1983, 11-10 Permit: 83B-1498 StoragePLAN NUMBER
.r'PLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHInirarl 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
1.
2.
STREET ADDRESS
N , Z\'j
LOT
BLOCK
p
PARCEL NO.
1'554=5 -
SUBDIVISION
OWNER
3�.�.
MAILING ADDRESS
N . u�
4.
PHONE
PHONE
LEGAL DESCRIPTION: s t.,5 vc. � dF ev7..
t3F C'f2 C5i-t3._ic VE21c,
C_on3 /LC ICra
ZIP
Actual Set Backs in Feet to:
North 'South S'
CONTRACTOR
CGCNC
c7 t4tS
ADDRESS
LICENSE EXPIRES
PHONE
East I West '31 /
Zone Classification Residential [�'
Commercial El
Size of Parcel
t35 K l5`d
ZIP
444 7
Tnst.
n.i
Occupancy
Wti
Sprinklered
❑Yes ❑No ❑Req'd.
5.
DESIGNER
PHONE
ADDRESS
ZIP
Remodeled Valuation
Const. Valuation
71.Sf\-00
Upper Floors
Main Floor
Total
Bldg. Floor Area
QetD
Garage/Storage
Greenhouse
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE LofNEW ❑ ALT. ❑ AD' N. 0 RPL. ❑ MVE.
7. OF BLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL
WORK
0 OTHER
No. Baths
No. Floors
Certifi. of Exempt.
or Variance
DESCRIBE WORK
8. szo, F
VALUATION
9.
SOURCE
UTILLIITIES
GAS
ELECTRIC WATEFiJ
PUBLIC
PRIVATE El
aoX4
SEWAG
SEPTIC
SEWER ❑
Shorelines/Flood Hazard
Yes❑ Not App Jlc. ❑
No. Fin. Rooms
No. Dwellings
Required Yes❑ Nodi —
Received Yes❑ No❑
Plans Required
Received r
Number
Ownership
Public ❑ 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 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 RE ERSE - IDE FOR REQUIRED INSPECTIONS
SIGNATURE OF
OWNER OR AGENT-
SPECIAL APPRVV S
PRELIM. FINAL DATE
Env. Health
Planning
1114
Pire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
t5�
ri
Building
Tech.
APPLICATION ` i
DATE //
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFEI?ABLE
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 $ 60.00
PERMIT NUMBER
c
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEJISLUI'i). 0 — S 3
PERMIT1NQ.9 8 Z
*68,00aOAL
CY-t-- Ni • '7
E -f E15 :•
02-
Porde/ 35q 3- 09'010 '71
j7,51 Code /40
3
sq.
6 al m
41
1 05
H-0 us e
135
< Con k 11.Y)
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d
3
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