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1983, 04-12 Permit: 83A-2849 Addition
PLAN NUMBER -1� APPLICATION/PERMIT (1 SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY NORTH 811 JEFFERSON / SPOKANE; W!SHINGTON 99260 / (509) 456-3675 APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES 1. STREET ADDRESS -2Z0' KI LOT BLOCK SUBDIVISION 2. VO G% CI ��r{Z OW ER 1 PHONE 3. r C\us 5C -4-104a1 f2.8-5� NJfi>N A Aasskx is 7+ D=SIGNER 5. ADDRESS MAILING ADDRESS x.2.205 4. PARCEL NO. 2-, t-I—f IcP LEGAL DESCRIPTION: PHONE LICENSE PIR S 3z-5 39— ZIP - 0323 `QZI PJq PHONE Actual Set Backs In Feet to: North I South I Size of Parcel jO0X [Z's New Const. Valuation 1 8.65 (p ? I west IIZone gificatrigs/i East Rmldentiale7 Commercial 0 Spr nklered ❑Yes DNo ❑Req'd. Remodeled Valuation Total Bldg. Floor Area ZIP CHANGE OF USE FROM 6. TO Main Floor Upper Floors Cover �c Garage/Storage Greenhouse Uncv. Deck Fin. Basement Unf in. Basement TYPE 0 ,BAD 43 -LO. ❑ ALT. 'N. 0 RPL. 7. OF C38LO. 0 PLMB. 0 MECH. 0 M.H. WORK ❑ MVE. O POOL 0 OTHER No. Bathe No. Floors No. Fin. Rooms No. Dwellings Cerlifl. of Exempt or Variance Required Yes❑ No Received Yes❑ No D SCRIBE WORK 8. jib VALUATION 9. Ct �©oII-�' (vl V SOURCE ELECTRIC F UiILLIITIES GAS Shorelines/Flood Hazard Yes: Not Applic. 0 Number ❑ Flans Required Received• WATER PUBLIC PRIVATE 0 SEWAG SEPTIC SEWER 0 Ownership Public 0 Private 22.- I X 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 of state or local law regulating construction or the performance of construction. SEE REVERSE SIDE FOR REOU D INSPECTIONS SIGNATURE OF OWNER OR AGEN -.,x•s •_ Q - APPLICATION OiC DATE SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) PRELIMiRINAL DATE Env. Health Planning Fire Prevent Engineer Utilities SEPA Plans Exam. Building Tech. /n2 4112x' 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) TOTAL $ PERMIT NUMBER 02* *89.00 *89.006 A *000 8 28482 04-12-83 2 6479. 0 0 O LU J LL WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 04,_,1.2,.8'3. DATE ISSUED 28499 *89.010 TOYNL PERMIT NO. 6 I 25 1 / .• /m / ), -0 • — s4 5 PLOT PLJ i;rcu D's _ P 1 P . _ _ DT 16 Lk. 1 ddesrE ...5 QQ05 DR. No RT,R. Iooc, / , / 0 1._TOLERANCI i....n -• .0, OlCIMAL -.CT1OM• • • _