1983, 03-29 Permit: 83A-2336 MHLOT BLi
2. OWNER
3. ,A94'
MAILING ADDI
RT L i
CONTRACTOR
4. ADDR
DESIGNER
5.
ADDRESS
rcIIIVn 114UMDcn
SPOKANE COUNTY — DEPARTMEPJ.T OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES —
D I c.IC s -TR IE.ET
SUBDIVISION
PHONE PHONE
TZ
ZIP
0,
LICENSE EXPIRES PHONE
ZIP
— PRESS HARD TO MAKE 3 COPIES
FNorth.
/Y543- 0ZG'7
RIPTION:
G`i I exc S.`(O' OF E MI f AND 5-j- Ot=
vOp LOT 3 DwcIG zZvijttoNS /WDr77in Feet to:
South Z V East West —t -'r
Size of Parcel Zone Classification t Residential�9
. J'0 .7 Ar-KiCommercial C
ncuL
Type Const. Occupancy Sprinklered
I R,--_-4 ❑Yes ❑No ❑Req'd.
PHONE New Const. V.
ZIP Main Floor
I Remodeled Valuation Total Bldg. Floor Area
a,,: .
Upper FloorsGaragelStorage Greenhou
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
C�IEW El ALT. ElAD' N. El RPL. 1-1MVE.
z
'
7 OF El OTHER
WORK El BLD. ElPLMB. ❑ MECH. ".H. ❑ POOL
Certifi. of Exempt.
Required
Yes[:] No❑
Number
or Variance
Received
Yes❑ No❑
DESCRIBE WORK
8'
Shorelines/ Flood Hazard
Plans Required ❑
MC13 L A ') C� :_74 �-X i
Yes❑ Not Applic. ❑
Received LlVALUATION
SO'
GAS ELECTRIC
pUBLICR2t
SEPTIC
ee�h�p
FEES COLLECTED
9• UTILITIES
PRIVATE ❑
1 SEWER ❑
Public ❑ Privat
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 INSPECTIONS
Plumbing
SIGNATURE OFAPPLICATION
OWNER OR AGENT DATE1-0?10kyMach.
SPECIAL APPRO S
ECIAL CONDI ON : (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
l✓ l,(J�j
Plan Check
Q // iRk
SEPA
Planning
t 4
>ql'
Modular/
MFG. Home
Fire
Prevent.
Utilities
Plans PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS
Other (Specify)
pU
TOTAL $ �� X
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0'3 2 9 -8 3 2'33.6z *10a0;0a�
DATE ISSUED PERMIT NO. TOTAL
a
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(5'
186, as'
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