1983, 07-27 Permit: 83A-7018 ShopPLAN NUMBER
' APPLICATION/PERMIT ti
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 I
106'61- MIx J e,Liu-
LOT BLOCK
2. jj 2i e>
I
J
3. �Nk k1/41000 E
PARCEL NO. I60 4. 2 _ 14-08
SU, BQIrVISI. ON
j�/I OKI r`00 rc
T3-!+-7324:HONE
MAILING ADDRESS 7/-
- I o4 MAXI.,J�u—
LICENSE EXPIRES
4. COIAAB
6TH
— 13 u0c1.
AD 56. MOS
DESIGNER
5. ADDRESS
LEGAL DESCRIPTION:
43129&
4 _Z
Actual Set Backs in Feet to:
North ISouth 5 frast
�� la Ifl tion
•
Size of Parcel
16x 9S
West
Residential T. --
Commercial 0
Typ; flt.
Oocupa ICY
Spr'nklered
Dyes DNo DReq Id.
PHONE
ZIP
New Const. Valuation
31-5 to.
Upper Floors
Main Floor
Remodeled Valuation
Total Bldg. Floor Area
Garage/$torraace
Greenhouse
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv. Deck
Fin. Basement
TYPE 11 EW ❑ ALT. ❑ AD' N.
%. OF
WORK 2 eLD. 0 PLMB. 0 MECH
❑ RPL.
D M.H
❑ MVE.
O POOL
0 OTHER
No. Battu
No. Floors
No. Fin. Rooms
jJo.
UDwellings
nfin. Basement
Certitl. of Exempt.
or Variance
Required Yes° NoD
Received yesO Non
Number
DESCRIBE WOR
8. �I or mal ctce
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECFRIC PWB IERI,'
PRIVATE 0
Shorelines/Flood Hazard
Yes Not Aeolic. 0
Pans Required
Received 0
SEWAG
SEPTIC
SEWER ❑
Ownership
Public 0 Private -
I hereby certify that I have read and examined thls 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 R OUIRED INSPECTIONS
SIGNATURE OF APPLICATION 7-�O
OWNER OR GENT DATE
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Mans
Exam.
Building
Tech.
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)
1--5Lfr
TOTAL $
PERMIT NUMBER
&34 7643
02* *54.00
*5400'6
A *000 8
701.72
07-27-83
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
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DATEQSSUEL2 7' - 8{ f'
PERMITU.L8g*5400 WTAL
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