1983, 01-10 Permit: 83A-209 Demo 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. I 00 r -r
LOT BLO�t SUBDIVISION
2. I'7 Cr71F7IN �%
3.
OWNOR
mss✓► G
MAILING ADDRESS
4--K 2
kz-1.1
PHONE
t1414140dSJ AC
LICENSE EXPIRES
CONTRACTOR
4. pv,A0L �o
DRS�
ADS .6,06
PHONE
ZIP
5.
ADDRESS
DESIGNER
CHANGE OF USE FROM
PHONE
ZIP
TO
TYPE Ei NEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7. OF WORK BLD. ❑ PLMB. CIMECH. ❑ M.H. 0 POOL .. THER
DESCRIBE 0 K
9. 4ggATIONF
SOURCE
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC D
PRIVATE ❑
SEWAGE
SEPTIC ❑
SEWER ❑
PARCEL NO. 54_ i I
LEGAL DESCRIPTION:
0--.c-14i'4NI0
- I5 z 3
I. ,-r���I 4 I..-2
Actual Set Backs in Feet to:
North South
5
Size of Parcel
New Const. Valuation
Cover Deck
No. Baths
East
West
Zone Classification
Residential 12
Commercial ❑
Spr'nklered
❑Yes ❑No DReq'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
Received Yes ❑ No rl
Shorelines/Flood Hazard
Yes ❑ Not Applic. ❑
Ownership
Public D Private ❑
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 wh er pecified h -re' or not. The granting of a permit does not presume to give au-
thority to violate or cancel th p ov' ions of ' h r state or local law regulating construction or the performance
of construction. SEE REVER SI FO - -f 1! I D INSPECTIONS
SIGNATURE OF
OWNER OR AGENT
APPLICATION I^
DATE iV e a
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDI ONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Unfin. Basement
No. Dwellings
Number
Plans Required ❑
Received ❑
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $ `7)
PERMIT NUMBER
••(;)
02* *1000
* 1 0.006
A *000
20.82
01-10-83
6479.
FnFrnPv
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATESSUEIT O _ J' PERMIT Ng. 1 9 z * 1 0.0 O T07AL