1983, 08-03 Permit: 83A-7310 Addition, RemodelPLAN NUMBER
APPLICATION/PERMIT PERM IT NUMBER
0 -
[ 7?<U
SPOKANE COUNTY — DEPAR cMEHT OF BUILDING
& SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
1:
STR,ElE7 ADDRESS
- 1191 PS
PARCEL NO.
O l 4–I o1 og
2. LOT
BLOCK
SUQDIVISION T-`Wrr.
owNvER,yii zq
3 M� NG i t
LY-{ 4.4ts:c.
jfbA
PHONE
ZAP
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:� �I =
North ISouth
I
East I West
CONTij�1C TA
4.
ADDRESS
LICENSE
LICENSE EXPIRES
PHONE
SI rcel
x 1 Aro
ne C,ass`I do
Residential
Commercial 0
21P
Typo rfiz j
Ocpupancy
3
Spr nklered
❑Yes ONo OReq'd.
DESIGNER
5. ADDRESS
PHONE
New Cpnst Valuation
Remodeled Valuation
I2oo
Total Bldg. Floor Area
ZIP
Man Floor
Upper Floors
Garage/Storage
Greenhouse
6.
CHANGE OF USE FROM
TO
Cover
Uncv.Deck
IC/d
Fin. Basement
UnfIn. Basement
TYPE 0 NEW „Z‘LT. ZAD'N. 0 RPL. 0 MVE.
7. OF
el -
WORK QD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL
8. DERlacVIORKal ce>"cooIT
0 OTHER
4 NeAcO
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Gerbil. of Exempt.
or Variance
Shorelines/Flood Hazard
YesD Not Appllc. 0
Required Yes0 NoO
Received 'teen No0
Number
Plan Req Ired
Received
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC
PRIVATE 0
SEWAGEZ
SEPTIC
SEWER 0
Ownership /
Public O Private/
7--
hereby certify that I have read and examined this app('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 RE ERSE SIDE FOR REOUI: ED INSPECTIONS
SIGNATURE OF
OWNER OR AGENT
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech
vog
1&4
74263
�2FD
APPLICATION
DATE7 _ ZGD _83
SPECIAL CON '" TIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building 9 {(/
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $ —,[=
.91
02* *9600
*196006
A *Q00 a
697.82
07-26-83
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEILD0 3 = 8
�3
PERMIT7IC3 L 0 i
*9'6,00foiisL
riac7.
RI