1983, 03-09 Permit: 83A-1649 Inspect FeePLAN 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. 6- (vSo7
LOT
2.
BLOCK
SUBDIVISION
PARCEL NO.
LEGAL DESCRIPTION:
OWNER SNE ' 7 7
3 OMAILING AD r�KI /
�
5 - c05 7 r` or• I G7°MEi2-r,
CONTRACTOR
4.
ADDRESS
LICENSE EXPIRES
PHONE
PHONE
Actual Set Backs in Feet to.
North I South (East I West
Zone Classification
Size of Parcel
Residential 0
Commercial 0
ZIP
Type Const.
Occupancy
Spr nklered
Oyes ONo DReq'd
DESIGNER
5.
ADDRESS
PHONE
New Const Valuation
Remodeled Valuation
Total Bldg. Floor Area
ZIP '
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE D NEW 0 ALT. 0 AD' N. 0 RPL. 0 MVE.
7. OF D HER
WORK 0 BLD. 0 PLMB. 0 MECH. 0 M.H. D POOL ,�OTHER
DESCRIBE WORK 8.1 1‘9
`�-'
r6c-itg., ofe----ric4 (
VALUATION DURCE G ELECTR WATER 1 SEW E
OF PUBLIC 0 SEPTIC 0
UTILITIES PRIVATE 0 SEWER 0
9.
No. Baths
No. Floors
No. Fin. Rooms
No Dwellings
Cerin. of Exempt.
or Variance
Required VesO NoD
Received YesD NoD
Number
Shorelines/Flood Hazard
Veep Not Aeolic.❑
Plans Required D
Received 0
Ownershlp
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 � -� DATE -- �/ �3
OWNER OR AGENT APPLICATIONS
SPECIAL APPROVA S SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent. •
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
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) DJ
0
TOTAL $
PERMIT NUMBER
eo5A - K04/9
02* •800
16488
03-09-83
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEQsuEDV 9
•8131
PERMIT146.4 9 2 * 8. 0 0 foes-