HomeMy WebLinkAbout1983, 03-11 Permit: 83A-1760 MHPLAN NUMBER APDL IUAT ION / PERMIT
SPOKANE COUNTY — DEPARTMENTOF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
PRELIM. FINAL DATE
Env. Health
Planning
�Ao.c) Fp(L 'p^ -c
Utilities
PlansPERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building I Z"J] IN 180 DAYS
PERMIT NUMBER
-i o
SEPA
APPLICANT: COMPLETE NUMBERED SPACES —PRESS HARD TO MAKE 3 COPIES
�
CL
O
Other (Specify) �^
STREET ADDRESS
CHANGE OF USE FROM
CHANGE OF USE FROM
PARCEL NO.
Cover Dock
Cover Deck
Uncv. Deck
A
a
IRS.
N o
T
LOTBLOCK
SUBDIVISION
�• Batns No.
LEGAL DESCRIPTION:
No. Fin. Rooms
2.
a
i
uv�lSSlba� tits �M )5i
/RPL.
%. OF El OTHER
OWNER
PHONE
PHONE
3.
Nbf2nn A N
NAI t ` N
Required
q -
Number
or Variance
MAILING ADDRESS
Yes❑ No[-]
ZIP
Actual Set Backs in Feet to:
Shorelines/ Flood Hazard
Plans Required El
F_ . -.-.L-
'bel -> L.E-(
Q q 0-_-1--7
North "' I South Z o' East
West 4l `
GAS
CONTRACTOR
PUBLICREf
F91VALUATION
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential
4.
PRIVATE ❑
SEWER ❑
-t S x A4.-) 064vR der
-a m
Commercial ❑
provisions included on
ADDRESS
reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this type of
ZIP
Type Const.
Occupancy
Sprinklered
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 INSPECTIONS
Plumbing
❑Yes ❑No ❑Req'd.
SIGNATURE OF APPLICATION
1�3
DESIGNER
OWNER OR AGENT DATE
PHONE
ew Const. Valuation
Remodeled Valuation
Total Bldg. Floor area
qen
5.
l C�
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
PRELIM. FINAL DATE
Env. Health
Planning
�Ao.c) Fp(L 'p^ -c
Utilities
PlansPERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building I Z"J] IN 180 DAYS
PERMIT NUMBER
-i o
SEPA
MFG. Ho . SO - CV
MFG. Home
�
CL
O
Other (Specify) �^
V
W
J
CHANGE OF USE FROM
CHANGE OF USE FROM
TO
TO
Cover Dock
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
IRS.
T
�• Batns No.
Floors
No. Fin. Rooms
No. Dwellings
TYPE eNEW ❑ ALT. ❑ AD' N. ❑ ❑ MVE.
/RPL.
%. OF El OTHER
`
W ❑ BLD. ❑ PLMB. ❑ MECH. LTJ M.H. ❑ POOL
WORK
Certifi.ofExem t.
P
Required
Yes❑ No
Number
or Variance
Received
Yes❑ No[-]
DESCRIBE WORK
8' ��
Shorelines/ Flood Hazard
Plans Required El
jj
Sti'tC�LE �l M6P�it, E �pVYtLr CAA1L-Tb
Yes Not Applic. ❑
Received El
SOURCE
GAS
ELECTRIC
PUBLICREf
F91VALUATION
SEPTIC D
Ownership
FEES COLLECTED
UTILITIES
PRIVATE ❑
SEWER ❑
Public ❑ Private
I hereby c9Ytify 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 INSPECTIONS
Plumbing
SIGNATURE OF APPLICATION
1�3
OWNER OR AGENT DATE
Mach.
SPECIAL APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
cis„ r•ti�v
PRELIM. FINAL DATE
Env. Health
Planning
�Ao.c) Fp(L 'p^ -c
Utilities
PlansPERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building I Z"J] IN 180 DAYS
PERMIT NUMBER
-i o
SEPA
MFG. Ho . SO - CV
MFG. Home
�
CL
O
Other (Specify) �^
V
W
J
U_
TOTAL $ 15ao I
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE'fSIED' 1 - 3 PERMITNO. 5
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