1983, 06-28 Permit: 83A-5879 AdditionPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - PEPA RTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1. s- 715 OMS
2. "7
SJrOCK
SUBDIVISIONO'Q
MM 0f l 1-101
�PH-)O rryAE
3. orarnslyI�AJ�
MAI ING ADDWS , r, . efal
CONTRACTOR
�i ii-- H cGiR%IY1 Ifr+J
a. A°°7k SS 302- -- PALt
PHONE
PARCEL NO
29..6+(_
LEGAL DESCRIPTION:
ZIP
DESIGNER
5.
ADDRESS
LICENSE EXPIRES
- 4975
Actual SetI/Backs In Feet to:
North 6 (South 0 LEast I West
SizeO ZnaCl� if�lon
��XITYpe¢pt. Occupancy
ResIde '
Commercial
D
Spr nklered
DYes CNo DReq'd.
PHONE
New Inst. Valuation I Remodeled Valuation OW° 27
Total Bldg. Floor Area
ZIP
tql
Upper Floors
6.
CHANGE OF USE FROM
TO
fiver Deck
Uncv. Deck
Garage/Storage
7 GP
lFFin. BBaass ment
J d
Greenhouse
Unlin Basement
TYPE' 0 NEW 0 ALT. IETAD'N.
7. OF
WC?K»'BBLLD.I 0 PLMB. 0 MECH.
8. DE ,Eo
1ef�'v_�l AYEprjLNi
0 RPL. 0 MVE.
❑ M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Fin Rooms
No. DwellIngs
Caroti. of Exempt.
or Variance
Shorelines/ Flood Haza d
`INC Not Apollo. 0
Required Yes0 NoD
Received YesD NoD
Plans Requred�/
Received 4
Number
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC
PRIVATE 0
SEWAGE/
SEPTIC
SEWER 0
Ownership
Public 0 Privat2,2(/
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 provlsio Is of any other state or local law regulating construction or the performance
of construction. SEE REVE R RE•rl• DINSPE TIONS
SIGNATURE OF
OWNER OR AGENT
z---"r
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOT) CE)
°OKI< uc. (Mcc c 24-0 I -4 -
SPECIAL APPROVALS
PRELIM. FINAL DATE
APPLICATION G
DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
b,ld
PERMIT 1S NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
150'
TOTAL $ y=�
NUMBER
02* *150.00
*15Q006
A - *0,00 0
57672
06-27-83
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE I3/�11gd— I81.. PERMIT -C,, pp Z 7 2 * 1 5 0. 0 0
95YU_� MN. o POIfAL