1983, 04-22 Permit: 83A-3181 PorchPLAN NUMBER APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOK:ANE, WASHINGTON 99260 / (509) 456-3675
STREET ADDRESS
1. . 0 v ;?p
T BLOCK
2. �j -7
OWNE
3. � b
MA6NGADD E S
CO.NTNTRACTII Q
�i
4. AD ESS
DESIGNER
5.
ADDRESS
APPLICANT: COMPLETE NUMBERED SPACES —PRESS HARD TO MAKE -3 -COPIES
___jPARCEL NO.
v'CJ
SUBDIVISION LEGAL DESCRIPTION:
v24e�r_ k'zrAJ iM , 4 1<
I.. _-
16 �q fti2
LICENSE EXPIRES
%i415'
ZIP
North I South
PHONE
Size of Parcel
Cover4�ck
11
7.
Fin. Basement
ZIP
TYPE El ytW El ALT.
AD' N. El RPL. El MVE.
Type ¢ons .
Floors
No. Fin. Rooms
No. Dwellings
PHONE
New Const. Val
-%G
ZIP
Required
I Main Floor
East West
Zone Classification I Residential
Commercial ❑
Sprinklered
❑Yes ❑No ❑Req'd.
ed Valuation I Total Bldg. Floor Area
Upper Floors I Garage/ Storage
CHANGE OF U6. SE FROM
TO
Cover4�ck
11
7.
Fin. Basement
Unfin. Basement
TYPE El ytW El ALT.
AD' N. El RPL. El MVE.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
❑OTHER
WORK BLD. EIPLMB. 1:1MECH. ElM.H. ID POOL
Certifi.ofExempt.
Required
Yes❑ No❑
Number
or Variance
Received
Yes❑ No❑
DESCRIBE ORK
8.
d
�r `
Shorelines/Flood Hazard
Plans Required
Yes NotApplic. ❑
Received ❑
VALUATION SOURCE
OF
9 OF
GAS
ELECTRIC
WATER
PUBLIC
WAG
EPTIC
Ownership
;�[
FEES COLLECTED
PRIVATE ❑
SEWER ❑
Public ❑ Private
1 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
20
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 FOR REQUIRE RINSPECTIONS
Plumbing
SIGNATURE OF APPLICATION n
OWNER OR AGENT DATE ,`L
Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Plan Check
Env. Health
SEPA
Planning
Modular/
MFG. Home
Fire
Prevent.
Engineer
Other (Specify)
utilities
Plans 'ERMIT IS NONTRANSFERABLE
Exam. ERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
ch.ing
Tech.
eIN 180 DAYS
`tech.
TOTAL $ 20.
WHEN MACHINE VALIDA'1 ED IN THI
T HIS BECOMES A PERMIT.
PERMIT NUMBER
gI
v
DATEjs D2 2— 8 3 PERMIT�6 "- 1 z * 2 O. O 0 -000tAL
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