1983, 11-14 Permit: 83B-1606 AdditionPLAN NUMBER
APPLICATION/PERMIT !
SPOKANE COUNTY — DEPARTPg'ENT 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.
z'? Z 1 S
2.
LOT
Z2+
BLOCK
SUBDIVISION
SISU i e w t�c.res
V.
OWNE
PHONE PHONE
PARCEL NO. c 4 all
LEGAL DESCRIPTION:
MAILING ADDRESS
S 2:7 Z1
Sq TES
CONTRACTOR
4. Sfl►�n�
LICENSE EXPIRES
ADDRESS
DESIGNER
5.
ADDRESS
CHANGE OF USE FROM
6.
ZIP
PHONE
ZIP
PHONE
ZIP
TO
TYPE ,,11'11E ❑ ALT. f7 AD'N. ❑ RPL. ❑ MVE.
7. OF WORK ❑ PLMB. C]MECH. M.H. 7! POOL ❑OTHER
Actual Set Backs in Feet to:
North (South
Size of Parcel
l.(46 'free)
Occupancy
1Z3
Type Const.'A\\
Y�
New Const. Valuation
X30 0
East
West
Zone Classification
Residential C7
Commercial ❑
Sprinklered
❑Yes ❑No ❑Req'd.
Remode ed Valuation
Total Bldg. Floor Area
2_c)o
Main Floor
2 O O
Upper Floors
Garage/Storage
Cover Deck
No. Baths
Certifi. of Exempt.
or Variance
Uncv. Deck
No. Floors
DESCRIBE WORK
8. A D D e
VALUATION
9.
x 2S
SOURCE
UTILITIES
o 12ZS
GAS
Greenhouse
Fin. Basement
No. Fin. Rooms
Required
Received
YesC Nom
Yes= Nor.
Shorelines/Flood Haze d
Yes❑ Not Appllc. ❑
ELECTRIC
WATER
PUBLIC ❑
PRIVATE ❑
SEWAGE
SEPTIC
SEWER ❑
Ownership
Public C Private
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 REVERS' SIDE FOR RE UIRED INSPECTIONS
OWNER OR AGENT.K
SIGNATURE OF ':•
APPLICATION /4 /tro-ii
DATE
Unfin Basement
No. Dwellings
Number
Plans Required
Received C3
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning -
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
Writtk P co 00\ e0, tn5�
k-f+Me (.)-( 't -OLA -C-1 A
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 $
Ge
PERMIT NUMBER
ei3 EL I to o (p
02* *6800
*68.006
A *000 8
16Q5�
11-14-83
2 6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE1S3UED1 4 - R 3
PERMlT1 �1 O' U 2
*68.00;OAL
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