1983, 10-04 Permit: 83A-9900 InsertPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, V`'AS41kIl3TON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1. S. 1211 Newer Road
PARCEL NO.
LOT
2.
BLOCK
SUBDIVISION
OWNER
3 Wilford Hardy
PHONE
926-1051
PHONE
LEGAL DESCRIPTION:
MAILING ADDRESS
S. 1211 Newer Road Veradgle WA
ZIP
99037
Actual Set Backs In Feet to:
North ISouth (East I West
CONTRACTOR LICENSE EXPIRES
4. VR11-7 'PireplRna 1/1/84
ADDRESS
E. 16610 Sprague Ave. Veradale, WA
DESIGNER
Contr License 4VALLEF-177CG
ADDRESS
5.
PHONE
922-2780
Size of Parcel I Zone Classification
Residential 0
Commercial 0
ZIP
99037
Type Const.
Occupancy
Spr nklered
OYes ONo OReq'd.
PHONE
New Const. Valuation
Remode ed 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 0 NEW 0 ALT. 0 AD' N. 0 RPL. 0 MVE.
7. OF
WORK 0 BLD. 0 PLMB. ❑ MECH. 0 M:1-1. 0, POOL
0 OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Gerbil of Exempt.
or Variance
Required Yes❑ Non
Received YesD No❑
Number
8.
DESCRIBE WORK Installation of No. 101 Earth
9.
Sto
ex6A.S g LE
O ECTRIC
�OF
UTILITIES
Shorelines/Flood Hazard
Yes❑ Not Apollo. 0
Flans Required 0
Received 0
WATER
PUBLIC 0
PRIVATE 0
SEWAGE
SEPTIC 0
SEWER 0
Ownership
Public 0 Private 0
I hereby certify that I have read and examined thls 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 REQUIRE NSPECTIONS
SIGNATURE OF yi APPLICATION
OWNER OR AGENT et- A-01.Uuv I o a4 DATE 1O
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Flans
Exam.
Building
Tech.
ec6
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. Home
Other (Specify)
2a
TOTAL $ 2-49-
PERMIT NUMBER
04* *2000
*20006
A *000
989,92
10-04-83
2; 6479
U.?
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
'10=04-83
DATE ISSUED /,
I
990.0•z *2.0.00
PERMIT NO.
oa1-
TOTAL