1983, 06-15 Permit: 83A-5346 DeckPLAN NUMBER
APPLICATION/PERMIT
t 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
1.
ISill
3. OWI 1/ V eft l
MAILING AD E
CDNIgfl
2.
PARCEL 140.
BLOCK
u
tueoivlgtdN ,.,�
G�
-S 7
PHO
Or
1 LICENSE EXPIRES
4.
5.
PHONE
ot7r552 — 0107
LEGAL DESCRIPTION:
Z 7
PHONE
Actual Set Backs In Feet to:
North (South
Slier >c I to Zone Clami'icatlon
East I b I West
Residential
Commercial 0
ADDRESS
DESIGNER
ZIP
PHONE
Type rnsbl
Spr nklered
❑Yes ❑No ❑Req'd.
New Co t. Valuation Remodeled Valuation
5-7
Total Bldg Floor Area
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
6.
CHANGE OF USE FROM
TO
7.
TYPE ❑NEW 0 ALT. 21,D'N. ❑ RPL. 0 MVE.
OF rO BLD. 0 PLMB. O MECH. 0 M.H. 0 POOL
WORK
0 OTHER
weiDgo
No. Bath
Uncv. Deck
Fin. Basement
Unfin. Basement
No. Floors
No. Fin. Rooms
No. Dwellings
Certin. of Exempt.
or Variance
Required Yes❑ NM:
Received YesO No❑
8.
DESCRIBE y/0
Shorelines/Flood Hazard
Yes❑ Not Applic.❑
Number
$
Rana Requ red
Received ❑
VALUATION
9.
SOURCE
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC ❑
SEWAG
SEPTIC
SEWER ❑
Ownershlp
Public ❑ Private.P'
I 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
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 REQUIRED INSPECTIONS
SIGNATURE OF a ve! t
OWNER OR AGENT l
APPLICATION//
DATE !a 7Sr-I%3
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Env.
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plan
Exam
Building
Tech
PRELIM. FINgLA DATE
6/5.
gr
i
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. Horne
3'
Other (Specify)
3
TOTAL $
PERMIT NUMBER
a3P1/4 -534.10
02*
A
53372
06-15-83
2 6.479.
*3200
*32006
*00.0
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE1/4E121 5 `-8 3
i /I L o *( 2 O OO
r, Y U J
PERMIT mi. Z TOTAL
of
/r
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of
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GRACE COURT
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