HomeMy WebLinkAbout1983, 05-24 Permit: 83A-4432 MHPLAN NUMBER
AFFLIC+A l 1UN/rtKmi I
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 PARCEL NO.
1
ISO -27- % or � rJ � 2___
LOT BLOCK SUB IVISION LEGAL DESCRIPTION:
2. � Si .c
PHONE PHONE
ZIP
CNI C
LICENSE EXPIRES I PHONE
4.
North South 5' 1 East (4 I West
Size 1& I 7 Zo�opg Cyl�aa,ssi i tion Resident
T x L�If V V Commen
PERS MIT�IUM'HAZ
PERMIA& 12 z * 5 O. O 0 VtAL
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Dyes ❑No ❑Req'd.
DESIGNER
PHONE
Const. Valuation
Remodeled Valuation
Total,@Idg. Floor Area
1
`17CA
5.
ADDRESS
ZIP
ain oor Upper
Floors
Garage/Storage
Greenhouse
CHANGE O USE FROM
TO
over Deck
Uncv. Deck
Fin. Basement Unf in. Basem
6.
jew
TYPE NEW ❑ ALT. ❑ AD' N. ❑ RP ❑ MVE.
o. Baths No.
Floors
No. Fin. .RRoo ms
No. Dwellings
7• ❑OTHERertifI.ofExempt.
W ❑ BLD. ❑ PLM13. ❑ MECH. H. ❑ POOL
Required
Yeso No
NumberWORK
r VarianceReceived
Yes❑ No❑DESCRIBEWORK
8.
Shorelines/Flood Hazard
Plans Required ❑
% SLgU �Cul
Yes❑ NotApplic.
Received ❑
VALUATIQV4
SOURCE
GAS
ELECTRIC
PUBLICR
SEPTIC E
OwnershipOF
FEES COLLECTED
9•
UTILITIES
PRIVATE ❑
SEWER !0
Public ❑ 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
Building
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 INSRECTIONSPlumbing
SIGNATURE OF APPLICATION
OWNER OR AGEN DATE
Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FIN.AL DATE
Plan Check
nv. Health
Al
SEPA
Planning
Modular/ 5 p
MFG. Home
Fire
Prevent,
rngir�-_F_
Other (Specify)
Utilities
TOTAL $
SEPA
WHEN MACHINE VALIDAT
Plans
PERMIT IS NONTRANSFERABLE
THIS BECOMES A PERMIT.
Exam.
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS
Tech.
((�� � _
DATE 4SS1JIgo 4 �
PERS MIT�IUM'HAZ
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