1984, 04-20 Permit: 84A-3599 ResidencePLAN NUMBER APPL I(CAT ION /PERMIT PERMIT NUMBER
SPOKA AE COUNTY — DtPARfiMENT OF BUILDING & SAFETY A - 2:GQC1
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
1. C7.
APPLICANT: COMPLETE NUMBERED SPACES —PRESS HARD TO MAKE 3 COPIES
PARCEL NO. kq
LOT I BLOCK SUBDIVISION
OWNER
3. L-AP_ej-L
MAILING ADDRESS
PHONE PHONE
ZIP
It) . —IE5 z b ti� ; ,L
North South East
I West
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification7149sidential
`s4yw�- 8;5X .13 �
R
Commercial El4.
ADDRESS
ZIP
Type Const. Occupancy
Sprinklered
❑Yes ❑No ❑Req'd.
DESIGNER
PHONE
N Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5. ADDRESS
ZIP
Main Floor Upper
Floors
G raage/Storage
Greenhouse
,5
—
CO Z`>
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
—�
6.
,---
--_
—
WN ❑ MVE.
No. Baths No.
"2_
Floors
No. Fin. Rooms
No. Dwellings
TYPE W ❑ ALT. ❑ AD' N. ❑ RPL.
7. OF El OTHER
BLD. ❑ PLMB. ❑ MECH. ❑ M. H. ❑ POOL
)
ayifl.oExempt. Required
Yes❑ No
Number
WORK
Received
Yes❑ No El
DESCRIBE WORK
Shorelines/ Flood Hazard
Plans Required LIK
8, i ,ate,
Yes❑ Not Applic. ❑
Received L(
VALUATION
SOURCE
GAS
ELECTRIC
pUB IC�
GE
SEPTIAC ❑
Ownership
FEES COLLECTED
9 •
UTILI .S
PRIVATE ❑
)
SEWER �/
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
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 OF ! APPLICATION
OWNER OR AGENT -y DATES -�
Mach.
SPECIAL APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env. Health
SEPA
Planning
t
Modular/
MFG. Home
Fire
Prevent.
Other (Specify)
Engineer
` �c
Ccs, 7t � C1,- a gip`
Utilities
' �
f
TOTAL $ -
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
PERMIT IS NONTRANSFERABLE
THIS BECOMES A PERMIT.
Plans
Exam.
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building
Tech.
IN 180 DAYS
Lb—J * xO Oo f
D A
DATESS"
CL
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C.3
W
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