1983, 12-15 Permit: 83B-2559 Change to DuplexPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY -- DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE,=vVASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES ® PRESS HARD TO MAKE 3 COPIES
1 STREET �SS/-2
LO2
2. "
AILING RES$
CONTRACTOR
4. ADDRESS
BLO/K
SU5 //J ,0 7S
3 — �fc
/'C i7../ -
/c &1
PARCEL NO
LICENSE EXPIRES
PHONE
PHONE
LEGAL DESCRIPTION:
//9,,6-C)/us 3 4/)
• m S
Actual Set Backs in Feet S
West
North South East I Wes
Size of Parcel Zone Classification
Residential
Commeroia ❑
ZIP
77A
Occupancy
Spr nkr
❑Yes emo Req 'd.
DESIGNER
5.
ADDRESS
PHONE
ZIP
New Const. Valuation
XJ5 ?//I
Main Floor
Remodeled Valuation
Upper Floors
y
Total Bldg. Floor Area
260
Garage/Stora a Greenhouse
6.
CHANGE OF USE FROM
TO .)"j
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
7.
TYPE
OF
WORK
❑ NEW
D.
fALT."N. 0 RPL. ❑ MVE.
ETHER
1l -FMB. ( ivfECH. ❑ M.H. 0 -POOL
8. �
DESCRIBE WORK
,
/4/1ilf..").05I/A/6 X12') 70
VALUATION S
9. to(
SOURCE
UTILF
ITIES
No. Baths
No. Floors
Z_
No. Fln. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required Yes No❑
Received Yes ❑ No ❑
Number
Shorelines/Flood Hazard
YesD Not Applic. ❑
Plans Required 0
Received 0
ELECTRI
IttLi
I hereby certify that 1 have read and examined this
reverse side, and know the same be true aj • cor,
work will be complied with w
thority to violate or cancel t
of construction. SEE REV
SIGNATURE OF /
OWNER OR AGENT
SPECIAL APPROVALS
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech_
WATER
PUBLIC t
PRIVATE 0
SEWAG
SEPTI
SEWER 0
Ownership /
Public ❑ Private II
plication and have read the "NOTICE" provisions included on
ect. A ii provisions of laws and ordinances governing this type of
ot. The granting of a permit does not presume to give au -
ate or local law regulating construction or the performance
NSPECTIONS
APPLICATION
DATE
AA
PRELIM. FI AL DATE
`�lic5
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
BLOC- ��•li 1 i GUA- 5 .7-.4. ot
/4) i q7 o /= , &--S
6/7/0-u
,422 /7/,41-0/2 cj 0, /%rS / Q
AA) Ee r - /97 c?,//t.)-z.
/'x. a
> E P4g4. 7-€
/ 7- 4'47' •
li€re- OS %-U5J%,(Z D /f"-3
121
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 $
PERMIT NUMBER
e? �z j
02—
- 0° 2—
Od
O O' c
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATES 1JED 5 U 3
9 z
PERMIT0
O
*5u.00°
TOTAL