1983, 02-17 Permit: 83A-1157 Attached GaragePLAN NUMBER y APPL ICAT 11ON / PERM IT PERMIT NiUMBER .
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 PARCEL NO.
13 1'5
LOT I BLOCK SUBDIVISION LEGAL DESCRIPTION:
OWNER _ PHONE PHONE
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
kQ4> Z-) t' JIL\
cy;.
North South ? East
i t West
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel
Zone
Classification
Residential —
4.
Env. Health
j/
Commercial ❑
ADDRESS
Z]IP
T Const.
Occupa y
Sprinklered
�1 �lHiCC2`
gC1mn
SEPA
��, -�
Planning
❑Yes ❑No ❑Req'd.
DESIGNER _
PHONE
New Const. ValuationRemodeled
Valuation
Total Bldg. Floor Area
Modular/
MFG. Home
},
Fire
Prevent.
A RESS
tvQ2_� merit='
ZIP
Main Floor Up
r Floors
Garage/Storage
Greenhouse
i����
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1 �'
e G.
O
Cj
� _�
-
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
6.11
!I
'
/
TYPE
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
M/, EW ElALT. ElAD' N. 11 RPL. ElMVE.
7
- -7 . Z
7
—7
WORK BLD. ElPLMB. ElMECH. ElM.H. El POOL El OTHER
Certifi. of Exempt.
Variance
Required
Yes❑ WE(
Number
or
Received
Yes❑ No�'f
DESCRIBEWORK
8. i -
�"Z
Shorelines/ Flood Hazard
Plans Required
K Ct:�- I (� C N'—_E 1? �1 { r
Yes Not Applic. ❑
Received Cr
VALUATION
9•
I SOURCE
GAS
ELECTRIC
I WATER
PUBLIC ❑
SEWAGE
SEPTIC ❑ /
Ownership
�7F
DATE ISSUED PERM" *DEAL
FEES COLLECTED
UTILITIES
PRIVATE ❑
SEWER L�'
Public ❑ Private
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 ofb
Building
work will be complied with whether specified herein or not. The granting of a permit
P P 9 9 P
does not resume to
P 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
Plumbing
SIGNATURE OF/ 1 — APPLICATION
OWNER OR AGENT < / 011? ! i ) DATE
2-1-9)Z ___
Mech.
SPECIAL
APPROVALS
SPECIAL CONDITIO14 SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL
DATE
Plan Check
Env. Health
SEPA
Planning
Modular/
MFG. Home
},
Fire
Prevent.
d
Other (Specify)
O
Cj
Engineer
'Z
IEt2
3
W
!I
J
LL
Utilities
_
TOTAL $�'��
SEPA
PERMIT IS NONTRANSFERABLE
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
Plans
j
Exam.
t CXt'
`/
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
0 2 -17 8 3a 5 7 z * 9 C, O p
Building-�
Tech.
DATE ISSUED PERM" *DEAL