1983, 06-14 Permit: 83A-5230 FixturesPLAN 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
S7 i(
LOT
2.
BLOCK
OWN E
3
SUBDIVISION
PHONE
(de A4•'+y C.p�sL
MAILING ADDRESS
C TRAC
T .
4. fA` ,��C6( 'l-•'�
LICENSE EXPIRES
ADDRESS
F 5S 4--
5.
DESIGNER
ADDRESS
CHANGE OF USE FROM
PHONE
ZIP
PHONE
PHONE
ZIP
TO
7. TYPE ,ANEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE. ❑OTHER
WORK ❑ BLD. fePLMB. ❑ MECH. ❑ M.H. ❑ POOL
PARCEL NO.
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North 0 South East % West
Size of Parcel Zone Classification
Type Const.
Occupancy
Residential El
Commercial E
Sprinklered
❑Yes ❑No ERN 'd.
New Const. Valuation
Remode ed Valuation
Total Bldg. Floor Area
Main Floor
Cover Deck
No. Baths
Upper Floors
Uncv. Deck
No. Floors
Garage /Storage
Greenhouse
Fin. Basement
Unfin. Basement
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required Yes No
Received Yes No❑
Number
DESCRIBE WORK
8.
VALUATION
9.
SOURCE
F
UTILITIES
/c! 7=-ne 7=-n Tc.,e ry
GAS
ELECTRIC
WATER
PUBLIC ❑
PRIVATE ❑
SEWAGE
SEPTIC ❑
SEWER ❑
Shorelines /Flood Hazard
Yes❑ NotApplic. ❑
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
OWNER OR AGENT
APPLICATION G ��
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)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plans Required ❑
Received ❑
FEES COLLECTED
Building
Plumbing
�S "�
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
'jlS/4e._
PERMIT NUMBER
8-111 523C
03* *45.00
*45006
A *0.00 ES
-2292
06 -14 -83
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATSUED1 4
EyS — 8 3
PERMIT51. 3.. 0 5
*45.00 L
7/Pt-CT/WV a-/ WATER DISTRICT:
fi HUTCHINSON
, v0 v'r;r ,er! ' / CONTRACTOR:
HIMALAYA CONSTRUCTION CORP.
/DOD 6-firt f <l«°i7c %�•✓•�.
(1 L/02e0
[V6) 8'x.o l
k
.1 /-
t4 rt.. 51-,
(F%01
1=0.1
Gf�Af/•FL
v
PROPERTY ADDRESS:
E. 71 ALKI
LEGAL DESCRIPTION:
Lot 7, except the
E. 59.821 and except
the N. 1251 of Block
189 HUTCHINSON ADDITION
PARCEL NUMBER:
18544 -0235
SCALE:
1” : 20'
(oo)
7j?cJ2 Jo-)