1983, 05-10 Permit: 83A-3854 FencePLAN NUMBER
1_
2_
3.
4. 7 -If
ADDRESS
DESIGNER
5.
ADDRESS
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
67-G� PARCEL NO. 1,e?r!r5I — t)
K SUED VISION LEGAL DESCRIPTION: rr� , / 0 V
V 11� `
HO E PHONE 'IJ ( 0, 15
SSIP ua Set Backs in Feet to:
IJ C,�' North South East West
LICENSE EXPIRES AhtrONE Size of ParcelneClgssificq)I 1r Residential
Commercial ❑
ZIP Type Cord3t. I Occupancy Sprinklered
❑Yes ❑No ❑Req'd.
PHONE New Const. Valuation I I Remodeled Valuation Total Bldg. Floor Area
ZIP Main Floor Upper Floors I Garage/ Storage I Greenhouse
CHANGE OF USE FROM
TO
ver Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
6.
. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
TYPE NEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
% OF ❑OTHER
ALD.
ifi.ofExempt.
Required Yes❑ No❑
Number
WORK ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
Variance
[Public
Received Yes❑ No❑
DESpCR�IBE WORKtI
8.
-7 L4 +
Shorelines/ Flood Hazard
Plans Required ❑
(10 —
10
Yes Not Applic. ❑
Received ❑
VALLI ON SOOUFCE
9.-2
GAS____7
ELECTRIC
PUBLIC �
SE W C ❑
wnership
FEES COLLECTED
UTILITIES
PRIVATE ❑
SEWER ❑
❑ 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 of,
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au-
Building
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction. SEE REVERSE SIDE F REQUIRED INSPECTIONS
Plumbing
SIGNATURE OF `1PPLICATION cj
OWNER OR AGEN c'"r "r�%� DATE S O
Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE
PRELIM. FINAL DATE
Plan Check
Env. Health
SEPA
Planning
Modular/
,
MFG. Home
Fire
Prevent.
Other (Specify)
Enoineer
I
Plans I I I PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS
Tech. i
PERMIT NUMBER
g Ufa -
� t
TOTAL $ 7—o �o I
WHEN MACHINE VALIDATED IN THIS
THIS BECOMES A PERMIT.
E
DATEf53UEDy O_ 8 3 PERMITJ. 5 4 z 2 �. fOiAAL
d
O
C.3
W
J_
LL
I
4