1983, 06-17 Permit: 83A-5457 MHPLAN 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
1 STREETgDDRESSn 2 n^�
N lSL / �M1iV/Y 01/417
LOT
2. I
BLOCK
SUBDWISION VjyrA
OWNER
3. 6169KgC. re\l e" _
MA. I vINGI z
4.
CONTi
PARCEL NO. 1757. _ 0
50
I
- GO65
PHONE
LEGAL DESCRIPTION:
LICENSE EXPIRES
PHONE
ADDRESS
ZIP
Actual Set.Backs In Feet to: 3
North i (South East 0
Slze10 rel ✓ 7e, ZonkAssilcation
Type Cprpt. I
Occupancy
IWest
Residential V
Commercial 0
Spr nklered
°Yes ONo OReq'd.
5.
DESIGNER
PHONE
New Const. Valuation
Remode ed 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
Unftn Basement
TYPEW
7• OF
WORK 0 BLD.
0 ALT. 0 AD'N. 0 �RPL. 0 MVE.
0 PLMB. 0 MECH. kTM.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Caroti. of Exempt
or Variance
Required YesO No0
Received YesO No❑
Number
8. 1.10651 L.e>
DESCRIBE WORK
9.
l3JATTIION
kforit(z4-->c 50)
C GAS ELECTRIC
SOUR
F
UTILITIES
Shorelines/Flood Hazard
Yes° Not Applic.0
Plans Requ red 0
Received 0
WATER
PUBLIC
PRIVATE 0
SEWAGE
SEPTIC.
SEWER 0
Ownership
Public 0 Private
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
OWNER OR AGENT
APPLICATION
DATE - / ',r�.j
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
-03
(4\-q
P1
\s ii
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
3 -
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
I N 180 DAYS
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
100
TOTAL $ 10
0'
PERMIT NUMBER
o'A-5y57
07* *10000
*100006
A *000 S
544.5
06-17-83
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE
Ep17'=8'3
545.75 *100,0020
PERMIT NO. TOTAL
N . /-r-2 3 A 96 4 c�
6F;' F/v;Qc.p4-s LJ s<�.
J
cs
� vi
(fid.-j,c.c t•� GL��...�.
S\
POWER:
WATER: -
R
LOT: /
ADDRESS: ;
OWNER:
PR:FARED E
INST LLET:
1.07E IN:
,'`,T7R METE