1983, 09-15 Permit: 83A-9096 BarnPLAN NUMBER
APPLICATION/PERM IT
SPOKANE COUNTY - DEPAPTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
1.
2.
STREET ADDRESS
�- LIQ '-
LOT SUBDIVISION
BLOCK
PARCEL NO. 17 5 04.
2,
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3.
MAILI�IGADD iss
CON -TSR
A OR
4.
ADDRESS
P O E PHONE
om
LEGAL DESCRIPTION:
(o►J stT p�
LICENSE EXPIRES
Z�
Actual Set Backs in Feet to: I W
North 1South !o 'V East ` est
PHONE
Size of Parcel
11 Z nelass ification
rG .
Residential ZJ
Commercial ❑
ZIP
Type.
Occuparyi
Spr nklered
❑Yes ❑No ❑Req'd.
DESIGNER
5.
ADDRESS
PHONE
New Coast. `�ITValuation
"tr[? Q C4f�
Remodeled Valuation
Total Bldg. Floor Area
ZIP
Main Floor 1 Upper Floors
Garage/$torlece,
Greenhouse
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE JZ( EW ❑ ALT. ❑ AD' N. 0 RPL. ❑ MVE.
7 OF ❑ OTHER
W TURK `J BLD. ❑ PLMB. 0 MECH. 0 M.H. 0 POOL
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required Yes❑ No CI
Received Yes❑ No❑
Number
DESCRIB WORE{
8• � N
VALUATION
9.
IV / f t-- `'`r_
Shorelines/Flood Hazard
Yes❑ Not Applic. ❑
Plans Requ'red ❑
Received ❑
SOURCE
UTI LLIITI ES
GAS
ELECTRIC
WATER
PUBLIC ❑
PRIVATE ❑
SEWAGE
SEPTIC 0
SEWER 0
Ownership
Public 0 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
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 ' e provisions of any other state or local law regulating construction.or the performance
of construction. SEE REV SE SI • (WIRED 1 SPECTIONS
SIGNATURE OF
OWNER OR AGE
APPLICATIO
DATE ,4 •
SPECIAL APP OVALS ("SPECIAL CONDITIONSt -( EE REVERSE SIDE FOR NOTICE
PRELIM. FINAf DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
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)
6I
TOTAL $ I
PERMIT {NUMBER
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE 9 D1 5tl — 8 3
PERMIT914J 9. 6 z
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AL DESCRIPTION CORRIN 4DD TO UREENACRES116
/B2
S 71..5 326 EXC ,43O4.50FT & EXL S210FT OF E153FT OF SD L8 L EXC
5FT OF W465FT OF S150FT OF SD LT 8 ALL LYu S OF MOEN 3RD ADD
4