1983, 08-12 Permit: 83A-7725 ResidencePLAN NUMBER
CHANGE OF USE FROMTO
APPL ICAT ION /PERMIT
82A-220
Cover Deck
—
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
Fin. Basement
Unf%ITement
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
—
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
i5U
PARCEL NO.
1. N. 4722 Lillian
Road
TYPE If NEW
01541-0601
LOT
2. 1
BLOCK
3
SUBDIVISION
Peplinskis
1st Addn
LEGAL DESCRIPTION:
OF
WORK t�" BLD.
ElPLMB. ElMECH. ElM.H. 11 POOL ❑OTHER
Lot 1, Block 3 Peplinskis' 1st Addn
OWNERN
3. Tupper Inc. Realtors
�' 5991
PHONE
MAILING ADDRESS
E. 12929 Sprague Ave.
Number
ZIP
99216
Actual Set Backs In Feet to:
43'1 15' 8230'
or Variance
Received
Yes❑ Nor]
North south East West
CONTRACTOR
4. Tupper Inc.
#TUPPEIR179DC
Res/ double
LIC �E IRES
M-1991
120aex140
Zone cation
sg -Yam
Residentia
Commarcial ❑
ADDRESS
E. 12929 Sprague Ave.
Received ❑
ZIPTX�Const.
99216
VN
O� 21ricy
K—S
Sprinklered
oyes ❑No ❑Regld.
DESIGNER
I WAT
PUBLI
SEWAG
SEPTIC
PHONE
Const. Valuation
Remodeled Valuation
Total Bldg. f=loor Area
5. -
-
-
-
979
ADDRESS
ZIP
Main Floor
Upper Floors
Garagel torage
Greenhouse
-
-
979
-
52b
-
9 UTILITIES x x PRIVATE ❑ SEWER ❑ Public ❑ Private
1 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 INSPECTIONS
SIGNATURE OF I37 #�APPLICATION 8-3-83
OWNER OR AGENT 4 DATE
SPECIAL APPROVALS I SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Env. Health
�tcca ell
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans m PERMIT IS NONTRANSFERABLE
Exam. tLg PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building1 IN 180 DAYS
Tech.50 �7 �12
Building +wCA .ca
Plumbing
Mach.
Plan Check
SEPA
Modular/
MFG.Home
Other (Specify)
PERMIT NUMBER
TOTAL $ gni `Cb I
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE (S E D 12 PERMIT NO. o * 1' O O TOTAL
C
C
C
CHANGE OF USE FROMTO
—
Cover Deck
—
Uri. Deck
Fin. Basement
Unf%ITement
s.
—
i5U
O I
TYPE If NEW
C1 ALT. AD' N. C3 RPL. ❑ MVE.
No. Bjhs No.
Flpors
I
No. Fin .4Rooms
No. �ilings
7.
OF
WORK t�" BLD.
ElPLMB. ElMECH. ElM.H. 11 POOL ❑OTHER
Certifi.ofExempt.
Required
Yes❑ 160
Number
or Variance
Received
Yes❑ Nor]
8.
DESCRIB WO K
Sing 1, F�ami ly
Res/ double
Shorelines/Flood Hazard
Plans Required
with garage
yes❑ NotApplic.L
Received ❑
VALUATION
I SOURCE
OF
GAS
ELECTRIC
I WAT
PUBLI
SEWAG
SEPTIC
Ownership
FEES COLLECTED
9 UTILITIES x x PRIVATE ❑ SEWER ❑ Public ❑ Private
1 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 INSPECTIONS
SIGNATURE OF I37 #�APPLICATION 8-3-83
OWNER OR AGENT 4 DATE
SPECIAL APPROVALS I SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Env. Health
�tcca ell
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans m PERMIT IS NONTRANSFERABLE
Exam. tLg PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building1 IN 180 DAYS
Tech.50 �7 �12
Building +wCA .ca
Plumbing
Mach.
Plan Check
SEPA
Modular/
MFG.Home
Other (Specify)
PERMIT NUMBER
TOTAL $ gni `Cb I
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE (S E D 12 PERMIT NO. o * 1' O O TOTAL
C
C
C
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