1984, 03-12 Permit: 84A-2099 Siding, Soffit, Fascia PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING &SAFETY 01A — w s
NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS +11 PARCEL NO.
1. E. (cktiSr 11S
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
3 (t (Q - L' J PHONE. PHONE
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
G.L' 1 5 ' C1/c -i )- North (South
(lEast I West
CONTRACTOR LICENSE EX IRE RHONE Size of Parcel Zone Classification
Residential❑
4. �( vat.' ev flK rs 57fDLI /'aO 'TmoCommercial❑
ADDRESS ' ZIP Type Const. Occupancy ❑Yes Sprinklered❑No ❑Req'd.
N • 3/vhcn��.e hc( �19�1
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
5. ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse c_ it '-`
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unfin.Basement .. — 1 _ 11
6.
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE ❑ NEW ❑ ALT. ❑ AD'N. El RPL. ❑ MVE.
7. OF A OTHER
WORK ❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOLCertifi.ofExempt. Required Yes No Number
/fir pu ✓ or VarianceReceived Yes❑ No❑
DESCRIBE WORK �/ � � f� Shorelines/Flood Hazard Plans Required❑
8. 31 5l(i`tel / -t- y ?Ld�•ciYes❑ Not Applic.❑ Received ❑
VALUATION SOURCE G/IS ELECTRIC WATER SEWAGE OwnershipFEES COLLECTED
9. 55-7/ g= OF PUBLIC❑ SEPTIC❑ Public IDI Private❑
UTILITIES PRIVATE❑ SEWER❑
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 Building 6�j
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 REVERSES DE FO E IRED INSP TIONS Plumbing
SIGNATURE OFAPPLICATION
OWNER OR AGENT 4:7l DATE Mech.
SPECIAL APPROVALS SPECIAL CONDITION . (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env.Health
SEPA
Planning Modular/
MFG.Home
Fire d
Prevent. 0
Other(Specify) v
Engineer W
—J
EC
Utilities /_Q 0°
TOTAL $ f"='J
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
Plans PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building /� /)z.....
IN 180 DAYS f'I �j nI �jI 1l { o o f
Tech. / , DATEYSSiIED. 2 PERMIT . 9. 9 z * 6 8, 0 I �ofAL