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1983, 10-13 Permit: 83B-0401 Insert
PLAN NUMBER l 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 C2 ZZ Vk oeQo'.J PARCEL NO. LOT 2. BLOCK SUBDIVISION OWNER o. PLR- - Ld A 4E 3 MAILING ADDRESS S ICoZZ V1ko (fo (43 CONTRACTOR 4 SAtAnl✓ ADDRESS PHONE PHONE gz8•Zzy7 LEGAL DESCRIPTION: ZIP 90�t( Lp Actual Set Backs In Feet to. North (South (East west LICENSE EXPIRES PHONE Size of Parcel 1 Zone Classification Residential 0 Commercial 0 ZIP Type Const Occupancy Sprinklered ❑Yes ❑No ❑Req'd 5. DESIGNER PHONE New Const. Valuation Remode ed Valuation Total Bldg. Floor Area ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse , 6. CHANGE OF USE FROM TO Cover Deck Uncv. Deck t TYPE I�EVV 0 ALT. 0 AD' N. 0 RPL. 0 MVE. 7. WORK ❑ BLD. ❑ PLMB. 8'MECH. 0 M.H. 0 POOL o OTHER No. Baths No. Floors Fin Basemen No. Fin. Rooms Unfin Basement No. Dwellings Certifi. of Exempt. or Variance Required Yes❑ No❑ Received Yes❑ No❑ Number 8. DESCRIBE WORK R a-ap(ALE i4SEar Shorelines/Flood Hazard Yes❑ Not Apollc.0 Plans Requ red ❑ Received ❑ VALUATION 9. SOURCE GAS OF UTILITIES ELECTRIC WATER PUBLIC 0 PRIVATE 0 SEWAGE SEPTIC 0 SEWER Ownership Public O 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 SIDE FOR REOUIRED INSPECTIONS SIGNATURE OF ( I 2H, ^�I L62 APPLICATION /O_/3 _ OWNER OR AGENT }/ DATEO✓ SPECIAL APPROVALS PRELIM FINAL DATE Env. Health Planning Fire Prevent. Engineer Utilities SEPA Plans Exam. Building Tech. SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) 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. Horne z_O Other (Specify) TOTAL $ Zo PERMIT NUMBER gag ©c -tot 04* *2000 *20.00'o A *000 0 40.02 10-13-83 2 6479. >- 0- 0 0 V W J LL WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. DATE tSSDED1I3` Lit?, PERMITNO4 a1 *2i u.UU1°04-AL