1983, 06-10 Permit: 83A-5114 MH'I1irr���.r► 1 nin/ r-mr-i rll 1
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
PERM IT N"MBER
. C5 -5A 45II'
CHANGE OF USE FROM
1__�
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
Uncv. Deck
Fin. Basement
STREET ADDRESS
Unfin. Basement
6.
PARCEL NO.
1
E. i►�.
�.pra �Ew G �.
TYPE
oel
0
No. Fin. Rooms
LOT
BLOCK
SUBDIVISION
LEGAL DESCRIPTION:
2.
Certifi.ofExempt.
I 2
I ,a1AL.t-t F2 T
Number
or Variance
OWNER
PHONE
PHONE
3.
G ICOQfac U.?inrv0T-r
Plans
Required ❑
�CA-061—C (r.) [ � M . P. �g}C�o
Yes Not Applic. ❑
Received ❑
MAILING ADDRESS
SOOURCE
ZIP
Actual t Backs in Feet to:
P ATE BLIC
SEPTIC
Ownership
Er - 1 t 'FA t Q_J LCkl�) C7
Q:'7
North'aA south
East kv' west
CONTRACTOR
SEWER ❑
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential
4.
reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this type of
14 ��
'Rl M o L�
Commercial ❑
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
SIGNATURE OF APPLICATIONf
a
ern€
OWNER OR AGENT
DATE
91 Z!5
❑Yes ❑No
❑Req'd.
CONDITIONS: (SEE REVERSE SIDE FOR NOTICE
DESIGNER
PHONE
V Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
I
(01
lr
V1111.1
to
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
PERM IT N"MBER
. C5 -5A 45II'
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
6.
TYPE
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
NEW ❑ ALT. ❑ AWN. ❑ FjPL. ❑ MVE.
% OF El OTHER
WORK ❑ BLD. ❑ PLMB. ❑ MECH. M.H. ❑ POOL
Certifi.ofExempt.
Required
Yes No
Number
or Variance
Received
Yes❑ No 1-1
DESCRIBE WORK
8'
Shorelines/ Flood Hazard
Plans
Required ❑
�CA-061—C (r.) [ � M . P. �g}C�o
Yes Not Applic. ❑
Received ❑
VALUATION
9•
SOOURCE
GAS
ELECTRIC
P ATE BLIC
SEPTIC
Ownership
FEES COLLECTED
UTILITIES
PRIVATE ❑
SEWER ❑
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-
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 APPLICATIONf
a
OWNER OR AGENT
DATE
Mach.
SPECIAL APPROVALIJSPECIAL
CONDITIONS: (SEE REVERSE SIDE FOR NOTICE
PRELIM. FINAL DATE
Plan Check
Env. Health
I
(01
V1111.1
to
SEPA
Planning
Modular/
MFG. Home
►I�-ems
Fire
Prevent.
Engineer �iAPRbAC�S�Cr2t1Nt��O 1C T4k�S Cc/v.t:
�rll4vb P41,0 AVPRo,*A,_W -12 ''0 AT Yi wiZ OF 41:� ALPC, E
Utilities u"N;ST. 6'9 ".,/sN 0^4S YO 1011:1 -
Plans I I I I PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building �
Tech. IN 180 DAYS
11, Z (O , s.
Other (Specify)
TOTAL $
LCQ-
WHEN MACHINE VALIDATED IN T
THIS BECOMES A PERMIT.
E,
0
DATE UJ D1 0— 8 3 PERMIT51J. 1, 4 5, * 10 O' 0 0 �0j
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1$712 E. FA/RVIE W GT.
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to
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