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1983, 09-22 Permit: 83A-9370 Relocate Residence
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY 1 NORTH 811 JEFFERSON / SPOKANE, WA5HINaTON 99260 / (509) 456-3675 s. CHANGE OF USE FROM I TO T Cover Deck Uncv. Deck Fin. Basement Unfin. Basement L/ APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES No. Dwellings STREET ADDRESS PARCEL NO. �. C'iogbl MALL010 A.UG toga LOT BLOCK SUBDIVISION Number LEGAL DESCRIPTION: &T2. � �a� i wIl], mr Tix. G.ti I �- DESCRIBE WORK 8' �JtC ZiZ CVL. j , ZjZ r OWNER ,p,, PHONE PHONE Received ❑ VALUATION SOURCE OF GAS ELECTRIC WATER PUBLIC SEPTIC MAILING ADDRESS ZIP Actual Set Backs In eetto: I UTILITIES T2- PRIVATE ❑ I North South East West public ❑Private ❑ CONTRACTOR LICENSE EXPIRES PHONE �eofParoel Zone Classification Residential 4. 6 of construction. SEE REVERSE SIDE FOR REOU RED INSPECTIONS Plumbing SIGNATURE OF APPLICATION ,—��3 5K� Commercial ❑ ADDRESS ZIP Type Const. Occupancy Sprinklered � 3 1 2 --_-I ❑Yes ❑No ❑Req'd. DESIGNER PHONE New Const. Valuation Remodeled Valuation Total Bldg. Floor Area 0 0 d 5. ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse s. CHANGE OF USE FROM I TO T Cover Deck Uncv. Deck Fin. Basement Unfin. Basement SPECIAL APPROVALS SPECIAL CONDITION . (SEE REVERSE SIDE FOR NOTICE) LI . FI DTE 41r -Plan Check .Sc�i�s-t At,.,��v_�r�tP �1 ory Cs2�45i3`/ �"i1Ar-7.cYpt3 Env. Health SEPA FI4nl,g jZEL.00t+°:Z�S7;� tat - �l �iL��:2.�trl Modular/ MFG. Home Fre Prevent. EngineerrI A)W W&OT Other (Specify) ©tea '1 YT3 AJwt . ✓A e. �,u rC6. cJ Qe�k�ea s,l.E'> � } i`� 12.ts+ To 13�.- t(loCt. Utilities vro,i Vorne— t iD SEPA to tt�G TOTAL $ PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN TH Plans THIS BECOMES A PERMIT. Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED rr_Nrv11l rvvnntsrn / J IN 180 DAYS(,Q L_Q3 p ;7(]o' �?,Da0� DATE S UE PERMITNO. TOTAL CL O C) W J_ LA. No. Baths No. Floors No. Fin. Rooms No. Dwellings TOFPE ElNEW ElALT. C3AD' N. E] RPL. WMVE. 7. ❑OTHER Certifi.ofExempt. or Variance Required Yesr No❑ Number WORK Kr"BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL Received YesV NOD �- DESCRIBE WORK 8' Shorelines/ Flood Hazard Plans Required ❑ ��3r✓c�fAtY� "r�+C��o=iJi Yes❑ NotApplic.❑ Received ❑ VALUATION SOURCE OF GAS ELECTRIC WATER PUBLIC SEPTIC Ownership FEES COLLECTED 9 I UTILITIES PRIVATE ❑ I ISEWAG&/ SEWER ❑ 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 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 REOU RED INSPECTIONS Plumbing SIGNATURE OF APPLICATION ,—��3 OWNER OR AGENT DATE Mech. SPECIAL APPROVALS SPECIAL CONDITION . (SEE REVERSE SIDE FOR NOTICE) LI . FI DTE 41r -Plan Check .Sc�i�s-t At,.,��v_�r�tP �1 ory Cs2�45i3`/ �"i1Ar-7.cYpt3 Env. Health SEPA FI4nl,g jZEL.00t+°:Z�S7;� tat - �l �iL��:2.�trl Modular/ MFG. Home Fre Prevent. EngineerrI A)W W&OT Other (Specify) ©tea '1 YT3 AJwt . ✓A e. �,u rC6. cJ Qe�k�ea s,l.E'> � } i`� 12.ts+ To 13�.- t(loCt. Utilities vro,i Vorne— t iD SEPA to tt�G TOTAL $ PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN TH Plans THIS BECOMES A PERMIT. Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED rr_Nrv11l rvvnntsrn / J IN 180 DAYS(,Q L_Q3 p ;7(]o' �?,Da0� DATE S UE PERMITNO. TOTAL CL O C) W J_ LA. Im 1� ................