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1984, 01-20 Permit 84A-613 MHFLAN NUM13tH AI-PI-'L IL:A 1 ION / 1'EFITV1 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 ADp S 1. ILVI U� 0 ri-614., 2. LOT BLOCK MAILINGI A�DR�SS rtortot COCNTAI(��/ 4. "' ADDRESS DESIGNER ADDRESS CHANGE OF USE FROM io LICENSE EXPIRES PHONE PHONE PHONE TYPE gr<EW ❑ ALT. 0 AD' N. ❑ RPL. 0 MVE. 7. OF WORK ❑ BLD. ❑ PLMB. 0 MECH. ,ZM.H. ❑ POOL ❑ OTHER DES 8. 9. RIBE WORK SOURCE UTILITIES GAS ELECTRIC -'ram i$CG WATER," SEWAGE/ PUBLICZ SEPTIC PRIVATE ❑ SEWER ❑ PARCEL NO. --7 51-`/�, O J � r.7l LEGAL DESCRIPTION: 6�i' i or OF:- ` 7 Actual Set Backs in Feet to: North 1,0 !South Sizxfprcel New Const. Valuation Main Floor Z. e Classification West Z Residential 21 Commercial ❑ Spr nklered ❑Yes ❑No ❑Req'd. Remodeled Valuation Upper Floors Cover Deck No. Baths Certifi. of Exempt. or Variance Uncv. Deck Garage/Storage No. Floors Total Bldg. Floor Area Greenhouse Fin. Basement No. Fin. Rooms Required YesNoO Received Ye ❑ No Shorelines/Flood Hazard Yes NotApplic. ❑ Ownership Public ❑ Privat I her 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 OWNER OR AGENT SPECIAL APPROVALS PRELIM. FIN L DATE I Env. Health Planning Fire Prevent. MKS tik 4/6 Engineer Utilities SEPA Plans Exam. Building Tech. APPLICATION p DATE l 6' a SPECIAL CO DITIONS: (SEE REVERSE SIDE FOR NOTICE) PERMIT IS NONTRANSFERABLE PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED IN 180 DAYS Unfin. Basement No. Dwellings Number Plans Required ❑ Received ❑ FEES COLLECTED Building Plumbing Mech. Plan Check SEPA Modular/ MFG. Home 50, Other (Specify) TOTAL $ PEiw NUM i 2) 02* *5000 61.2 0.1 20-84 6.479, WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. DATEQSSUEE D . 4 PERMIT Nd. �' * 5 a °(4AL