1983, 05-18 Permit: 83A-4296 ResidencePLAN NUMBER
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APPLICATION4PERMIT
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. 5.34.04
Fox GT.
PARCEL NO.
3354-1- OQG¢j
LOT
2. 3
BLOCK
SUBDIVISION
AI71L-OmE ItT
OWNER
3 GIA rtY IZOTN
PHONE
PHONE
C128 -Z948
LEGAL DESCRIPTION:
MAILING ADDRESS
4 . "'-aEG. Tt i N ES
CONTRACTOR
4 " Arste
ADDRESS
N1vMaE
DESIGNER
5. ADDRESS
ZIP
�G7.C7Co
LICENSE EXPIRES
PHONE
Actual Set Backs in Feet to:
North ZS !South 36' LFmt IS. 1 west to'
Residential d
Commercial 0
Size of Parcel
Rant-Cal.txyagz_
Zone Classification
ZIP
Type Const.
'3N
PHONE
ZIP
Occupancy
F2. -3/n4 -
Remodeled Valuation
New Const. Valuation
I(05
Main Floor
I�SLie
Spr nklered
❑Yea ONo ❑Rev'd.
Tota Bldg. Floor Area
878
Upper Floors
aa-
Garage/Storage
5524i &
Greenhouse
CHANGE OF USE FROM
8.
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin Basement
TYPE
7. OF
WORK
EW 0 ALT. 0 AD' N.
® BLD. 0 PLMB. 0 MECH
❑ RPL.
❑ M.H.
❑ MVE.
O POOL
0 OTHER
No. Baths
No. Floors
Certill. of Exempt.
or Variance
No. Fin. Rooms
Required YesO Noll
Received Yes❑ N00
No. Dwellings
Number
DESCRIBE WORK
8. S.Aic.c. F.Ayvttlot✓g.AC
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
Y.
PUBLIC
PRIVATE 0
Shorelines/Flood Hazard
Yes❑ Not Apollc.0
Plans Required d
Received D'
SEWAGE
SEPTIC
SEWER
Ownership
Public 0 Private d
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 other state or local law regulating construction or the performance
of construction. SEE REVERSE SIDE FOR REOU : ED INSPECTIONS
SIGNATURE OF
OWNER OR AGENT
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Pre
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
NIR
'I6
APPLICAT
DATE
.4/A,1983
1
SPEC AL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
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)
34c,.wo
TOTAL $ 34-&-60
PERMIT NUMBER
83A -4'2
02.* *34600
*346006
A *000
42612
•05-19-83
2 6479
d
O
V
W
J
LL
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE
=01'9 '9i3
PERMIT P 9' U Z *3 460 OCTAL
i
5 B9' 47'
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