1983, 02-03 Permit: 83A-0817 GaragePLAN NUMBER APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES —PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1= L 7.4-Z� n—t ��1543'+it-.-z>
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
OWNERPHONE PHONE
3. N" '+ 7
MAILING ADDRESS I tA ZIP Actual Set Backs in Feet to:
. i 7-4-Z� -:so` 4;%,G{ Zl North t 1Suth East West i
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel
--
Zone Classification
Residential .
`1�-cam -T'EEL.,r�C,�
Main Floor
- z- rl ,
F1
a x t�i�
Greenhouse
��f��=�t..c�`�.�+�:'.
Commercial
L14.
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
JDRESS
Wt'-
ZIP
Ty��nst.
Occupancy
I
Sprinklered
C7> . 1 � `4'��]�+
Oiti � i4
._.k6\
iii. '-1
[-]Yes ❑No ❑Req'd.
DESIGNER
PHONE
NeTPnst. Valuation
Remodeled Valuation
Total Bldg. Floor Area
TYPE 1'J NEW 11 ALT. ElAD'N. 11 RPL. 1:1MVE.
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-`
-
^--)/
5.
--
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
/
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
TYPE 1'J NEW 11 ALT. ElAD'N. 11 RPL. 1:1MVE.
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-`
-
7 ❑OTHER
WORK V`BLD. ElPLMB. ElMECH. 1-1M.H. El POOL
Certifi. of Exempt.
Required Yes Nod'.
Number
or Variance
Received Yes❑ Nom
DESCRIBEWORK
Shorelines/ Flood Hazard Plans Required
8' "'l'4�4 1 t,: � I f .. '4 r <^ / f S! '` Yes 11 Not Applic. ❑ Received I
VALUATION SOURCE GAS ELECTRIC PUBLIC e7 SEPTIC LTA Ownership / FEES COLLECTED
9• UTILITIES PRIVATE ❑ SEWER SEWAGE Public ❑ Private ea'
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 ofl
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 REDUIRED INSPECTIONS Plumbing
SIGNATURE OF APPLICATIO
t7WNFR nR ArFNT/- / DATE -% Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health I t
Planning
Fire
Prevent.
Utilities
SEPA
Plans PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building l
Tech. �� f� IN 180 DAYS
J
Plan Check
SEPA
Modular/
MFG.Home
Other (Specify)
TOTAL $ �—
PERMIT NUMBER
' C
WHEN MACHINE VALIDATED IN THIS SPAC
THIS BECOMES A PERMIT.
C5
DATA UE PERMIT Nd. -' " z
n2- n3" -'A3 R1 755
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