1983, 04-11 Permit: 83A-2820 ResidencePLAN NUMBER
y
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.
2.
STREET ADDRESS
LOT
ID
BLOCK
OWNER
3. I -I i 111 RLA� 1}
MAILING ADDRESS
s. 5x,5
SUBDIVISION
E - RANI LE- l+E))+TS FtF714 Aix >.
4.
5.
CONTRACTOR
ADDRESS
�p.MtS
DESIGNER
N,S-igiic-c1
•SuN W/VR..1>
PHONE
PHONE
`f`f — 07617
ZIP
cri 203
PARCEL NO.
IA- k2.0`361
LEGAL DESCRIPTION:
LICENSE EXPIRES
PHONE
Actual Set Backs in Feet to:
North Z? South t CEast I West 47
Residential N
Commercial 0
Size of Parcel Zone Classification
1Rf:Ec,x �c,�r- R-1
ZIP
Type Const.
V-l'f
Occupancy
Spr'nklered
❑Yes ❑No Req Id.
PHONE
ADDRESS
ZIP
Ne Const. Valuation
3c;ja17
Main Floor'
Remodeled Valuation
Total Bldg. Floor Area
Cl/ .2._
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv.0
Fin. Basement
Unfin. Basement
TYPE ❑ NEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7. OF
WORK ❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. E]POOL
❑ OTHER
No. Baths
No. Floors
Certifi. of Exempt.
or Variance
No. Fin. Rooms
Required Yes! No
8. DESCRIBE WORK
SfNG Lir rpmty
VALUATION
SOURCff
UTILITIES LI
9.
/2f-7/DANCE.
Shorelines/Flood Hazard
Yes Not Applic. ❑
No. Dwellings
Number
Received Yes CI No[1
Plans Required C9/
Received
GAS
ELECTRIC
WATE
PUBLIC
PRIVATE ❑
SEWAG
SEPTIC
SEWER ❑
Ownership
Public 0 Private {p
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 o not. The granting of a permit does not presume to give au-
thority to violate or cancel the provisions of an of state or local law regulating construction or the performance
of construction. SEE REVERS, SIDE FO R - • U D IN PECTIONS
SIGNATURE OF ` APPLICATION
OWNER OR AGENT
SPECIAL ROVALS SPECIAL CONIaXTIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. "• FINAL DATE
Env. Health
/7 65a1.1.0
Planning
111
Fire
Prevent.
Engineer
Utilities
414
SEPA
Plans
Exam.
• Building
Tech.
? �.+ Fri 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
Z 58
Other (Specify)
TOTAL $
PERMIT NUMBER
f53-3 'zS2c'
`-' 00
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATESSUED` 1 - 8 3
PERMI12tl. 2. O z *2 5 8' O O 9'OTAL
CONTRACTOR:
HIMALAYA CONST. CORP.
PROPERTY ADDRESS:
930 N. Calvin, Spokane, WA
LEGAL DESCRIPTION: -
Lot 10, Block 5, VERADALE
HEIGHTS FIFTH ADDITION
SCALE:
1" 201
100CCs 2 Sern
. I
\
-7 -
_.�
C_
C.1
z•69
o')
L.1/ (AD