1984, 03-30 Permit: 84A-2761 Storage BldgPLAN NUMBER APPL ICAT ION /PERMIT PERMIT NUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY -Z-761�
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
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APPLICANT: COMPLETE NUMBERED SPACES ,-- PRFSS HARD TO MAKE 3 COPIES
STREET ADDRESS
PARCEL N0.
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5.
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OT
BLOCK
SUBDIVISION
LEGAL DESCRIPTION:
2.
Z1-
jOW
ADDRESS
ZIP
Main Floor Upper
ow
Gara
P ONE
Greenhouse
PHONE
I
3
Fin. Basement Unfin. Basement
MAILING ADDRESS
��
TO
IPActual
Set Backs in Feet to:
' I
4
15
North South East West
CONT9AT
LICENSE EXPIRES
P ONE
Size of Parcel
ZongClas§ification
�
Residential
Commercial ❑
4.
ADDRESS
TYPE NEW 1:1 ALT. ❑ AD' N. El RPL. 1:1 MVE.
<
`
ZIP
TypeCogst.
U
Occul cy
ag
(�
I
Sprinklered
❑Yes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Required
Remodeled
Valuation
Total Bldg. Floor Area
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/
5.
ADDRESS
ZIP
Main Floor Upper
Floors
Gara
/$t ee
Greenhouse
I
Fin. Basement Unfin. Basement
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
,
TYPE NEW 1:1 ALT. ❑ AD' N. El RPL. 1:1 MVE.
`
7. OF ❑ OTHER
BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑POOL
empt.
Required
Yes❑ No❑
Number
WORK
aVarianE
Received
Yes❑ No❑
DESCRIBE WORK
Shorelines/Flood Hazard
Plans Required ❑
8.(�✓�%{,,�
Yes❑ Not Applic. ❑
Received ❑
VALUATION' SOOUFCE
GAS
ELECTRIC
WATER
PUBLIC ❑
SEWAGE
SEPTIC ❑`
Ownership
FEES COLLECTED
9• UTILITIES
PRIVATE El
SEWER H
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
tel/
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au-
Building
thority to violate or provisions of any other state or local law regulating construction or the performance
of construction. SE0REVERSIa Simses R110 ED INSPECTIONS
Plumbing
APPLICATION- 3
'-�2OWNER
SIGNATURE OF6�
OR AGENT
DATE
Mach.
SPECIAL APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env. Health
SEPA
Planning
Modular/
MFG. Home
Fire
Prevent.
Other (Specify)
Engineer
Utilities
TOTAL $
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
Plans
PERMIT IS NONTRANSFERABLE
THIS BECOMES A PERMIT.
Exam.
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
r -+
* 6. 0
Building
3
IN 180 DAYS
A
(� — _. 2 / 6. 1 z
Tech.
DATEiS�UE� PERMIT NO.
TOTAL
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