1983, 04-18 Permit: 83A-2982 MHPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - DEPARTMENT 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. 1J�1
LOT BLOCK
2. ;
OWNER
3. v16RAJ° J "PA
SUBDIVISION
1 ' ` A 1 't010 Yo � : 'r.-bP
PHONE
PHONE
MAILING ADDRESS ZIP
E:1 EScr) f/et
CONTRACTOR
4.
ADDRESS
LICENSE EXPIRES
DESIGNER
5.
ADDRESS
CHANGE OF USE FROM
PHONE
ZIP
PHONE
ZIP
TO
TYPE E1 NEW ❑ ALT. ❑ AD' N. E RPL. ❑ MVE.
7. OFWORK ❑ BLD. ❑ PLMB. ❑ MECH. E{M.H. ❑ POOL El OTHER
PARCEL NO.
-3S3i - it 0
LEGAL DESCRIPTION:
Actual Set Backs in Feet to: EYm"T s eac4
North 'South (East
Size of Parcel
Type Const.
Occupancy
DESCRIBE WORK
8. -7
VALUATION
9. tg;cr r.
SOURCE
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC 0
PRIVATE
SEWAGE ,
SEPTIC Er
SEWER ❑
Main Floor
Cover Deck
No. Baths
West
Zone Classification
Residential
Commercial ❑
Spr'nklered
❑Yes ❑No ❑ Req 'd.
Remodeled Valuation
Uncv. Deck
No. Floors
Certifi. of Exempt.
or Variance
Total Bldg. Floor Area
Greenhouse
Fin. Basement
No. Fin. Rooms
Required Yes No 71
Received Yes ❑ No El
Shorelines/Flood Hazard
Yes El Not Applic. ❑
Ownership
Public ❑ Private Ni.'"
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 other state or local law regulating construction or the performance
of construction. SEE REVERSE SIDE FOR REOUIREDJNSPECTIONS
SIGNATURE OF
OWNER UR AGENT
APPLICATION. j
DATE g
Unfin. Basement
No. Dwellings
Number
Plans Required ❑
Received ❑ '
SPECIAL APPROVALS
oRELIM. FINAL DATE
Env. Health
Planning
Wry
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
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
97M-
)7*
7 'A
,7*
ri
*50,00
*50006
*000 E
298.1
0.4-18-83
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSU E1 8
8 3'
PERM IeN91.8 2 z
*50,0o TOAL