1983, 04-25 Permit: 83A-3228 AdditionPLAN NUMBER
611
STREET ADDRESS
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
1. 14-o12_ Z3
LOT
2. /6,
BLOCK
PARCEL NO.
2G542- fSi6
SUBDIVISION
eAR.Li Aotrionl
OWNER
ge)tsiAL.1) 120F3E—rS
MAILING ADDRESS
()4 2_ E... 2. 3 RS)
CONTRACTOR
4. SAME -
ADDRESS
LEGAL DESCRIPTION:
PI-IONE
qZ.Z- z 5
612-A9kLE...
PHONE
LICENSE EXPIRES
ZIP
1153-7
PHONE
Actual Set Backs in Feet to:
North 'South 596' East
ZIP
Size of Parcel
C70 ) L71 -
Type Const.
-N
DESIGNER
PHONE
upancy
i-7
Iwest
32.1
11 Zone Classification
511,160.E. MAIL -
Sp( nkl ed
0Yes ON° DReq 'd.
New Const. Valuation 1 Remodeled Valuation
315rPa 2,50
Residential
Commercial 0
Total Bldg. Floor Area
Igo 130
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
6.
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
TYPE 2 -(EW EALT. D AD' N. DRPL.
7. OF 2tigis.
WORK
PLM B. 0 MECH. D M.H.
MVE.
0 OTHER
0 POOL
No. Baths
No. Floors
Fin. Basement
No. Fin. Rooms
Untin. Basement
5 tp
No. Dwellings
CertIti. ot Exempt.
or Variance
Required YesO No0
Received YesO No0
DESCRIBE WORK
8. ADM-TioN1 -Th VX s-nrir, RE.41YENCe— ( 114 120011/1/4
VALUATION SOURCE GAS
OF
UTILITIES
9.
1
ELECTRIC WATER
PUBLICO
PRIVATE 0
Shorelines/Flood Hazard
Yes 0 Not Applic.
Number
Plans Required 0
Received 0
SEWAGE
SEPTIC 0
SEWER
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 SIDE FOR R UIRED INSPECTIONS
SIGNATURE OF
OWNER OR AGENT
SPECIAL APPROV5ES
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
0P-0
44A
APPLICATION
DATE
ECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
GI
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
6 c4-.:
TOTAL $
PERM
T NUMBER
-
7 Y.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEGsgua 5 - 8 3
PERM11411i. 2, 8 * 6 1, 0 0 iociAL