1982, 12-03 Permit: 82B-1619 Amend Permit #82B-952PLAN NUMBER
1
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. S. 22-1
Yb10N
LOT
2. 4
BLOCK
SUBDIVISION
Moe.)
‘`bT Apo. To CzP.F�ti%>4GZF
OWNER
3. 'Tlzt O1 SGbic CAL i us
MAILING ADDRESS
S. 10'7 ' 1ZAV
CONTRACTOR
4. ilcC4-0. h'tu-rn
ADDRESS.
S. ZICi7
PHONE
PHONE
S41-Z3z4-
PARCEL NO.
\C(SS 1— (-
LEGAL DESCRIPTION:
ZIP
CICtZ03
Actual Set Backs in Feet to:
North ISouth
[East
[.west
Coll ln/S
LICENSEEXPIRES
CC 41,5
PHONE
654--2.3z4-
Size of Parcel
Zone Grassi' 'cation
Residential 0
Commercial 0
ZIP
aq-z�
Type Const.
Occupancy
Spr nklered
OYes ONo DReq'd.
5.
DESIGNER .
PHONE
Const. Valuation
2,2 3s.
Remodeled Valuation
Tota Bldg Floor Area
10014- �-ZOva
ADDRESS.
ZIP
Main FI
13 —
Upper Floors
Garage/Storage .
Greenhouse
CHANGE OF USE FROM
6.
TYPE 0 NEW
7. OF
WORK 0 BLD.
TO
Gomer Deas
Uncv. Deck
Fin. Basement
Unfin Basement
❑ ALT. 0 AD' N. 0 RPL. 0 MVE.
❑ PLMB. 0 MECH. 0 M.H. 0 POOL
?OTHER
No. Batas
No. Floors
No. Fin. Rooms
No. Dwellings
Certif1. of Exempt.
or Variance
Required Yes° No0
Received Yes D No°
Number
DESCRIBE WORK
8. ArnctsD 2'M -r 62:13—ciat*
Shorelines/Flood Hazard
Yes0 Nit Aeolic.❑
Flans Required 0
Received 0
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC 0
PRIVATE 0
SEWAGE/
SEPTIC :rt
SEWER 0
Ownership
Public 0 Private 0
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/ASIDE FOR
REQUIRED INSPECTIONS
SIGNATURE OFOWNER OR GENT 11-4- 'in /l<c.r- ' L -4 -C2..' -4-J DATE APPLICATIONJa — 3 - foot
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Flans
Exam.
Building
Tech.
9
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
* AT I-, to _ SOW%sNaa. "Fbcrr'iGE,
Ci3r NOr INc-t.... Sc, 6.:—
M PoN FLO> CKTE.vD:N[., t IMto
Cs.g2N:a6
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED'
Building 4-1 Goo
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $ ` r'cb
PERMIT NUMBER
523
02* *4700
*47.008
A *GOO 2
161.82
12-03-82
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE4S&DEEP 3'I- 8 2.
PERMIT.NO.S 9 2 *47.00
o
QOFAL