1984, 04-04 Permit: 84A-2930 ResidencePLAN NUMBER APPLICAT>;ON/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
STREETADDRESS
P RCEL NO.
1. E. 11322 42nd Court
o Ie"rlp n/ m
LO�
BLOCK
SUBDIVISION
LEGAL DESCRIPTION:
2•
1 1
I Forest
OWNER
PHONE
PHONE
Lot 7 `?lock 1 Forest 'leadows Second Additi
t'Jolfland Inc.
2
3.
M LIN Rpines
2199206
i25Set 6acksin to:
Rd.
South 2Feet
North 3 East 56 West
CONTRACTOR
LICENSE EXPIRES
PHONESi
Zone
l�'M ft
Il,'f'cati
Residential
❑
same
sq
4.
ADDRESS
ZIPT
pe Const.
J
Opcupancy
Sprinklered
h
fi name V' V
(
❑Yes �No ❑Req'd.
DESIGNER
PHONE
NewPonst.
Remodeled Valuation
Total Bldg. Area
Valuation
CQ
Floor
5.
ADDRESS
ZIP
Main Floor Upper
Floors Garage/Storage
Greenhouse
1025
4pn
CHANGE OF USE FROM
TO
Cover Deck
1
Uncv. Deck
Fin. Basement
Unfin. Basement
6.
100 ea.
1 1025
TYPE
No.l the No.
�loors
No. FFiin. Rooms
No. Dwellings
IXNEW ❑ ALT. ❑ AD'N. ❑ RPL. ElMVE.
7. OF ❑ OTHER
WORK N BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
Certifi. of Exempt.
Required Yes❑ No❑
Number
or Variance
Received Yes❑ No❑
DESCRIBE WORK
8•
Shorelines/Flood Hazard
Plans Required
residence
Yes❑ Not Applic. ❑
Received
VALUATION
9.
I SOURCE GAS
ELECTRIC
Isil"!P
WATER
BLICC�
SEWAG
SEPT
Ownership
Public ❑ Private
FEES COLLECTED
80 , 900.
UTILLIITIES
RtIVATE ❑
SEWER
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
�
`jr2
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 cancel the provisions of any other state or local law regulating construction or the performance
1
of construction. SEE REVERSE SIDE FOR R OUIRED INSPECTIONS
Plumbing
SIGNATURE OF WQ LM I APPLICATION
Pres. March 8, 1984
OWNER OR AGENT DATE
Mach.
SPECIAL APPROVALS
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL dON,DITIONS: (SEE REVERSE SIDE FOR NOTICE)
tq"42� t�
V iP. Nem mor lir=
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
/,•, IN 180 DAYS
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $ �f o
WHEN MACHINE VALIDATED IN
THIS BECOMES A PERMIT.
PERMIT NUMBER
A 1 —
DAT I aUEUP n a PERMI�O.;' O z * 316, O O "AL
v
A!: O 177vIV