1983, 09-13 Permit: 83A-8981 AdditionPLAN NUMBER
C,
APPLICATION/PERMIT
SPOKANE COUNTY — DEPART VIENT 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. 3 Zc{ 'S ct 4z
LOT
2.
BLOCK
SUBDIVISION
OWNER
3.
J rn c� Sc t-4 ws t. gt921
MAILING ADDRESS
r� "?Ct. Cf!., aiht2CC.CQ
PHONE
PHONE
cxz2-Ili a
PARCEL NO.
LEG' _AL _SQRIPTION: C STT
N O tQq). of G 42. oc e>FSYy-
CONTRACTOR
4.)Y►�[
ADDRESS
LICENSE EXPIRES
DESIGNER
5.
ADDRESS
CHANGE OF USE FROM
ZIP
CZet1) (
PHONE
ZIP
PHONE
ZIP
TO
TYPE ❑ NEW El ALT. 0/AD'N. ❑ RPL. ❑ MVE.
7. OFWORK EYBLD. ❑ PLMB. ❑ MECH. l M.H. IDPOOL ID OTHER
Actual Set Backs in Feet to:
North 'South East 1 West * - '
Residential 1
Commercial ❑
Size of Parcel
AC.--Q_C.-
Type Const.
Occupancy
Zone Classification
Sprinklered
❑Yes ❑No ❑Req'd.
New Const. Valuatiaaf�.,
.LTi 7,
Remade ed Valuation Total Bldg. Floor Area
Main Floor
Cs (00
Upper Floors
Cover Deck
No. Baths
CertlfI. of Exempt.
or Variance
Uncv. Deck
Garage/Storage
No. Floors
DESCRIBE^WORK
8.
O♦'J i Dr(\.t_ (Z2 y, 310
VALUATION
9.
SOURCE
UTILF
ITIES
GAS
ELECTRIC
WATE SEWAGE/
PUBLIC SEPTIC C°'
PRIVATE SEWER O
Greenhouse
Fin. Basement
No. Fin. Rooms
Required YesE No Et?'
Shorelines/Flood Hazard
Yes❑ Not Applic. D
Ownership
Public D 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 9/3/271
DATE 7!/
SPECIAL APPROVALS
. PRELIM. FINAL DATE
Env. Health
('S
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
gift .5
3
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
UnfIn. Basement
No. Dwellings
Number
Plans Required L./
Received
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
144.en
Other (Specify)
TOTAL $ ,
PERMIT NUMBER
-t
02* * 1 44.00
*144006
A *000
8950.
09-13-83
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE agicol 3 - 8a 3
PERMIT Nc o. 1 L * 14 4. 0 0 1mfA1.
ora
�- $-.C000-
DAT! -/8-
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