1983, 08-24 Permit: 83A-8224 PoolPLAN NUMBER
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.
2.
STREET ADDRESS 7
LOT 16.
BLOCK
SUBDIVISION
PARCEL NO. 07 5+1-
2.
+1
3
01;I:Asitclw
Le.
PPHHO)N
PHONE
LEGAL DESCRIPTION:
MgGAD iNi .,6r9 61,0
4'
CONTR#CTOR.
GLI l f oGt-
4. et
ADI I DRESS
►� • pir��5
DESIG t ER
5.
LICENSE EXPIRES
Actual Set Backs In Feet to:
ISouth L0
East
North
Size of Parcel Q
Tye V lv �c Occupancy
New Const Valuation
Zene Classd G -
IWest Ir /
on Rmidential.0
Commercial ❑
Spr nklered
❑Yes ONo ❑Req'd.
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
TYPENEW ❑ ALT. O AD' N. ❑ RPL. D MyE.
7. OF
WORK BLD. 0 PLMB. 0 MECH. 0 M.H. OOL
0 OTHER
N0. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Cenifi. of Exempt.
or Variance
Required Yes No❑
Received Yes❑ No❑
Number
8.DESCRIB K WO
-� I 1 ifJ
Pact.
9• �L7IoN 0 UTIOF I SOURCE GAS
0
ELECTRIC
WATER
PUBLIC
PRIVAT 0
SEWAGE
SEPTIC
SEWER 0
Shorelines/Flood Hazard
Yes❑ Not AppJIc. 0
Ownership
Public 0 Private
Plans Required 0
Received 0
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 SID
/��7QR REOUIRED INSPECTIONS
SIGNATURE OF 2i /lX/. APPLICATION
OWNER OR AGENT—.dill DATE
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
zazizif
8/e
PERMIT IS 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) `�•
TOTAL $
PERMIT NUMBER
3A 9-2`
02* +25.00
*25008
A *Q00 8
82232
08-24-83
3 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS RRIAUEU'BECOMES A ZZPERMIT. pp G
DAT��I .8i/ PERMr&IZ.a4 Z * 2 5. 0 0 Er'04m.
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