1983, 01-28 Permit: 83A-0687 MHPLAN NUMBER
V
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
STREET ADDRESS
1 E. long YV\AR4ET1r
LOT
2.15
OWNER
BLOCK
\2
SUBDIVISION
SP2V-.E,2- :Pbnhc t4TG
3. T t4 *4 31 Cie. -N) C -c -
MAILING ADDRESS
CONTRACTOR
4. yvLe
ADDRESS
6-04 tni
DESIGNER
5.
ADDRESS
PHONE
PHONE
PARCEL NO.
O8557.- %3t 5
LEGAL DESCRIPTION:
ZIP
Actual Set Backs in Feet to
North ISouth
LICENSE EXPIRES
PHONE
Size of Parcel
10 X.
EXuSTlrut,
East
Zone Classification
iztJey
West
Residential !9'
iai
Commercial 0
ZIP
Type Const.
'MTN
Occupancy
Z
Spr nklered
Dyes 0 N DReq'd.
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
1 eat
ZIP
Main Floor
78
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
8.
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfln. Basement
TYPE /NEW D ALT. ❑ AD' N.
7. OF BLD. 0 PLMB. D MECH
WORK
❑/RPL.
2 M.H
❑ MVE.
D POOL
0 OTHER
NO. Baths
No. Floors
Certlfi. of Exempt.
or Variance
Required
Received
No. Fiiin. Rooms
Yes❑ Noll/
Veal NOl1
No. Dwellings
Number
DESCRI pE WORK
8. SI v--)L,l�
14SC-
-
Shorelines/Flood Hazard
YesD Not APPlic. D
Rana Required 0
Received ❑ "DA
VALUATION
SOURCE GAS
UTILITIES
ELECTRIC
WATER SEWAGV
PUBLIC 0 SEPTIC
PRIVATE 0 SEWER 0
Ownership
Public 0 Private Mf
I hereby certify that I have read and examined this appl cation 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 SIDE FOR REOUIRED INSPECTIONS
SIGNATURE OFOWNER OR AGENT Qx/� DATE CATION J ��
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Pans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
]=1C tGr; Pak, 4C7nC tN L.RX-sAT\ON
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 SO .010
Other (Specify)
TOTAL $ SO't7t7
PERMIT NUMBER
5-SA-cx i
07* *5000
6866
0;1-28-83
2 6479.
DP -
0
O
V
W
J
IL
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE
8tt ),8,,3.
PERMIT NCO o. / z
*.50,00'44L
70
i
13
moo' Le.
for t�
Pj.0z) r- 12
=-GS
[51—