1983, 09-26 Permit: 83A-9505 InsertPLAN 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
STREET ADDRESS
1.
51)-1 7.--g -E- AAA i 0-v'
PARCEL NO.
LOT
BLOCK
SUBDIVISION
2.
OWNER
3. -J -W ilnX2113c,C
MAILING ADDRESS
8-7-z8'C SS 1L3Y\
CONTRACTOR l'�1� yiwe .art.( \ CJtd
v.
4. ADDRESS T—
"Z, T (o..‘01/4C- IS
PHONE
PHONE
�zz ot09e
LEGAL DESCRIPTION:
ZIP
21D1Z,OC
Actual Set Backs in Feet to:
North I South lEast l West
LICENSE EXPIRES
PHONE
H 4 -See z
Size of Parcel 1 Zone Classification
Residential 0
Commercial 0
ZIP
9`jlo'7
Type Const
Occupancy
Spr"nklered
Dyes 0No Reg id
5.
DESIGNER
PHONE
New Const. Valuation
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
Untin Basement
TYPE tNeW
7. OF
WORK 0 BLD.
0 ALT. 0 ADT. 0 RPL. ❑ MVE.
❑ PLMB.ECH. 0 M.H. 0 POOL
0 OTHER
No Batns
No. Floors
No. Fin Rooms
No. Dwellings
Certlf 1. of Exempt.
or Variance
Required VesO No0
Received Ves° No❑
Number
DESCRIBE WORK,
8. E-?. 5,-e-tOt
Hazard
Ves0 Not Apollo. 0
Plans Required 0
Received 0
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC 0
PRIVATE 0
SEWAGE
SEPTIC 0
SEWER 0
Ownership
Public 0 Private 0
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 REQUIRED INSPECTIONS
SIGNATURE OF ����7777 APPLICATION 9
OWNER OR AGENT V--/-414– - - - � 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
lac
O y1n14es CZ CR IM IA)
,z( /v3
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 $ v —O
PERMIT NUMBER
83A °sus -
04* *2000
950.42
09-26-83
2 6479.
WHEN
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE {6511 D2' 6 7 83
PERMIT 2,1 0.512
*2:0:0.0;13,4L