1984, 01-26 Permit 84A-749 Storage BldgPLAN NUMBER
APPLICATION/PERMIT ,
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 ADDRESS
1.
LOT
2.
BLOCK
SUBDIVISION
OWNER
3. -
MAILING ADDRESS
PHONE
PHONE
PARCEL NO.
LEGAL DESCRIPTION: u i r.F�',- ,. [ w., t;,,4,C,
•14 .C; l L ei" C
CONTRACTOR
4. .1-1�an��,
•Y�-'i'v\c_q0
LICENSE EXPIRES
ZIP
�aGrzc�
PHONE
c:z4. L(,
Actual Set Backs in Feet to:
North 1Soutti Z r) [East
Size of Parcel
Zone Classification
1 West c7
Residential !?'
Commercial 0
ADDRESS
17
w (5 /v
ZIP
' C i CA CL
Types). Ofccuupany
Spr nklered
0Yes ❑No ❑Req'd.
DESIGNER
5.
ADDRESS
PHONE
NewConst. Valuatlon
•3,7E.()
Remode ed Valuation
Total Bldg. Floor Area
ZIP
Main Floor
Upper Floors
CHANGE OF USE FROM
\\ 6.
TO
Cover Deck
Uncv. Deck
Garage/Storage
4C )
Greenhouse
Fin. Basement
Unfln. Basement
\ TYPE {NEW ❑ ALT. ❑ AD'N. ❑ RPL.
7• OF I /
WORK ❑ BLD. ❑ PLMB. ❑ MECH. 0 M.H.
bESCRIBE WORK
8.
❑ MVE.
❑ POOL
❑ OTHER
No. Balks
No. Floors
No. Fin. Rooms
Certifi, of Exempt.
or Variance
Required
Received
Yes ❑
Yes❑
Nott/
No ❑
No. Dwellings
Number
Shorelines/Flood Hazard
Yes ❑ Not Apollo. 0
Plans Required 0
Received 0
9(
``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
t
SIGNATURE OF /i/ APPLICATI
OWNER OR AGEN �. l DATE
LUATION
SOURCE
F
UTILITIES
SPECIAL APPROVALS
PRELIM. FINAL DATE
GAS
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
ELECTRIC
WATER
PUBLIC 0
PRIVATE ❑
SEWAGE
SEPTIC Lit
SEWER ❑
Ownership
Public 0 Private 10'
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE$
iCIO 3L`.i 1L 7
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
PER TUMBR
N�-
02* *54 00
* 54 006
A *c00
74,82
01 —261 84
zq 647 c,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
01-26-84
74,9z
PERMIT NO.
*54,OO
TOTAL
DATE ISSUED
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