1983, 03-11 Permit: 83A-1760 MHFLAN NUMUCH I
HrrL 1%oA 11UN / rr-KM 1 1
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 I
CHANGE OF USE FROM TO Cover Deck Uncv. Deck Fin. Basement Unfln. Basement
6. ..w.. • . w -
No. Baths No. Floors No. Fin. Rooms No. Dwellings
7. OF
O NEW ❑ ALT. ❑ AWN. ❑ RPL. ❑ MVE. ❑OTHER I
WORK ElBLD. ❑ PLMB. ElMECH. F/M.H. ❑ POOL Certlfl. of Exempt. Required Yea❑ NOVI Number
STREET ADDRESS
or Variance
Received
PARCEL NO.
DESCRIBE WORK
8.
1.
Ir
llv_,)c,-
[A6 *tL_.e-' C%
?kw 0,
,%-I5 -.- 0
08
SOURCE
of
LOT
BLOCK
SUBDIVISION
SEWAG
SEPTIC 8S
LEGAL DESCRIPTION:
FEES COLLECTED
2.
I
I
OWNER
PHONE
PHONE
3.
f I .,1: r t rJ
M t r�►
Gi 'Z7
MAILING ADDRESS
ZIP
Actual Set Backs In
Feet to:
".-;;,^; -,, ,
*,^-N t~ -4-c-- it,,,je-1
q Q 07x.'7
North 44'
South 20
East
West
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential
4.
- -„ r '. ,. _
I
-78)c 14"1
14ilrs r c,-,,
I `a m
Commercial ❑
ADDRESS
ZIP
Type Const.
Occupancy
I Sprinklered
*. t"
17'
-�+, -,�
❑Yes ONO OReq'd.
DESIGNER
PHONE
gew.JConat. Valuation
Remodeled
Valuation
Total Bldg. Floor Area
-1`
Gj�o
5.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM TO Cover Deck Uncv. Deck Fin. Basement Unfln. Basement
6. ..w.. • . w -
No. Baths No. Floors No. Fin. Rooms No. Dwellings
7. OF
O NEW ❑ ALT. ❑ AWN. ❑ RPL. ❑ MVE. ❑OTHER I
WORK ElBLD. ❑ PLMB. ElMECH. F/M.H. ❑ POOL Certlfl. of Exempt. Required Yea❑ NOVI Number
9 ` UTILITIES PRIVATE ❑ SEWER ❑ Publ(aO Private 1
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 erformance
of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS r
SIGNATURE OF -7;,%- ��� -1 q APPLICATION l
OWNER OR AGENT / ' - t, - DATE
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SI DE FOR NOTICE)
PRELIM. FINAL DATE
: Health y/
N=� C.L. Fac - ,.. , &x% off:
PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
9`4'dirg y !jl IN 180 DAYS
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/ ,
MFG. Home
Other (Specify)
F•tHMI I NUIV10rh
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
fl i n r l
DATE ISSUED PERMIT NO
r _ TOTAL
I-
2
a
V
J
CL
CL
a
or Variance
Received
Yes❑ NOD
DESCRIBE WORK
8.
Shorelines/Flood Hazard
Plans Required ❑
r .. (>, i A:;; :.7r"
[A6 *tL_.e-' C%
Yes❑ Not Applic. ❑
Received ❑
VALUATION
SOURCE
of
GAS
ELECTRIC
WATER /
PUBLIC H
SEWAG
SEPTIC 8S
Ownership
FEES COLLECTED
9 ` UTILITIES PRIVATE ❑ SEWER ❑ Publ(aO Private 1
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 erformance
of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS r
SIGNATURE OF -7;,%- ��� -1 q APPLICATION l
OWNER OR AGENT / ' - t, - DATE
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SI DE FOR NOTICE)
PRELIM. FINAL DATE
: Health y/
N=� C.L. Fac - ,.. , &x% off:
PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
9`4'dirg y !jl IN 180 DAYS
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/ ,
MFG. Home
Other (Specify)
F•tHMI I NUIV10rh
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
fl i n r l
DATE ISSUED PERMIT NO
r _ TOTAL
I-
2
a
V
J
CL
CL
a