAL DESCRIPTION:y) Z.) / 12 , C/ /6 C,e / Sci ct. a c.( <-14,-,s i"'j Ct di h 0 11 LICENSE EXPIRES PHONE Actual Set Backs in Feet to: North /7/,Y,�/ jSouth �1�ry I East S / I West 3 Cy Residential Commercial Size of Parcel /c'? X -A.— T YS— Zone Zone Classification rkNA Type t. Qccupanf y Sprinklered y :�{� ( ❑Yes *Jo Req 'd. New Const. Valuation Remode ed Valuation Total Bldg. Floor Area ZIP DESIGNER 5. ADDRESS 6. PHONE CHANGE OF USE FROM TO ZIP Main Floor Cover Deck Uncv. Deck Garage /,Storage Fin. Basement Greene Unfin. Basement TYPE g NEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE. 7. OF ❑ OTHER WORK tBLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL No. Baths / s No. Floors No. Fin. Rooms 7 CertifI. of Exempt. or Variance Required Received Yes ❑ Nc;)4, Yes Noel No. Dwellings Number DESCRIBE WORK 8. sOrCIC-0 Shorelines/Flood Hazard Yes ❑ Not Applic. K Plans Required ❑ Received X VALUATION SOURCE GAS / ELECTRIC PUWATEBj BLIC, 9 UTILITIES eY PRIVATE ❑ SEWA SEPTIC SEWER ❑ Ownership Public ❑ PrivateK 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 OWNER OR AGENT SPECIAL APPROVALS PRELIM. FINAL DATE Planning Fire Prevent. Engineer Utilities SEPA Plans Exam. Building Tech. 4die* �+l APPLICATI / ,� /c _ ✓ DATE _. / MISL- SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) 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 $ PERMIT NUMBER( 04a— j410 ru r PAPV WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. DATE EDU 0 4 / 9 PERMIT2J6.'t2 *342,00 VI' 4L