HomeMy WebLinkAbout1984, 02-14 Permit: 84A-1252 ResidencePLAN NUMBER APPLICATION/PERMIT
SPOKANE COUNTY - DEP`ARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
STREET ADDRESS
L T BLOCK
2. .7?
OW
3.
MAIL NG AD ESS
I cv
4.
DESIGNER
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
PARCEL NO. 5 ,
SUBDiVISIOy ILEGAL DESCRIPTION:
PHON
LICENSE EXPIRES PHONE
ZIP
PHONE
Actual Set Backs in Feet to:
North South ISEast West ICr
Sim of Parcel ,i ne CIM;><i tion Residenti
Q � 7 �✓ 1¢j Commercial ❑
TypeCohst) upa y . Sprinklered
Dyes ❑No ❑Req'd.
New,Const. Valuatlo Remodeled Valuation Total Bldg. Floor Area
�J.
ADDRESS
ZIP
MaiiFJpor
II?�
upper Floors
Garage/$tora
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
�.
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
TYPE NE ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7.
OF El OTHER
LD ❑ PLMB ❑ MECH ❑ M H ❑ POOL
Certifi of Exempt
Required Yes❑ No El
Number
WORK or Variance
Received Yes❑ No F1
DESCRIBE WORK /Shorelines/Flood Hazard Plans Required
8. 1 ( Yes❑ NotApplic. ❑ Receiv
��� �
VALUATION SOURCE GAS ELEC IC WATER SEW
AG
UTIOwnership FEES COLLECTED
9 OF PUBLIC SEPTIC Public ❑ Private
UTILITIES SEWER ❑
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 REVERS& SIDE FOR REQUIRED INSP TIONS Plumbing
SIGNATURE OF APPLICATION
n%AituFa na er_F=NT f ry DATE ___ Mach.
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
lqj I ��
Planning
Prevent.
Engineer
Utilities
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plans • PERMIT IS NONTRANSFERABLE
Exam. F -I PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building1/7,�".) IN 180 DAYS
Tech. N
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
WHEN MACHINE VALIDATED IN TH
THIS BECOMES A PERMIT.
PERMIT NUMBER
DATEYS, Eij 4_ 8 4 PERMIT'Nf . 5.262 *366,000'
COITAL
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