1984, 02-15 Permit: 84A-1282 Dampers PLAN NUMBER APPLICATION/PERMIT ' PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY e4A - 1IS2-
NORTH 811 JEFFERSON I SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION: 3
2. OC� �/ PlIONE
C/
3. ���111/ V Y` /.l i�Q
MAI L. ADDRESS/Ga.c).V— /F Z7y �� dActual Set Backs inFeet
South East `West
CONT CTRR,„ . , - j� LICE�♦S XPRES P NE Size of Parcel h I Zone Classification Residential 0
�- /IA , %I ([ L� g---g-/OD Oorr nercial❑
4. AD L'– oC iL) it Z �`� Type Const. Occupancy ❑Yea ❑Norte ❑Req'd.
l
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area ,
FJ. ADDRESS' ZIP Main Floor Upper Floors 'Garage/Storage Greenhouse E
i - LI.
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
6.
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE 0 NEW 0 ALT. 0 AD'N. 0 RPL. 0 MVE.
7. OF WORK
0 BLD. 0 PLMB. MECH. 0 M.H. 0 POOL 0 OTHER Certifi of Exempt. Required Yes❑ No❑ Number
�/�} or Variance Received Yes No❑
8. DESCRIBE WORK Jr—Luz
moi ^�(,p Shorelines/Flood Hazard Plans Required❑
v Yea❑ Not Applic.❑ Received ❑
VALUATION SOURCEOGys ELECTR PUBLICWAT0 SSEWAGE
PTIC E❑ Ownership FEES COLLECTED
9 UTILITIES /X\ PRIVATE❑ SEWER❑ Public❑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
Building
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 REVER E SID FOR REOU -ED INSPECTIONS Plumbing
SIGNATURE OF / - ' " APPLICATION
OWNER OR AGENT '� DATE Mech. /1.0 L)
SPECIAL APPROVALS SPECIAL CONDITIONS:(SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env.Health /
�� �fy<< SEPA
Planning . 62......et4068 i4
/U} _ Modular/
MFG.Home >-,
Fire a
Prevent. I 9° C
Engineer Otherjp (Specify) C3
IL
A00 �.v� J
Utilities i� L ti
TOTAL �
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 AzA_
IN 180 DAYS Eq� -�� 5 — uI. 1NZ.3,2 z *2 G, 0 0 iOT1AL
Tech. DAT UE PERMIT