1983, 04-01 Permit: 83A-2514 Residential AdditionPLAN 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
1.
STREET ADDRESS
E.10125 ALK1
LOT
2.
BLOCK
SUBDIVISION
OWNER
3 T,ctc 1- lt.,t.44 Ru�ISJO
MAILING ADDRESS
1 - . '1421s ALt -
PHONE
PHONE
t=t -izca 11
PARCEL NO.
1aS - - 0ZS+
LEGAL DESCRIPTION: E 3 /e}. OF LOT P L Y-ZZ
xc.. r £XC.. N. U.O' G w►'� tOr +-u "CS
aL% - Z2- . N. t o' ijt.tTGtAIN`s A CIO
CONTRACTOR
4. �,At■.E
ADDRESS
.1k note
LICENSE EXPIRES
DESIGNER
5. a
ADDRESS
S
'511
F.o @2
CHANGE OF USE FROM
6.
ZIP
C C
PHONE
ZIP
PHONE
ZIP
Ct2dG
TO
TYPE ❑ NEW ❑ ALT. iAD' N. ❑ RPL. ❑ MVE.
7. WORK L'BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL ❑OTHER
Actual Set Backs in Feet to:
North I South
Size of Parcel
CIO Ni
Type Const. Occupancy
12
New Const. Valuation
Main Floor
5i
Cover Deck
East
IWest Z '
Residential
Commercial ❑
Zone Classification
Sprinklered
❑Yes ❑No ❑Reg'd.
Remodeled Valuation
1(a .E5Ct
aUpper Floors Garage /Storage
Uncv. Deck
No. Baths
No. Floors
Certifi. of Exempt.
or Variance
Required
Received
Total Bldg. Floor Area
'�)Z
Greenhouse
Fin. Basement
No. Fin. Rooms
Z.
DESCRIBE WORK
8. ADD ; —tO AI 'T� ►2 .f:�.Y�7C�
VALUATION
9.
SOURCE
UTILLIITIES
GAS
ELECTRIC
(u)(3-.X
WATER SEWAG
PUBLIC ❑ SEPTIC
PRIVATE SEWER ❑
Shorelines /Flood Hazard
Yes El Not Applic. ❑
Ownership
Public ❑ Private IV
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 REVER: SIDE FOR REOUI.- E INSPECTIONS
SIGNATURE OF _ IMMIIiA► APPLICATIO
OWNERORA - -Ai1A• A. AAA/- -e/ DATE
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL COND TI • NS: (SEE REVERSE SIDE FOR NOTICE)
%/gv
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Unfin. Basement
No. Dwellings
Yes Nc4 Number
Yes Nof7
Plans Required P/
Received
FEES COLLECTED
Building 4° 3 Vo
Plumbing
Mech.
Pfan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $ '
PERMIT NUMBER
02, /'r - 254
* *13800
*138006
A 4000 53
251.36
04 -01 -83
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE`iSSUED' 1 - 8 3
PERMI"KNO.1, 4 z * 1 3 8. O O adTAL