1983, 08-11 Permit: 83A-7666 ResidencePLAN 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. E. •il31.t
PARCEL NO.
�C1.5�1-)-- ►�aO2.
LOT
2.
BLOCK
1.
SUBDIVISION
OWNER
PHONE
PHONE
3. YNA A l f i %.\ CCti taS– i ta.tn.0 rt Ci V 44-S, -0-161'7
MAILING ADDRESS
. 526`.3 `•7L . UL AtO
CO TRACTOR
4.rn
ADDRESS
LICENSE EXPIRES
DESIGNER
J. ADDRESS
CHANGE OF USE FROM
6.
LEGAL DESCRIPTION:
Zlp Actual Set Backs in Feet to:
CiCA703 North 'South {East IC' `West
PHONE
ZIP
PHONE
ZIP
TO
TYPE /NEW ALT. CIAD'N. CIRPL. ❑ MVE.
7. CI OTHER
WORK BLD. ❑ PLMB. ❑ MECH. CIM.H. IliPOOL
Size of Parcel
&:) ?C to S
Zone Classification
Residential C'
Commercial ❑
Type Const.
.v
Occupancy
New Const. Valuation
3 s; Zea -
Main Floor
a1Z
Spr'nklered
DYes ❑No ❑Req'd.
Remodeled Valuation
Upper Floors
Cover Deck
No. Baths
Certifi. of Exempt.
or Variance
Uncv. Deck
Total Bldg. Floor Area
Garage/Storage
No. Floors
DESCRIBE WORK
• —>r N:C>t_C. tvL' _y � ' �� r
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
Greenhouse
Fin. Basement
No. Firt. Rooms
4
Required Yes❑ Nof
Received Yes❑ No
Shorelines/ Flood Hazard
Yes❑ Not Applic. ❑
WATE
PUBLIC
PRIVATE ❑
SEWAG
SEPTIC
SEWER ❑
Ownership �/
Public E Private 1:I
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 l /
SIGNATURE OF
OWNER OR AGENT
SPECIAL APP S
PRELI F AL DATE
Env. Health
llf
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
APPLICATION
DATE )?
SPECIAL CONDITIONS: EE REVERSE SIDE FOR NOTICE)
ia'r'fft00E_o` ,ati? PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Unfin. Basement
No. Dwellings
Number
Plans Required
Received V/
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
z-10 X.1a
TOTAL $
PERMIT NUMBER
,l 74;, (c.,
02* *2.7000
*270006
A *000
76642
08-11-83
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEYSSUEDL 1 - 8 5
�7 (, LJ
PERMIT{N�. 6.6 z *2 7 O. O O tolrAL
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r
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CONTRACTOR:
HIMALAYA CONSTRUCTION CORP.
PROPERTY ADDRESS:
.11311 E. Buckeye, Spokane, WA
LEGAL DESCRIPTION:
Lot 2, Block 1, FAIRACRES
REPLAT #3
SCALE:
1" 201
C -c)