1983, 04-13 Permit: 83A-2912 DemolitionPLAN 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
1 STR ETADDRES � i PARCEL NO. O ,) o, 3
' Ve"�
2. LOT BLOCK su q SIGN LEGAL DESCRIPTION: f 00
3.
OWNER� e
P l
PHONE
MAILING ADDRESS qt7 I
Z
Actual Set Backs in Feet to:
r , `
��
North South East West
CONTRA TOR
T;C'E�XPIRES
PHONE
Size of�Pa� t Z��
sn ificatl
Residential
4
.
4
Commercial ❑
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑Req'd.
DESIGNER'
PHONE
New Const.
Remodeled Valuation
Total Bldg. Floor Area
�ll:CJ
5.
ADDRESS
ZIP
Main FI, r Upper
Floors Garage/Storage
Greenhouse
0
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
6.
TYPE ❑ NEW 11 ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
No. Baths No.
Floors
[No. Fin. Rooms
No. Dwellings
7 OF �THER
WORK QLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑POOL
�ifiaof mpt.
Required Yes❑ No❑
Number
nce
or Variance
Received Yes❑ No❑
8 DESCRIBE RK
Peqt�Ls io�
Shorelines/ Flood Hazard
Plans Required ❑
Yes Not Applic. ❑
Received ❑
VALUATION
9•
I SOOUFCE
GAS
ELECTRIC
PUB IC ❑
SSEWAGE EPTIC ❑
I
Ownership
FEES COLLECTED
UTILITIES
PRIVATE ❑
SEWER ❑
Public ❑ Privet
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
ID'
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au-
Building
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 REQUIRED INSPECTIONS
Plumbing
/
SIGNATURE OF APPLICATION 0
OWNER OR AGENT DATE
o
Mech.
SPECIAL APPROVALS S
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
Sc:PA
Plans
Exam.
CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
r
ERMIT UMBER
-Z Z
02* *1000
2 9 1,-1 z
04613-83
o 6,479.
�v.
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED PERMIT NO.
*:l.0.0'0.
TOTAL
CL
O
C.3
W
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