1983, 09-23 Permit: 83A-9428 Special InspectPLAN 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
STREET ADDRESS
1. e•-. 1 L� 3� 'I LJ -f F l t { .
LOT BLOCK SUBDIVISION
2.
PARCEL NG.
3.
4.
OWNER
rio
WNNEERoJ 7e. _, I
ONE
5?
g" 5?56
PHONE
LEGAL DESCRIPTION:
MAILING ADDRESS
zyo6 IJ • ritg_
CONTRACTOR
LICENSE EXPIRES
PHONE
Actual Set Backs In Feet to:
North ISouth
Size of Parcel
East
IWest
Zone Classification
Residential 0
Commercial 0
ADDRESS
ZIP
Type Const.
Occupancy
Sp nklered
DYes DNo UReq'd.
5.
DESIGNER
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
Unf in Basement
TYPE ❑ N W DALT. ❑ AD' N.
7• OF
WORK BLD. 0 PLMB. 0 MECH.
❑ RPL. O MVE.
M.H. ❑ POOL
OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Cortin. of Exempt.
or Variance
Required YesD No❑
Received YesD No0
Number
8.
9.
DESCRIBE WORK
rc-IA1-- I
VALUATI6N SOURCE
UTILITIES
GAS
7 *15(1.r M61K6)
ELECT C WATER SEWAGE
PUBLIC 0 SEPTIC 0
PRIVATE 0 SEWER 0
Shorelines/Flood Hazard
Yee 0 Not Apollo. 0
Ownership
Public D Private 0
I hereby certify that I have read and examined this 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 canIons her state or local law regulating construction or the performance
of construction. SE VERS EiF RIRE IRED INSPECTIONS
SIGNATURE OF -
OWNER OR AGENT
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
APPLICATION `Z j.� �Q
DATE / �(
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plans Req fired D
Received 0
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
8-00
TOTAL $ g
PERMIT NUMBER
e-7421
02* *800
*8006
A *0.00 8
94272
09-23-83
2 6479.
0-
0
-
0
V
W
J
1t.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0923'-83' 942.85
DATE ISSUED PERMIT NO.
*8.00 DJF,
TOTAL