1983, 11-07 Permit: 83B-1384 InsertPLAN NUMBER
APPLICATION/PERMIT
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.
STREET ADDRESS -
PERMIT NUMBER
e3F3-1
04* *20.00
*20.006
LOT
2.
BLOCK
SUBDIVISION
OWNER
3. CCP-a,liSaa.ra HVAYzz
MAILING ADDRESS
S. • 1, CZz-
CONTRACTOR
4.
5.
9AYyiE
PHONE
PHONE
G�Zz—\s3c
LEGAL DESCRIPTION:
6,tzwcE
ZIP
QCctcc
Actual Set Backs In Feet to'
North (South
LICENSE EXPIRES
PHONE
Size of Parcel
IlZone Classification
East
West
Residential 0
Commercial 0
ADDRESS
D RLz
DESIGNER
ZIP
Type Const.
Occupancy
Spr'nklered
OVes ONo DReq'd.
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg Floor Area
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
6.
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
7.
TYPE Q'NEW D ALT.
OF BLD. 0 PLMB
WORK
D pD'N. ❑ RPL. ❑ MVE.
6/MECH. D M.H. D POOL
0 OTHER
res Batns
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required VesD NoD
Received VesO NoD
Number
8.
9.
DESCRIBE WORK
c 1 CC CA4c8
VALUATION
11vSr:-tZ-T
Shorelines/Flood Hazard
VesO Not Applic. 0
Plans Required 0
Received 0
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC 0
PRIVATE D
SEWAGE
SEPTIC 0
SEWER 0
Ownership
Public 0 Private 0
I hereby certify that I have read and examined thls 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 REOUIRED I PECTIONS
SIGNATURE OF
OWNER OR AGEN
• :
SPECIAL APPROVAL SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
APPLICATION 7,d73
DATE
PRELIM FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
f /1
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 $ eS
*000 0
13832
1.1-07-83
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
4 "ti
C. t
DATE ISSU!D' Q / -8 3
PERMIT Nb,.3. 8' •4'a
*2.0.0'0 L