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1983, 06-16 Permit: 83-A5354 Pre-Fab
PLAN NUMBER C APPLICATION/PERMIT 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 1. STREET ADDRESS N - ZG ►1 E L 'Rd xa p PARCEL NO. O 52-ISOg LOT 2. BLOCK Z SUBDIVISION C© 14-- 1.►TE E, CATE-s 3 OWNER �\ PHONE rOi � 2 SE ASC+ N"5 �,.IAvZ ty PHONE 32Co -dao` LEGAL DESCRIPTION: MAILING ADDRESS \p-,..)-€3 iNp:ANA ZIP Actual Set Backs in Feet to: North 1 l SouthEast I West fj 3 t CONTRACTOR 4. . S7tCJ:.Arz.o ADDRESS U+.2d'v INDLANa LICENSE EXPIRES PHONE 3240-4433o Size of Parcel qo xt25© 11 Zone Classification 1?.M Vic Residential V Commercial ❑ ZIP Type Const. Occupancy IZ. 3 Sprinklered ❑Yes ❑No ❑Req'd. DESIGNER 5. ADDRESS PHONE NuewConst. Valuation Tr Z,3o4- Remodeled Valuation Total Bldg. Floor Area 11 s2 ZIP Main Floor 1i 5Z Upper Floors Garage/Storage Greenhouse CHANGE OF USE FROM 6. TO Cover Deck Uncv. Deck Fin. Basement Unfin. Basement TYPE NEW ❑ ALT. ❑ AD' N. ❑ RPL. 7. OF WORK BLD. ❑ PLMB. ❑ MECH ❑ M.H. ❑ MVE. ❑ POOL ❑ OTHER No. Baths No. Floors No. Fin. Rooms Certifi. of Exempt. or Variance Required Received DESCRIBE WORK 8' '{ (2C -_ Y A [32-1 C P4 Ct✓) VALUATION Z$CCO SOURCE OF UTILITIES IBES t O C C:E (24X 4e) Shorelines/Flood Hazard Yes El Not Applic. ❑ --No. Dwellings X Yes ❑ Not/ Yes No❑ Plans Required Received H Number GAS ELECTRIC WATER / PUBLIC LR' PRIVATE ❑ SEWAGE/ SEPTIC fd SEWER ❑ Ownership 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 REVERSEIDE FOR REQUIRE INSPECTIONS SIGNATURE OF'�!�'!�/�XiC� APPLICATIO�L,i --(/ / OWNER OR AGEN d DATE OJ SPECIAL APPROVALS Env. Health Planning Fire Prevent. Engineer Utilities SEPA Plans Exam. Building Tech. PRELIM. FIN L DATE 61* SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) (°/WO It9P2OALt4 ?Ea..w. tT 1ZFsu.4two AT c'1415 it t'4•1C /51. $'3 STAgIOeuR,A AfetZ..o*r_N 2E[3'o ray T: wt.s a r GArzIrGe- C:N LSI :J1 bvV6 VEA 2.G f= /}rE VF'ZAR.C_14 ASC - 9e3 - C%* r j5 PERMIT IS NONTRANSFERABLE PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED IN 180 DAYS FEES COLLECTED Building tf? •00 Plumbing Mech. Plan Check SEPA Modular/ MFG. Home Other (Specify) 00 -Ca TOTAL $ X41 -OC PERMIT NUMBER eSA - �J3rJ�- WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. Sl7ED DATE ISD 1 6 i 555.45 PERMIT NO. *1'x.7.00°1=1 TOTAL