1983, 05-27 Permit: 83A-4547 AdditionPLAN NUMBER
1
APPLICAT'ON/PERMIT
`POKANE COUNTY - DEPARTMEN 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.
0 f�
LOT
2. q
OWNER
3.
BLOCK
4
SUBDIVISION
®?f'J. YL..t,u ,'T' tz.rza.l. '
MAILING ADDRESS
C`• A710 �(i r'Yt0rN
PHONE
PHONE
ZIP
GCt�,i4y
4.
5.
CONTRACTOR
ADDRESS
DESIGNER
ADDRESS
4-ti"4- 'TIAc _
LICENSE EXPIRES
PHONE
PARCEL NO.
�.1541-Lecc1
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North 'South 6 l [East
Size Parcel
141-0
West
Zone Classification
Residential
Commercial 0
ZIP
TypeLst.
�
Occupancy
Spr nklered
❑Yes ❑No ❑Req'd.
PHONE
27` , -r--Ca C /
Const. Valuation
i t C)
Remodeled Valuation
Total Bldg. Floor Area
44-0
ZI
Main Floor
440
Upper Floors
Garage/Storage
Greenhouse
6.
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE ❑ EW
7. OF BLD.
WORK
❑ ALT. L°I AD' N. ❑ RPL. 0
❑ PLMB. 0 MECH. ❑ M.H. ❑
MVE.
POOL
0 OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required Yes Noir
Received Yes No❑
Numb,_
8.
D SCRIBE WORK
Shorelines/Flood Hazard
Yes❑ Not Applic. ❑
Plans Required'/
Received a,!
VALUATION
9.
SOURCE
F
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC
PRIVATE 0
SEWAGE
SEPTIC
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 REVERSE SIDE FOR R IRED INSPECTIONS
SIGNATURE OF \.
OWNER OR AGENT
APPLICATIO
DATE
SPECIAL APPROVALS SrCIAL COND T • NS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
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 $ l�
PERMIT NUMBER
a511 if51'
- L7—
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATETS1E-D27-83
4�4,75 *108.O00
E-
PERMIT N . TOTAL