1983, 10-31 Permit: 83B-1129 Finish BasementPLAN 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.
PARCEL NO.
LOT
BLOCK
2.
OWNER
3. --BoY
MAILING ADDRESS
CONTRACTOR
4. S;(qv'Y►E
ADDRESS
P 4kE
DESIGNER
5.
ADDRESS
SUBDIVISION
PHONE
PHONE
535- lZ-
LEGAL DESCRIPTION:
C wtz Ai i4 4' )
ZIP
CRC( 2.
Actual Set Backs in Feet to: t= kL r t N Ct.
North 'South East
West
LICENSE EXPIRES
PHONE
Size of Parcel
etiVL
Zone Classification
Residential
Commercial ❑
ZIP
11- Const.
Occupancy
Sprinklered
❑Yes ❑No ❑Req'd.
PHONE
New Const. Valuation modeled Valuation
Total Bldg.Fioor Area
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv.Deck
Fin. Basement
Unfin. Basement
TYPE ❑ EW l'ALT. ❑ AD' N.
7. OF
WORK BLD. ❑ PLMB. ❑ MECH.
'44
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
•
No. Floors
Certif1. of Exempt.
or Variance
Required
Received
No. Fin. Rooms
Yes NoL9� /
Yes No❑
No. Dwellings
Number
8.DESCRIBE WORK
Ft -r
VALUATION
T71 CIeC)
SOURCE
UTILITIES
GAS
Shorelines/Flood Hazard
Yes NotApplic. E
Plans Required ❑
Received ❑
ELECTRIC
WATER
PUBLIC MI
PRIVATE ❑
SEWAGE/
SEPTIC
SEWER ❑
Ownership
Public ❑ Private V
I hereby certify that I have read and examined this appl'cation 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 REVERE SIDE FOR REQUIRED INSPECTIONS
SIGNATURE OF APPLICATION
OWNER OR AGENT d� r L y_. Ira. DATE /(r- 3( )J
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
"'14r
13/
SPECIAL CONDITIONS: (SEE - EVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building 4c90O
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $`127
PERMIT NUMBER
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE 1114E131 - i1
PERMIT 140.1.2. 9 • o
* 4 0.0 OTQTAL