1983, 06-24 Permit: 83A-5759 GreenhousePLAN NUMBER
.
APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, W/4,51-1INGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
ti-.ktCtOS
LOT
2. 15
OWNER
3.
MAILING ADDRESS
s k\405
CONTRACTOR
fV4/11.6"
ADDRESS
DESIGNER
BLOCK
PARCEL NO.
SUBDIVISION
en 0— A 12:eAck., L-& v•.>
4.
5.
PHONE
LICENSE EXPIRES
PHONE
PHONE
c1 (
LEGAL DESCRIPTION:
Actual Set
North
ks in Foot to:
Size of Parcel
CIOXiSS"
East [ West
Zone Classification
-11Aift j
Residential 441
Commercial
ZIP
TZonst.
Occupancy
OA— I
Spr nklered
ElYes 0No
C.]Req'd.
PHONE
ADDRESS
ZIP
Nett Const. Valuation
It Ce—>
Main Floor
Remode ed Valuation
••••sosamMli
Total
Upper Floors
Garage/ Storage
Bldg. Fioor Area
1€
Greenhouse
6.
CHANGE OF USE FROM
TO
TYPE i(NEWLJALT. El AWN. DRPL,
7. OF
WORK 12"BLD. 0 PLMB. 0 MECH. 0 M.H.
Cover Deck
Uncv, Deck
Fin. Basement
Unf in. Basement
0 MVE.
0 POOL
0 OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certlfi. of Exempt.
or Variance
DESCRIBE WORK
8.
VALUATION
9.
(low>)
Shorelines / Flood Hazard
Yes LI NotApphc.EJ
Required Yes 0 NoV
Received Yes 0 Non
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC .E
PRIVATE 0
SEWAGE
SEPT!
SEWER 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 REVE SE SE FOR REQUIRE INSPECTIONS
SIGNATURE OF
OWNER OR AGENT
APPLICATION44e,
DATE
SPECIAL APP •VALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PELI1FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
tIVII`i
99
Gbr
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Number
Plans Required 0 a
Received 0 NO!
FEES COLLECTED
Building
(numbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
2-0 0)
Other (Specify)
TOTAL
PERMIT NUMBER
C.3
LU
-J
WHEN
-
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE is6o5 2 4 - 8 3
PERMIT h07 5, 9 e5
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