1983, 04-26 Permit App: 83A-3342 Attached GarageSF'VMANt WUN 1 Y — UtPAHTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HN FO MAKE 3 COPIES
STREET ADDRESS PARr:FI Nn
IF_ \ \ 2{ B4:T t-►
LOT I BLOCK SUBDIVISION
OWNER PHONE
3 1A \Y -.c M G N z IA
MAILING ADDRESS
LEGAL DESCRIPTION:
PHONE J
2374-
ZIP Actual Set Backs in Feet to:
�c,� t
��%�W North South tea` East Q West
CONTRACTOR
GAyvk�c
Env. Health
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential V
4.
Engineer
x
r\
Commercial ❑
ADQRESS
'a,4
SEPA
ZIP
Tynst.
Occupancy
Sprinklered
Mr-'
Q
f,
rn_f,
Dyes ❑No ❑Req'd.
DESIGNER
PHONE
ewConst. Valuation
Remodeled Valuation
Total Bldg. Floor Area
ADDRESS
ZIP
Main Floor Upper
Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
6.
__
_...-
❑ EW ❑ ALT.
AD' N. F-1RPL. 11 MVE.
No. Baths No.
Floors
No. Fin. Rooms
No. DwellingsTYPE
7.
l
OF El OTHER
WORK BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
Certifi. of Exempt.
Required
Yes[-] Noe
Number
or Variance
Received
Yes❑ No❑
8 DESCRIBE WORK
Shorelines/ Flood Hazard
Plans Required
(f Wino 1�12.Iq
Yes❑ NotApplic. El
Received V
VALUATION
9•
SOURCE
GAS
ELECTRIC
/�Zk
pU6 ICRQY
SSEAGE EPTIC ❑/
Ownership/
FEES COLLECTED
UTILITIES
PRIVATE DDD
SEWER Pf
Public 11Private�d
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
t OGS
Building ��
work will be complied with whether
p
specified herein or not. The granting of a permit does not resume to
p g g p p give au-
thority to violate or cancel th
p ovisions of any other state or local law regulating construction or the performance
of construction. SEE REVE S
SIDE REOUIRED INSPECTIONS
Plumbing
SIGNATURE OF
APPLICATID. L �
OWNER OR AGENT
_�6_
DATE ! U
Mech.
SPECIAL APPROVA
PRELIM. FINAL
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
Q
CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plan Check
SEPA
Modular/
MFG.Home
Other (Specify)
( .O�
TOTAL $ I
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEQSSUE� 6— 8 3 j �. 4 2 0
PERMI
*61,00OjAL
CL
O
V
W
J_
U.
iv
205
MIKE MENZ 1 A
II Z 45E, 34 n n o A