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1984, 02-09 Permit 84A-1127 SidingHrrL1�H 1 IVIV/ r''tKIYII 1 SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 PERMIT NUMBER /A-Iiz7 APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES 1. 2. STREET ADDRESS G, IL �, 's5,on LOT BLOCK SUBDIVISION PARCEL NO. LEGAL DESCRIPTION: OWNER 3. TerrLF L. Bol'SC.. MAILING ADD ESS y � r SL� fwd '5 or) CONT ACT R 4. Nurilrw Bu rs ADD SS jot, Airril ate_ DESIGNER PHONE7 6 4- 54 7'g LICENSE EXPIRES 5//7/S14 PHONE ZI / (G North 'South Actual Set Backs in Feet to: PHONE Size of Parcel (1.,?8— 46,86 zip Type Const. Occupancy East West Zone Classification Residential ❑ Commercial ❑ Sprinklered ❑Yes ❑No ❑Req'd. ADDRESS CHANGE OF USE FROM 6. TO TYPE ❑ NEW 7. OF WORK ❑ BLD. PHONE New Const. Valuation ZIP ❑ ALT. ❑ AD'N. RPL. ❑ MVE. OTHER ❑ PLMB. ❑ MECH. ❑ M.H. E POOL Remode ed Valuation Total Bldg. Floor Area Greenhouse Unfin. Basement Main Floor Upper Floors Garage/Storage Cover Deck Uncv. Deck Fin. Basement NO. Baths No. Floors No. Fin. Rooms No. Dwellings Certifi. of Exempt. or Variance Required Yes❑ No❑ Received Yes❑ No Number DESCRIBE WORK 8. VALUATION,) 9' .26ID5 Sf .2t-i 5 I'd -ir Cl SOURCE GAS UTILLIITIES ELECTRIC WATER PUBLIC E PRIVATE ❑ SEWAGE SEPTIC SEWER E 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 INSPECT ONS SIGNATURE OF OWNER OR AGENT SPECIAL APPROVA S PRELIM. FINAL DATE Env. Health Planning Fire Prevent. Engineer Utilities SEPA Plans Exam. Building Tech. APPLICATION DATE SPECIAL CONDIT NS: EE REVERSE SIDE FOR NOTICE) PERMIT IS NONTRANSFERABLE PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED IN 180 DAYS Plans Required ❑ Received ❑ FEES COLLECTED U l Building Plumbing Mech. Plan Check SEPA Modular/ MFG. Home Other (Specify) TOTAL $ -17 Qe- *47.00 *47.006 *0,00 0 126g 02-09-84 6479, O. 0 W J_ U. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. DATE FS JEDU 9 - 4 PERMITLJ 2.7 *4 7.0 0,.F,,L