1984, 04-11 Permit: 84A-3235 GaragePLAN NUMBER APPL MCAT ION /PERMIT
SPOKANE COUNTY — DEPA RTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
STREET ADDRESS
L,OBLOCK
2. 1 1 C)
APPLICANT: COMPLETE NUMBERED SPACES -PRESS HARD TO MAKE 3 COPIES
(— �µ PARCEL NO. .2--7 14 (4
SUBDIVISION LEGAL DESCRIPTION:
L -i I .irA�l" AclnelS Z NJQ AM,
SPECIAL APPROVALS SPECIAL CONDITI NS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE --Ds
�� TIC 0
Env. Health
Planning
Prevent.
Engineer
Utilities
PERMIT IS NONTRANSFERABLE
Plans
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Ridldinn IN 180 DAYS
Plan Check
SEPA
Modular/
MFG. Home
PERMIT NUMBER _
I
Other (Specify)
TOTAL $ w
WHEN MACHINE VALIDATED IN THIS
THIS BECOMES A PERMIT.
E,
DATSSUEDl 1— 8' 4 PERMIT�1@. 3 5 z * 6 �. 0 n NTAL
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WNER
nils, �"wc -- vo 0 r)
PHONE
PHUNE
�' 2 r - I
3
MAILING ADDRESS,
ZIP
Actual Set Backs in Feet to: 1
i,r
I _ ' /�T
t 1 '
North lI`��I ' South East
I. (i West /�) %
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
ResCommercial 1
Commercial 0
_
'Sprinklered
4.
ADDRESS
ZIP
TY V n
1:1 Yes ❑No ❑Req'd.
_i
PHONE
New nst V ti
Remodeled Valuation
Total Bldg. Floor Area
DESIGNER
Ga
Cu
5.
ZIP
Floor
Upper Floors
Garage Storage
Greenhouse
ADDRESS
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
CHANGE OF USE FROM
TO
s
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
TYPE ❑ NEW ❑ ALT. ))(AD'N. ❑ RPL. ❑ MVE.
7.
❑ OTHER
OF ry�gLD. ❑ PLMB. ❑ MECH. ElM.H. ❑ POOL
Certifi. of Exempt. Required
Yes❑ No❑
Number
WORK r —
or Variance Received
Yes [I Non
DESCRIBE WORK _; .�
Shorel8 Hazard
❑
Plans Required❑
Received ❑
s1-1inesl otA
Yes❑ NotApplic.
Yes
VALUATION
SOURCE
GAS
ELECTRIC
I WATER
PUBLIC
SEWAGE
SEPTIC 1]-
Ownership
FEES COLLECTED
9.
OF
I UTILITIES
PRIVATE
SEWER
Public 11 Private
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included on
r �,
reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this type of
Building I
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 REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
SIGNATURE OFAPPLICATION
/-J DATE
Mech.
OWNER OR AGENTjbo
SPECIAL APPROVALS SPECIAL CONDITI NS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE --Ds
�� TIC 0
Env. Health
Planning
Prevent.
Engineer
Utilities
PERMIT IS NONTRANSFERABLE
Plans
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Ridldinn IN 180 DAYS
Plan Check
SEPA
Modular/
MFG. Home
PERMIT NUMBER _
I
Other (Specify)
TOTAL $ w
WHEN MACHINE VALIDATED IN THIS
THIS BECOMES A PERMIT.
E,
DATSSUEDl 1— 8' 4 PERMIT�1@. 3 5 z * 6 �. 0 n NTAL
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