1983, 09-26 Permit App: 83A-9513 Detached Garage_ brUMANt C:UUN I Y — UtF'AK I MI=N 1 OF IiUILUINU & 5AFtTY 1
NORTH 811 JEFFERSON / SPOKANE, WASH114GTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES —PRESS HARD TO MAKE 3 COPIES
PARCEL NO.
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LEGAL DESCRIPTION:
2. t
OWNER
S �
P O� �
P ON�
3.
tC!
MAILr ING ADDR�
Actual SemisBacks in
i
Q r
l¢
North mouth East West -Z•j
CONT T
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential
4.
Commercial ❑
ADDRESS
ZIP
Type Corlst.l
Occupancy
Sprinklered
�N
❑Yes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
_Z_
5.
ADDRESS
ZIP
Main Floor Upper
Floors
Garage/ orage
Greenhouse
J
CHANGE OF USE FROM
TO
Cover Deck
ncv. Deck
n . Baserhent
Unf in. Basement
6.
1
T
I
1
'
TYPE:Ja
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
El ALT. ❑ AD' N. ❑ RPL. F-1MVE.
7• ❑OTHER
rLD.
Certifi.of Exempt.
Required Yes❑ No El
Number
WORK 'a C]PLMB. ElMECH. ElM.H. El POOL
or Variance
Received Yes❑ No❑
DESCRIBE WORK
8
Shorelines/ Flood Hazard
Plans Required El
Yes❑ Not Applic. ❑
Received El
VALUATION SOURCE
AS ELECTRIC
PUBL�CRC�
SEPTICII
ownership
FEES COLLECTED
9 UTILITIES
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
"7
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
of construction. SEE REVERSE SIDE FOR-ArEQUIRMINSPECTIRNS
Plumbing
SIGNATURE OFLAPPLICATION � Z
OWNER OR AGENT DATE —6—=-_
Mach.
SPECIAL APPROVA
PRELIM. FINAL DATE
Env. Health
Planning
Prevent
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
1.
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 $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS
nnBECOMES A PERMIT.
DATEY 9UEI� 6p z
PERMITO N
*75.00q"#L
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