1984, 02-14 Permit 84A-1242 Storage Room[PLAN NUMBER
APPLICATION/PERMIT
SPOKANE euiuNTY — DEPARTMENT 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 lit 111 C 4.sv€, C. >, 12_
LOT
2. Z
BLOCK
SUBDIVISION
4-►�T3GP�y Y'Y\ei-k
OWNER
3. iAr3xtfvL At.1-3R\c 1AT
MAILING ADDRESS
' VI 1
4.
CONTRACTOR
ADDRESS
VAC
PHONE
LICENSE EXPIRES
•
DESIGNER
ADDRESS
CHANGE OF USE FROM
TO
PHONE
G(Z4,- r
ZIP
PHONE
ZIP
PHONE
ZIP
TYPE GINEW ❑ ALT. Y AD'N. 0 RPL. 0 MVE.
7 OF WORK O BLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL ❑OTHER
DESCRIBE WORK
8'
VALUATION
9.
SOURCE
F
UTILLIITIES
GAS
PARCEL NO.
LEGAL DESCRIPTION:
Actual Set Backs In Feet to:
North South
Size of Parcel
`7O NIC lots "Vikey
T = st. Occupancy
G _r.)
East
Zone Classification
Residential
Commercial ❑
Spr nklered
❑Yes ❑No ❑Req'd.
Const. Valuation Remode ed Valuation
112-C "-)
Main Floor Upper Floors Garage/Storage
No. Baths
Certif 1. of Exempt.
or Variance
Uncv. Deck
No. Floors
Fin. Basement
No. Fin. Rooms
Total Bldg. Floor Area
G eenhouse
Required Yes❑ Noe -
Received Yes No❑
/n�
`` Shorelines/Flood Hazard
Ao U `� D 1'Vl Oft LC (" \C5 fM Lt Yes❑ Not Apollo. 0
ELECTRIC
WATE
PUBLIC
PRIVATE 0
SEWAGE
SEPTIC
SEWER ❑
Ownership
Public 0 Private le
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
SOF
OIe74/Z WNER OR AGENT � L a� — '///'
^/ ,/ �L/
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Unlin. Basement
No. Dwellings
1
Number
Required o
Received lD/
FEES COLLECTED
Building :24. c)
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $ 24, zza
PERMIT NUMBER
PA-I24Z
02* *24.00
*24.006
11 *000 2
1 2 4. 1
02-14-34
6Q79..
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEQS UEDI- 4 - 84
.11
PERMIT-WU.' 2
*24,UO2OtTAL