1983, 10-25 Permit App: 83B 853 GaragePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
1.
STREET ADDRESS
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
1.
LOT BLOCK
2. Z 4
OWNER
(„64(..t..\ '—Dt
SUBDIVISION
AWLEv y -•1/41144-t
PARCEL NO.
3 fJ J
MAILING ADDRESS
1?ZCa)
CONTRACTOR
4.
ADDD4RESSSS�`
DESIGNER
5.
ADDRESS
PHONE
Cokca
PHONE
12l -et;?
ZIP
LEGAL DESCRIPTION:
14552 - 110'Z.
LICENSE EXPIRES
PHONE
Actual Set Backs in Feet to:
North 'South Gr
ZIP
PHONE
Size of Parcel
70 >< t).-1
East 'N771
West
Zone Classification
Residential Sr
Commercial 0
Type Const. Occupancy
�N
CHANGE OF USE FROM
6.
TO
ZIP
Sprinklered
❑Yes L0 No 0Req 'd.
New Const. Valuation Remode ed Valuation Total Bldg. Floor Area
1q?c7 2
Main Floor
Upper Floors
Garage/Storage
Greenhouse
Cover Deck
Uncv. Deck
Fin. Basement
Unfig. Basement
TYPE ❑ NEW ❑ ALT. 7 AD' N.
7. OF
f� /
WORK BLD. ❑ PLMB. ❑ MECH.
8 DESCRIBE WORK
1A CIA iE
VALUATION
9.
SOURCE GAS
UTILITIES
❑ RPL.
❑ M.H.
❑ MVE.
0 POOL
0 OTHER
No. Batas
No. Floors
No. Fin. Rooms
Certifi. of Exempt.
or Variance
Required Yes No
7
Received Yes El No❑
No. Dwellings
Number
(izTER ,)ELECTRIC I WATER
PUBLIC
PRIVATE
PRIVATE 0
Shorelines/ Flood Haza d
Yes Not Applic.0
Plans Required ❑
Received E
SEWAG
SEPTIC
SEWER 0
Ownership
Public 0 Private
I hereby certify that I have read and examined this appl cation 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 APPLICATION
OWNER OR AGENT DATE
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
to
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building 40,.60
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $ 4-00
PERMIT NUMBER
836 P3
02* *40.00
*40,00
A *000
8522
10-25-83
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSED 2 5 - 8 J
PERMIT NO 5, 3
z *4O.002F
TOTAL
FILE COPY
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