1983, 10-24 Permit 83B-752 Storage BldgPLAN NUMBER
AF'F'LIC:A I IUIV/PERMIT
SPOKANE COUNTY — DEPART'VIENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1.
LOT
2.
BLOCK
1.0 �� $ ]).ib fL Pt
SUBDIVI ION
OWNER
3. V\1(!k e�-i-
MAILING ADDRESS
CQNTRACTOR
4. (4t ( c to
A
DRESS
Iry L£
DESIGNER
5.
ADDRESS
PHONE
LICENSE EXPIRES
PHONE
ZIP
C' t o I to
PHONE
534- 4304
ZIP
Cfl20.2—
PHONE
PARCEL NO.
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North 7 S I South- [East
Size of Parcel
Soo
Type Const.
rl��l
Occupancy
utitil
New Const. Valuation
Z `1 r✓ c)
Hest L .�
Zone Classification
Residential Y--
Commercial ❑
Sprinklered
❑Yes -No LReg 'd.
Remode ed Valuation
Total Bldg. Floor Area
ZIG2b
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE ENE ❑ ALT. ❑ AD' N. ❑ RPL.
7. OF
WORK LD. ❑ PLMB. ❑ MECH. ❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
CertifI. of Exempt.
or Variance
Required YesE Non
Received Yes❑ Non
Number
DESCRIBE WORK
8. .ma zr o(a e— bLAL. k—D1
VALUATION f SOURCE
UTILITIES
9.
AS
ELECTRIC
c* L4 c!' -
WATER SEWAGE
PUBLIC ❑ SEPTIC E:
PRIVATE ❑ SEWER
Shorelines/Flood Hazard
Yes El Not Applic.
Ownership
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
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 REOU%RED INSPECTIONS
SIGNATURE OF APPLICATION
OWNER OR AGENT
DATE /e2
SPECIAL AVWROVALS cSPECIAL Ct$NDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
`/nv. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
,441777
may\
— � C D AA V„ - k/a
f
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plans Required ❑
Received ❑
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $ 1 +k't
PERMIT NUMBER
8.3$-7�
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED 2 4 _
7 5, 2 z *114,002
PERMIT NO. TOTAL
SEV'IAGE SYSTIII VERIFICATION
THIS FOR!•i SHOULD BE COMPLETED ''11-1E1I THERE IS NO RECORD OF EXISTI'''!G
SE:VAGE SYSTEM
IN ORDER TO PROCESS YOUR BUILDING PROJECT; THE FOLLG'jING INFORMATION
NEEDS TO BE VERIFIED:
"D/O
ADDRESS c i4 S
AGE OF HOUSE 'Y.'.) — AGE OF SYSTEM i ��
TYPE OF SYSTEM INSTALLED AT THIS PROPERTY
MS THE SYSTEM LOCATION VERIFIED BY VISUAL OBSERVATION BY YOU? YES MO
L OGAT I ON OF THE SY ; T EE71: (PLEASE MAKE OTHERDRAWING
INGTSHCT, SHOWING NESOETC.)
JSE, TANK,
ERIE I
i ti+�la r..Z Ave:
REMARKS:
<20
mi
‘N
r
t
v
1\!
HIS INFORMATION IS PROVIDED TO THE BEST OF MY KNOWLEDGE.
SIGNED:
DATE
( !ACME
EST �`�� COLLEGE, ROOM,
MAIL THIS FOn`4 TO: ENVIRONEWTAL HEALTh, WEST
SPOKANE, S"WASHINGTON On (PHONE gn-I fl)
10/M