1984, 03-26 Permit: 84A-2592 Addition PLAN NUMBER a APPLICATION/PERMIT -1 - P MI NUMBER '
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SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY ` •` ? j
i NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS �_ {� PARCEL NO.
1. 1- - l 4-0 I I D"-Ni&• 4, r 1–' 2.- — 1 00
LQT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. 0 11:2 -='- PAIN)Ki iTci\l
OWNER PHONE cPHONE 02-)-1
3. t7&L61 L.1/C L /12' Actual Set Backs in Feet to:
MAILING ADDRESS TO ( J� I4:Z550
��-7 North ISouth [East / I West
CONTR CT fv�F�?iJ '(t LICENSE EXPIRES PHONENESizeof Parcel �J Zone Class�iccaatilpn Residential
�V ! '�' x 1 O .' f 744 - Commercial❑
4. ADDRESS ZIP Type{wn_ $t. Occupancy Sprinklered
vN ❑Yes OW ❑Req'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
5. 5i9 -
ADDRESS ZIPloG/ Upper Floors Garage/Storage Greenhouse •
CHANGE OF USE FROM TO Cover DeckUncv.Deck Fin.Basement Unf in.Basement
6. �,..
AD'N. ID RPL. ❑ MVE. No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE ❑ ❑ ALT. .T
7. OF ❑ OTHER
WORK BLD. ElPLMB. ElMECH. ElM.H. El POOL Certifi.of Exempt. Required Yes❑ No❑ Number
or Variance Received Yes No I: // i
DESCRIBE WORK Shorelines/Flood Hazard Plans Required
8. 17- 7 IllOCNI« • JI•lON E/ Yes❑ Not Applic.❑ Received
VALUATION SOURCEOGAS ELECTRIC piEtICz SEP ICS Ownership FEES COLLECTED
9• UTILITIES PRIVATE❑ SEWER"❑ Public❑Private
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included on O
reverse side,and know the same to be true and correct. All provisions of laws and ordinances governing this type of Building 6
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 REVERS SIDE FOR REQUIRED INSPECTIONS Plumbing
SIGNATURE OFf APPLICATION '/
OWNER OR AGENT 1, G j � DATE 3'-- �'—�'�" Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health -- yi SEPA
Planning Modular/
MFG.Home >.
Fire O.
Prevent. O
Engineer Other(Specify) W
J_
Utilities 6
TOTAL $
SEPA .
fi
PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE,
Plans , J, THIS BECOMES A PERMIT.
Exam. l PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCEDBuilding IN 180 DAYS InI� "'Tech. . • 3/, DATE ISS�ED 2 6 8 4 PERMIT IIo5 9. 2 z * 6 8, 0 0117
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