1983, 09-19 Permit: 83A-9190 GarageArrLIwA 1 KM/ FUMY' IT
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 DDRE
1. • 6 .1
LOT BLOCK SUBDIVISION
2. I I 3 (AILb rAF44 6-7
3
OWNER „IU6` 1 L ✓i 430 PHONE
MAILING ADDRESS
- CT.
4.
CONTR TIs LICENSE EXPIRES
ADDRESS
DESIGNER
5.
ADDRESS
CHANGE OF USE FROM
PARCEL NO. ,2,7"2„
7"z. — 24 1
LEGAL DESCRIPTION:
PHONE
ZIP
PHONE
ZIP
TO
TYPE iy.EW 0 ALT. 0 AD' N. 0 RPL. ❑ MVE.
7. OF WORK Z' BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL ❑OTHER
Actual Set Backs in Feet to:
North [South (East
Zone Classification
Sizq f
T
Pe
2)C4-0
Ral• tOcogpancy
New Const. Vaal_uation
1 Q
Main Floor
West
Residential
Commercia ❑
Sprinklered
❑Yes ONo ❑Req'd.
Remode ed Valuation
Upper Floors
Garage/
141 PI
Total Bldg. Floor Area
8.
DE CRIBE ORK
VALUATION
9.
SOURCE
UTILIF
TIES
OciAC (34D°1e)
GAS ELECTRIC WATE
pERP,
PRIVATE 0
SEWAGE
SEPTIC dr
SEWER 0
Cover Deck
No. Baths
ro. Floors
Uncv. Deck
Certifi. of Exempt.
or Variance
Fin. Basement
Greenhouse
No. Fin. Rooms
Required Yes No❑
Received Yes No❑
Shorelines/ Flood Hazard
Veen Not Applic. 0
Ownership
Public ❑ Private re
Unfin. Basement
No. Dwellings
Number
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 REVERSE SIDE FOR REQUIRED INSPECTIONS
SIGNATURE OF . i f, / _ APPLICATION
OWNER OR AGENT -�-�C� DATE
/GI (C
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
4.•,9"//,
Fire
Prevent.
Engineer
Utilities
141k.;
SEPA
Plans
Exam.
Building
Tech.
‘p6P10,
!A -
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 0
Received 0
FEES COLLECTED
Building 61
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
PIr
PERMIT UMBER
53 - 7IO
FILE COPY
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
•
DATEQSSUEDL 9 - 8 3
PERMITMA. 9, 0 z *6 1. 0 0 wMAL
-
a