1984, 03-20 Permit: 84A-2403 Addition GaragePLAN NUMBER
} APPLICATION/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
STREET ADDRESS
..en .r A . lEt `Oe PARCEL NO.
1. •
LOT BLOCK
2. 7 2
3.
4.
OWNER
4+5(z- R,r Vtvm
SUBDIVISION
T11'1{(W t i ScritITN t 7
PHONE
MAILING ADDRESS
SQ<rfl.-- ---
CONTRACTOR CONTRACTOR
iz�-ZB 18
0.4141 - cfo7
LEGAL DESCRIPTION:
ADDRESS
LICENSE EXPIRES
ZIP
PHONE
Actual Set Backs in Feet to:
North .1=-YIJI ' 1South )(19i2 3
1-1 East(9I 'I West
Size of Parcel 1
100)4130
Zone Classification
J
Residential
Commercial ❑
5.
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
ZIP
PHONE
ZIP
TO
TYPE ❑ NEW ❑ ALT. pt -AD' N. ❑ RPL. ❑ MVE.
7. OTHER
WORK ,,BLD. CI PLMB. El MECH. CI M.H. CI POOL
❑
Type Confit.
Occupancy'
Spr'nklered
❑Yes ❑No Req 'd.
Ne/Const. Valuation c�
amu' )0
Main Floor
Remodeled Valuation
Upper Floors
Cover Deck
Uncv. Deck
Total Bldg. Floor Area
Garage/Storage ,
Fin. Basement
No. Baths
No. Floors
Certifi. of Exempt.
or Variance
Required
Received
Greenhouse
No. Fin. Rooms
Yes(: Nor-
Yes= No'
Untin. Basement
No. Dwellings
Number
8.
DESCRIBE WORK
(z' X o' E kPPiT[O
VALUATION
9.
SOURCE
UTILITIES
GAS
ELECTRIC
(\.\
Shorelines/Flood Hazard
Yes 7. Not Applic. L:
WATER_
PUBLIC IJk
PRIVATE S
SEWAGE.
SEPTIC
SEWER' E
Ownership
Public _ Privateg
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
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 REVEIRSEDE FOR REQUIRED INSPECTIONS
SIGNATURE OF
OWNER OR AGENT
APPLICATION n G
DATE
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
NIIPt
Fire
Prevent.
Engineer
LUtilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plans Required H
Received
FEES COLLECTED
Building
41
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
PERMIT NUM
014 - ER 0.3
n n
*47.0C
*47.006
A *0.00
240.28
03-20-84
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATELtSSUECd Q
0
PERM -1'214v. Q z
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