1983, 07-06 Permit App: 83A-6209 GaragePLAN NUMBER APPLICATION /PERMIT PERMIT NUMBER
-i SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY $2
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
9
APPLICANT: COMPLETE NUMBERED SPACES —PRESS
HARD TO MAKE 3 COPIES
STREETADDRESS
Const. Valuation
PARCEL NO.
E
SOCA Tu
-
LOT
BLOCK
SUBDIVISION
LEGAL DESCRIPTION:
2.1-f k tti;>
43
I �o "-Cr✓w ��� z��
of construction. SEE REVERSE SIDE FOR WUIRED INSPECTIONS
OWNER
PHONE
PHONE
3
tLN
ADDRESS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
ZIP
MAILING ADDRESS
Floors
ZIP
Actual t Backs in Feet to:
V_
-Z'-r
act y4na
North South SC—' East West
CONTRACTOR
SEPA
LICENSE EXPIRES
PHONE
Sze of Parcel
Zone Classification
Residential
4.
Cover Deck
Uncv. Deck
Fin. Basement
koc> k %4-5
T
Commercial ❑
ADDRESS
Fire
ZIP
Type Const.
Occupancy
Sprinklered
TYPE �EW
M- Batns No.
-1 I evi
❑Yes ❑No ❑Req'd.
9
DESIGNER
PHONE
Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
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
4 ilk(_-
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au-
4�61
5.
of construction. SEE REVERSE SIDE FOR WUIRED INSPECTIONS
Plumbing
SIGNATURE OF JJ- /IfAPPLIC ION
OWNER OR AGENIP( DATE
Mach.
ADDRESS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
ZIP
Main Floor Upper
Floors
Garage/Storage
Greenhouse
SEPA
Planning
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basemf
6.
MFG. Home
Fire
Prevent.
TYPE �EW
M- Batns No.
Floor=s
No. Fin. Rooms
No. Dwellings
7
❑ ALT. C"AD' N. ❑ RPL.
OF
❑ MVE.
11 OTHER
WORK '=' BLD. ❑ PLMB. ❑ MECH. ❑ M.H.
❑ POOL
Cartifi.ofExempt.
Required Yes El No
Number
or Variance
Received Yes❑ No
8•
DESCRIBE WORK
Shorelines/ Flood Hazard
Plans Required 19/
C'0 -r_0 6.AVZ.ALke
Yes Not Applic. ❑
Received fS
VALUATION
I SOURCE GAS
OF
ELECTRIC I
WATER
PUBLIC
SEWAGE
SEPTIC
Ownership
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
Building C.
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au-
.fes
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 WUIRED INSPECTIONS
Plumbing
SIGNATURE OF JJ- /IfAPPLIC ION
OWNER OR AGENIP( DATE
Mach.
SPECIAL APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Plan Check
Env. Health
SEPA
Planning
Modular)
MFG. Home
Fire
Prevent.
Other (Specify)
Engineer
I
Utilities
n
Pm �/ PERMIT IS NONTRANSFERABLE
Exa.PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
BQu„ihding qy 74 Al, IN 180 DAYS
TOTAL $ ':�.I .aa
WHEN MACHINE VALIDATED I
THIS BECOMES A PERMIT.
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SHEET NO. OF SHEETS
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LOCATION
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MADE BY DATE
CHECKED
BY
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