1983, 03-31 Permit: 83A-2429 MHPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 458-3875
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
LOT
2.
`
BLOCK I( SUBDIVISION
1. 030
�. ico)X-
3.
4.
5.
6.
OWNER
Ua13 Miry
MAILING ADDRESS
Zoq I
PHONE
CTC-yoy7
® Rov Po oAlA0
PHONE
StI 4
PARCEL NO.
IS'SSt — 2714.
LEGAL DESCRIPTION:
S. tort I of Lot LOCj. I2-
vAu-Ey UjEtoo QdML
Actual Set Backs in Feet to: 7 Q
South 3•��Y
North .SK/ I Sou 5
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel
/'OSx/o&
ADDRESS
ZI P
Type` rConst.
DESIGNER
PHONE
ADDRESS
ZIP
Occupancy
N�—
New Const. Valuation
Sat 6t94)
Main Floor
135o
lit
Zone Classification
AG SukB
I west -
Residential}'
Commercial 0
Spr nklered
OYes ONo OReq'd.
Remodeled Valuation
Tota Bldg. Floor Area
350
Upper Floors
Garage/Storage I Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
UntIn. Basement
TYPE p -NEW 0 ALT.
7. - OF 0 BLD. 0 PLMB
WORK
0 AD' N. 0 RP'. 0 MVE.
O MECH. 1 H. 0 POOL
0 OTHER
No. Baths Z
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required Y O No0
Received YesO No0
Number
8DESCRIBE WORK
VALUATION SOURCEOFGAS
9• UTILITIES
btAOYIL-E 1\oi9s
ELECTRIC
WATER
PUBLIC 0
PRIVATE 0
Co 1727)
SEWAGE
SEPTIC 0
SEWER 0
Shorelines/Flood Hazard
Ves0 Not Apollo. 0
Rare Requ red 0
Received 0
Ownership
Public 0 Private 0
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 APPLICATION
OWNER G% AGENT %%' v DATE '2 ^ Z_/ - (5;"�
SPECIAL APPROVALS SPECIAL OONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PiRELIM. FINAL DATE
V/ Em. Health
Y Planning
Fire
Revell.
y0 Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
3/21
FQoNToN) to4tt'sf. -j8/inI pIrckicoJ-c rStioN
e
poka4) w oat �WNs SC7OULLL
‘itk
Dwt.,P /9Cv to,!X1 P2S 1;9 697
!7' /
PERMIT 15 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 $
ao —
Las -
PERMIT NUMBER
Bak -rS4-2q
074 *10Q00
*100.006
A *000
208'1 A
0321-83
2 6479.
(
0
O
W
J
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMESA PERMIT.
j
DnrElsSUEoj' L -L 8 .3.
PERMITNd. a 9 Z .*‘11C1 an O 4AL
694,4 6-2z
G doAc ecfs e�
NJ
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•