1988, 07-28 Permit App 88002160 ResidenceSPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509) 456-3675
I certify that I have examined this permit and state that the information contained in it and submitted by me or my agent to compile said permit is true and correct. In
addition, I have read and understand the IN SPECTI ON REQUI REMENTS/NOTICE provisions included herein and agree to comply with same. All provisions of laws
and ordinances governing this type of work will be complied with whether specified herein or not. I understand that the Issuance of this permit and any subsequent
inspection approvals or Certificates of Occupancy shall not be construed to give authority to violate or cancel the provisions of any state or local law regulating
construction, or as a warranty of conformance with the provisions of any state or local laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT nATE
INFORMATION WORKSHEET
// // ( / o --
PARCEL NUMBER: 3140 tAl
STREET DD. - R
CITY/STATE/ZIP:
SUBDIVISION: X41' 1Sd
BLOCK: Z- LOT:_ ZONE:e-1 DISTRICT:
LOT AREA: /Z 3-" F/A: WIDTH: /F1 DEPTH:J.7,7 R/W:
# OF BUILDINGS:_ # OF DWELLINGS: I WATER DISTRICT: 7-%m z9
OWNER: (/ C'fO circ PHONE:
MAILING ADDRESS: x D
CITY/STATE/ZIP:
CONTACT:
PHONE: SZZ�
SETBACKS: - FRONT:_ LEFT: -5— RIGHT: 3y REAR:
PERMIT USE: �¢
tzxxxzzzxxz*rcxxxxzxxxxxxxxzxxxxxxx:xxz*zxxxxx:xxz*zxxzxxxxxxxxxxxxxxxxxxxxxxzx
BUILDING INFORMATION
CONTRACTOR LICENSEENUMBER: p/ C-///g/,g,- *41 -?-G LG 5'®_
CONTRACTOR:_ ff 4 /--k c_ PHONE: - 9.?, -o
MAILING ADDRESS: Z-9 D, R -2C/3 %
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS:
NEW: REMODEL: ADDITION: CHANGE OF USE:
DWELL UNITS:_ OCCUPANT LOAD: BUILDING HGT: STORIES.
BUILDING DIMENSIONS: X (WIDTH X DEPTH) SQ. FT.:
REQUIRED PARKING: # HANDICAP: SEWER (Y/N): HYDRANT:
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