1984, 04-18 Permit 84A-3498 AdditionPLAN NUMBER
APPL ICAT ION /PERM 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
1.
STREET ADDRESS
LOT
2.[307
BLOCK
SUBDIVISION
OPPoNT-U Nl'
OWNER
3 �+ t. •
MAILING ADDRESS
CONTRACTOR
4. �(agui105Ki Cbr*
ADDRESS
4 ✓ I o MAYLG,054z4.
DESIGNER
ADDRESS
CHANGE OF USE FROM
PHONE PHONE
ZIP
LICENSE EXPIRES P.
BONE
1r _70fz
ZIP_ Y s1
PHONE
ZIP
TO
TYPE 0 NEW 0 ALT. XAD'N. ❑ RPL. ❑ MVE.
7 OF ❑ OTHER
WORK BLD. 0 PLMB. ❑ MECH. 0 M.H. 0 POOL
PARCEL NO.
LEGAL DESCRIPTION:
Size of Parcel
0 0 .%)( ZD
�,T(
East
West
Zone Classification
Type Con t Occ .ancx Sprinklered
❑Yes ❑No ❑Req'd.
New Const Valuation Remodeled Valuation Total Bldg. Floor Area
o
Garage/Storage Greenhouse
Uncv. Deck Fin. Basement Unfin. Basement
Residentlal.
Commercia
No. Baths
No. Floors
No. Fin. Rooms No. Dwellings
Certifi. of Exempt.
or Variance
IRequired Yes❑ No❑
Received Yes❑ No❑
Number
8. DESCRIBE WORK I
If ,C 1.0 P&PmoM Ire:
lr
VALUATION
9.
SOURCE
UTILLIITIES
GAS
ELECTRIC
WATER
PUBLIC ❑
PRIVATE ❑
SEWAGE
SEPTIC
SEWER ❑
Shorelines/Flood Hazard
Yes ❑ 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 REQUIRED INSPECTIONS
SIGNATURE OF ` ✓ r L/' APPLICATION I J r+ ` ��
OWNER OR AGENT �Tn-G C�C��L�'� DATE _
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
rn m
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plans Required ❑
Received ❑
FEES COLLECTED
I CC
Building Ca I.,
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
PERMIT NUMBER
02* *61,00
*61.00_4:
R *0,00
349,72
04•-18-'84
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEoS54J - 8 -'p 4
TOTAL
PERMIT �..9 8 z * 6 1. 0. 0 a H