1983, 01-17 Permit: 83A-0367 DeckPLAN NUMBER APPLICATION /PERMIT
SPOKANE COUNTY — DEPAFTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES
PRESS HARD TO MAKE 3 COPIES
r I I I --,-T-L"
STREET ADDRESS
Mech.
PARCEL NO.
Upper Floors
GaragelStorage
Greenhouse
CHANGE OF USE FROM
TO
LOT
BLOCK
SUBDIVISION
Unfin. Be:
LEGAL DESCRIPTION:
2. Q
I �a
;709_f_ -'r
TYPE ❑ ❑ ALT. dAD'
No. Baths
OWNER
PHONE
PHONE
NEW N. ❑ RPL. ❑ MVE.
3. '54tP q iAWIC5 e
7. OFElOTHER
WORK RIBLD. ElPLMB. 11MECH. ❑ M.H. ❑ POOL
MAILING ADDRESS�y/�`
ZIP
Actua t tacks in Feet to:
I
Yes❑ No
Number
qzQ("
North South East West
,5zs Y
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential
4. r , eU2y C�rU�'C.
ami%
`c COk 1Z'
-
Commercial ❑
ADDRESS
ZIP
Type Const.
Occupancy
Spri nklered
'�) a 5 LQ'I MQ V- lAU_'LC_
qCL_)_
ZL j
-
❑Yes ❑No
❑Req'd.
DESIGNER
I PHONE
y@wConst. Valuation
I Remodeled Valuation
I Total Bldg. Floor Area
5.
t
r I I I --,-T-L"
ADDRESSZIP
Mech.
Main Floor
Upper Floors
GaragelStorage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Be:
6.
ZZ4
22-
—
1
TYPE ❑ ❑ ALT. dAD'
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellin
NEW N. ❑ RPL. ❑ MVE.
7. OFElOTHER
WORK RIBLD. ElPLMB. 11MECH. ❑ M.H. ❑ POOL
Certifi.ofExempt.Required
Yes❑ No
Number
or Variance
Received Yes 11N.1
DESCRIBE WORK Shorelines/ Flood Hazard
8. C.� ¢ lriNiry ��miC� Yes El Not Applic. ❑
VALUATION I SOURCE GAS ELECTRIC WATER I SEWAGE/ Ownership
PUBLIC El
9• UTILITIES PRIVATE ❑ SEWER �❑
Public F1 Private (f�
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 SIDE FOR REQUIRED INSPECTIONS
SIGNATURE OF APPLICATION
OWNER OR AGE DATE �- "S'- .3
SPECIAL APPROVALS SP IAL CONDITIONS: (S REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Prevent.
Plans PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS
Received 0
FEES COLLECTED
Building,.,
t
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
00
TOTAL $1�
—e-
WHEN MACHINE VALIDATED IN T
THIS BECOMES A PERMIT.
P RMI NUMBERd3_6 Z
F314 ..
{�1 36.72 *28,00"
DATE ISSf7ED 7 PERMIT NO. TOTAL
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