HomeMy WebLinkAbout1983, 04-18 Permit: 83A-3035 MHPLAN NUMBER
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SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
PERMIT NUMBER
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APPLICANT: COMPLETE NUMBERED SPACES —PRESS HARD TO MAKE 3 COPIES
7 . 5 ?. —, r- P yrs24y_'
STREETADDRESS
PARCEL NO.
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SUBDIVISION 5 (
LEGAL DESCRIPTION:
Size of Parcel
2. Z
Z\�Stcv U,sT 1
4.
L �
OWNER
PHONE
PHONE
3. wz 6 1 t�F Y�
SEPA
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Commercial ❑
MAILING ADDRESS
ZIP
Actual Set Backs In Feet to:
SPECIAL
7 . 5 ?. —, r- P yrs24y_'
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
North I C ISouth East
3 C::�� I West
CONTRACTOR
LICENSE EXPIRES
1
PHONE
Size of Parcel
Zone Classification
Residential 19/
4.
L �
—76 r,
SEPA
\+ I
Commercial ❑
ADDRESS
ZIP
Type Const. Occupancy
Modular/
�
MFG. Home �
Sprinklered
Fire
SAY, -'e
Prevent.
7S
;2�
❑Yes El No ❑Req'd.
DESIGNER
P
PHONE
W Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
TOTAL $
Utilities
-2-2, C
SEPA
5.
PERMIT IS NONTRANSFERABLE
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
Plans
Exam.
ADDRESS
IIQ 18_85 ' �o *50.000)
DATIA'A ED PERM114 . �' 7 z COITAL
ZIP
Main Floor Upper
Floors
Garage/ Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
6.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TYPE NEW El ALT. El AD' N. El RPL.
❑ MVE.
7
OF
El OTHER
WORK ❑ BLD. ElPLMB. ElMECH. L-1
El
Certifi. of Exempt.
Required
Yes[]No❑
Number
or Variance
Received
Yes❑ NoF1
8•
DESCRIBE WORK
Shorelines/ Flood Hazard
Plans Required
S rN t;
14 lcCF G
Yes❑ Not Applic. ❑
Received ❑
VALUATION
SOURCE
OF
GAS
ELECTRIC
WATER
PUBLIC
SEWAGE
SEPTIC
Ownership _T
FEES COLLECTED
.� G�CC7
UTILITIES
PRIVATE ❑
SEWER ❑
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
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 INSPE TIONS
Plumbing
SIGNATURE OF
APPLICATIMN L/ �n p�
OWNER OR AGENTD
4 e
DATE /`f ,` d
Mech.
SPECIAL
APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. F IAL
DATE
Plan Check
Env. Health
SEPA
Planning
Modular/
�
MFG. Home �
Fire
Prevent.
Other (Specify)
Engineer
P
+f
TOTAL $
Utilities
SEPA
PERMIT IS NONTRANSFERABLE
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
Plans
Exam.
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
IIQ 18_85 ' �o *50.000)
DATIA'A ED PERM114 . �' 7 z COITAL
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