1983, 09-02 Permit: 83A-8532 GaragePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - DEPAMTM1=NT 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
.l?6,23 -Pcr,rc
PARCEL NO.
18552 -1.44R
LOT
2.
BLOCK
SUBDIVISION
LEGAL DESCRIPTION:oAL,t,,f, ADp To aa.EEve AGC85
3.
OWNER
W ESC -t y 4.. Li NDSN {
PHONE
PHONE
Data --,tea
MAILING ADDRESS
C , lZ�a"13 �aC
ZIP octet ce
Actual Set Backs In Feet to:
North -- 'South g S LEmt S tc I West
8o
4.
CONTRACTOR
ADDRESS
LICENSE EXPIRES
PHONE
Sim of Parcel
Zone Classification
Residential IV
Commercial 0
ZIP
Occupancy
rn -I
Spr nklered
DVes DNo OReg 'd.
5.
DESIGNER
PHONE
NIT Cant. Valuation
Remodeled Valuation
Tote
Bldg. Floor Areaa
4 -
ADDRESS
ZIP
Main Floor
Upper Floors
6.
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Garage rage
6C0 tf
Greenhouse'
Fin. Basement
Unfin. Basement
TYPE _3%EW 0 ALT. 0 AD' N. 0 RPL. D MVE.
7. WORK ElBLD. ❑ PLMB. El MECH. 0 M.H. 0 POOL o OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certif 1.of Exempt.
or Variance
Required VesQ Nett -
Reserved VesO NOD
Number
ESCRI BE WORK
VALUATION
9.
C-4.roc,
SOURCE
UTILITIES
GAS 1 ELECTRIC
WATER
PUBLIC W'
PRIVATE 0
SEWAG
SEPTIC
SEWER 0
Shorelines/Flood Hazard,.
Yes0
azarO-
VesD Not Aeolic. a
Ownership
Public 0 Private V
I hereby certify that I have read and examined this appl cation 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 otrer state or local law regulating construction or the performance
of construction. SEE REVERSE SIDE FOR REO 4- L NSPECTIONS
SIGNATURE OF.
OWNER OR AGENT
SPECIAL APPROVALS
' / t� PRELIM. FINAL
�L Env. Health
DATE
kh./ 4-I
Planning
Rre
Prevent.
Engineer
Utilities
SEPA
Building
Tech.
APPLICATION
DATEC�?
CIAL CONDITIONS: ( EE REVERSE SIDE FOR NOTICE)
Zt% i o orepop )47 M c G- 4-2
4v u9C0 Sts a, �sIC fl�?P+a C Cl
te-cis p tun V�'�`� pp-Q
lAAPlitt
t U
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plan Requ red
Received 1a
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
0
TOTAL $ d
ft
02* * 6&'010
-*'6'8010
A •*000 8
853.12
09-021-83
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEJSdUI'tO 2 t- 8 3
PERMItit3 2 is * 6° 0 0 1 AL
t
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Y0
ertvriAt
/ ,2Es
9
•
•
30
1
5
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