1983, 01-10 Permit: 83A-185 InsertPLAN 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, 112-2-0 1'o} e$osfr 012
SUBDIVISION
2.
LOT
BLOCK
nJ
PARCEL NO.
LEGAL DESCRIPTION:
OWN R 3 K. sAv.1`1
MAILING AD RESS
CONTRff!/to l6
4'
ADDRESS
ea3'67c35
PHONE
LICENSE EXPIRES
25D &
Actual Set Backs in Feet to:
North ISouth [East I Wast
Size of Parcel
Zone Classification
Residential 0
Commercial 0
ZIP
Type Const.
Occupancy
Spr nklered
DYes ONo DReq'd.
5.
DESIGNER
PHONE
New Const. Valuation ,
Remodeled Valuation
Total Bldg. Floor Area
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
B.
CHANGE OF USE FROM
TO
Cover Deck
Ulicv. Deck
Fin. Basement
Unfin. Basement
TYPE 141EW
7• OF
WORK D BLD.
❑ ALT. 0 AD' N. 0 RPL. ❑ MVE.
0 PLMB.% ECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Floo s
No. Fin. Rooms
No. Dwellings
Certlfi. of Exempt.
o Variance
Required Yes° NoD
Received YesD No°
Number
8. DESCNlIBE oo O K tJ�d-V Is] SC+ --1-
Shorelines/Flood Hazard
Yes0 Not Applic. 0
Plans Requ red D
Received 0
VALUATION
9.
SOURCE
OF
UTILITIES
GAS 1 ELECTRIC
WATER
PUBLIC 0
PRIVATE 0
SEWAGE
SEPTIC 0
SEWER 0
Ownership
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. Alt provisions of laws and ordinances governinglthis 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 REVE SE SID FO' /' E • IRED INSP CTIONS
/ IF
'- V%
SIGNATURE OF
OWNER OR AGENT
SPECIAL APPROVALS SPECIAL CON
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech
1251
APPLICATION
DATE
ONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN180 DAYS
FEES COLLECTED
Building
Plumbing
2-04
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL
PERMIT NUMBER
PsA-l55
04* *2000
*20.00,9
A *000 0
1842
0110-83
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATALE O -'813'
PERMIT N 1. 8.5 Z
*2'QOO?OVAL