1983, 10-19 Permit: 83B-604 DryerPLAN NUMBER
APPLICATLQN/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. £iD4/ g) 7%,eA-
PARCEL NO.
LOT
2.
OWNER
3
BLOCK
SUBDIVISION
cy at- MAILINGADDRE-r a�✓�
Sf
art vi N• 2)0teel-
CO RA TOR
4. frt //,' ge/971%4.1,7
RESS
DESIGNER
PHONE
PHONE
LEGAL DESCRIPTION:
ZIP
Actual Set Backs In Feet to:
North I South East I West
5.
ADDRESS
LICENSE EXPIRES
P/ 7 !J 9%
Size of Parcel 1 Zone Classification
Residential 0
Commercial 0
PHONE
Type Const.
Occupancy
New Const. Valuation
Spr'nklered
DYes 0No 0Req'd.
Remodeled Valuation
Total Bldg. Floor Area
ZIP
Main Floor
Lipper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE 0 NEW 0 ALT. 0 AD' N. 0 RPL. 0 MVE.
7. OF ❑ BLD. 0 PLMB. 12- ECH. 0 M.H. 0 POOL
WORK
0 OTHER
No. Baths
No. Floors
No. Fin Rooms
No. Dwellings
Corti! . of Exempt.
or Variance
Required YesO No❑
Received Yes❑ No❑
Number
8.
9.
DES WORK
L1t' J7 a
VALUATION
41/ _u) .s -
SOURCE (f1� GAS ELECTRIC WATER
PUBLIC O
UTILLIITIES I �� PRIVATE 0
Shorelines/Flood Hazard
YesD Not Apolic.0
Rens Required 0
Resolved 0
SEWAGE
SEPTIC 0
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 RE RSE SIDE FOR REQUIRED IN PEC IONS
SIGNATURE OF ,aC � /�� (-%1- 6, DATE APPLICATION/2) .—//9-- id
OWNER OR AGENT �(Y �J //
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
7, N
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
/2. /2 azA2 .
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)
00
TOTAL $ >r 0-
PERMIT NUMBER
253-15-+
04* *1800
*18006
A *000 0
60.32
10-19-83
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEISLEDI• 9 - 81C3
PERMIT Nd. 0-4 '2
*118.00'r°OIrAL