1983, 11-04 Permit: 83B-1334 Detached GaragePLAN NUMBER APPLIICATION/FIERM IT PERMIT NUMBER
SPOKANE COUNTY - DEPARTME' r OF BUILDING & SAFETY - _'M
NORTH 811 JEFFERSON / SPOKANE, NVASHIr.GTON 99260 / (F09) 456.1675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. C . 1 Z -Z4- TN Z8 4al;, Z Xo l
LOT I BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. -7" 5 Zcv K.vte or'v-u:s lL7 wNS t TCS
OWNER PHONE PHONE
3 6i NX �A�Z.tSKA 424- (V37
MAILING ADDRESS
ZIP
Actual Set Backs in Feet to:
(qcA Z:C.4
North South East Z West
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential
5th Mc
4.
i UC.? X t .:]CU
Commercial ❑
ADDRESS
ZIP
TyR2,Const.
Occupancy
Sprinklered
�ArvtE�
f� .
El Yes ❑No ❑Req'd.
DESIGNER
PHONE
wConst .Valuation
Remodeled Valuation
Total Bldg. Floor Area
"
•
t Z.
5.
-� \
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
6.
i'
--
�–
TYPE
No.Baths
No. Floors
No. Fin. Rooms
No. Dwellings
[i( EW ❑ ALT. 1:1AD' N.
❑ RPL. ElMVE.
-�
t
7• OF
El
WORK BLD. ❑ PLMB. ❑ MECH.
7 M. H. ❑ POOL
Certifi. of Exempt.
Required Yes❑ No _
Number
or Variance
Received Yes No(�
DESCRIBE WORK Shorelines/ Flood Hazard Plans Required r/
8• E %« ' Act e Yes Not Applic. ❑ Received �f
VALUATION I SOOUFCE GAS ELECTRIC pU13ICV SEPT C Ownership Ile, FEES COLLECTED
9• UTILITIES PRIVATE ❑ SEWER ❑ I 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
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 pro'yh9lions of any other state or local law regulating construction or the performance
of construction. SEE REVERSE,3ME FOR UqyIRED INSPECTIONS
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM NAL DATE
Env. Health 4%//k
1�/, /
Planning
Prevent
Utilities
Plans f; + PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT CO `MENCED
Buildingn-r- IN 180 DAYS
Building %1400
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
v�A *114.00
*114,006
*000
1 3331=1 –04-83
6479,
TOTAL $ ��=bd I
WHEN MACHINE VALIDATED IN THIS S
THIS BECOMES A PERMIT.
DATEI EDo 8 � PERMITiJ�. 5' 4 z * 1 14, 0 0 j>01fAL
}
CIL
C
L
LL