1983, 10-17 Permit: 83B-0500 ShopPLAN NUMBER ArrLiUgI 1UN/F LKMII , PERMIT NUMBER
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
PARCEL NO.
SUBDIVISION LEGAL DESCRIPTION: -3 Atz YV��gQ
PHONE PHONE
� .fit✓ �%(�.g--
ZIP Actual t Backs in Feet to:
IS,
SATREET ADDRESS
G
North South 3f East
LOT
BLOCK
2.
PHONE
I
Zone Classification
OWNER
3.
%-AD AL:rc42-
W
MAILING ADDRESS
APPLICANT: COMPLETE NUMBERED SPACES – PRESS HARD TO MAKE 3 COPIES
PARCEL NO.
SUBDIVISION LEGAL DESCRIPTION: -3 Atz YV��gQ
PHONE PHONE
� .fit✓ �%(�.g--
ZIP Actual t Backs in Feet to:
IS,
G
North South 3f East
`�j' West
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residentia
-�C G�Ll S
4.
W
�-zc-rlZ
Bz%x k4 -t
LL
Commercial
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
si .
(ZC� 7
N
01 -A
Dyes ❑No ❑Req'd.
DESIGNER
PHONE
Nfv Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
-2
1Z<=V
5
ADDRESS
ZIP
Main Floor Upper
Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement Unfin. Basem
6.
—
TYPE
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
LAEW ❑ ALT. ❑ AD' N. ❑ RPL.
7. OF/
❑ MVE.
ElOTHER
_-�-
WORK Q BLD. 1:1PLMB. ElMECH. ElM.H.
ElPOOL
Certifi. of Exempt.
Required
Yes❑ Noig
Number
or Variance
Received
Yes❑ No❑
DESCRIBEWORK wc
1C_
8.
Shorelines/ Flood Hazard
Plans Required
�r{ t ��TptZY�[�;` �v
�L7�GQ-Cj
Yes❑ Not Applic.❑
Received
VALUATION
SOURCE
OF
GAS
ELECTRIC
R
PUBLIWATC ❑
SEWAGE
SEPTIC ❑
Ownership
FEES COLLECTED
9•
UTILITIES
PRIVATE ❑
SEWER ❑
Public ❑Private
1 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
�j
8 Z
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 OFz�/�
APPLICATION
OWNER OR AGENT ..
DATE L1 c.-�
Mech.
PRELIM. FINAL DATE
Env. Health
Planning
Prevent
Utilities
Plans D L„ PERMIT IS NONTRANSFERABLE
Exam. rt L-15 PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building} /� /, IN 180 DAYS
Tech.
Plan Check
SEPA
Modular/
MFG. Home
>_
CL
O
Other (Specify)
C.3
W
J_
LL
TOTAL $ 52 , I
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE I��IfED y / � PERMIT NO) 0. O �
* 8 2 V_ OThL
3
Vd /yr -Y G Dove ?-
'?.Z I/-
.
q.ZI/- 3i39
Pd' Kr- Y/ AI rg�e-
f/,, 74
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