1983, 07-19 Permit: 83A-6696 ACPLAN NUMBER
APPLICATION/PERMIT 81y
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY 530 01.S
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
2.
STREET ADDRESS //ePau-o/f QQ
LOT BLOCK I SUBDIVISION
PARCEL NO.
34 /OWNER
LtSlefd"'"''�t �"es
MAILING ADDRESS //—
a.
PHONE
PHONE
LEGAL DESCRIPTION:
ZIP
Actual Set Backs in Feet to:
North ISouth
kEast
CONTRACTOR // LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential 0
4..N /IAP <P(//Q✓ L�CiL r {� Commercial ❑
ADDRESS ZIP Type Const.Occupancy
`I9z
West
5.
z? ye Afr/
DESIGNER
Sprinklered
0Yes UNo OReq'd.
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE 0 NEW • 0 ALT. AD'N.
7. OF BLD. 0 PLMB. 0 MECH.
WORK
9.
DESCRIBE WpRie
VALUATION
SOURCE"-
UTILITIES
GAS
FzL2TRIC
WATER
PUBLIC 0
PRIVATE 0
SEWAGE
SEPTIC 0
SEWER 0
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certih. of Exempt.
or Variance
Shorelines/Flood Haze d
VesD Not ApoIIc.0
Ownership
Public 0 Private 0
Required VesD No0
Received YesO No0
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 IDE FOR REQUIRED INSPECTIONS
SIGNATURE OF • cCo /� �i�� DATECATION + _ s7'3
OWNER OR AGENT %%
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Flre
Prevent.
Engineer
Utilities
SEPA
Plana
Exam.
Building
Tech.
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Number
Plans Required 0
Received 0
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Horne
Other (Specify)
G-
TOTAL $ //
PERMIT NUMBER
04* *1400
*14.006
A *Q00 8
669.5
07-19-83
z 6479,
WHEN
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
O'7til'9'=8,3`
669,62 *1'4OO2i'
DATEISSUED PERMITNO.
TOTAL