1983, 08-01 Permit: 83A-7178 Residence PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
_ SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY " - • %'A - -71
NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
-� APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. ZZ l (v �lz oCxrzsSr-.. 2p ZGS.4-i 2--'2.0g _
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. q 4 U Etz.t4 G)2rs T-
OWNER PHONE P ONE
3. M A1T I Aki L-Li 06&7 c'T• ('VD-S1----3CTiq
Actual Set Backs i n Feet to:
MAILINGt ADDRESS,` ZIIP % _
�J. 4.C-C. c C-(4 i\P(✓1l1N v ZIL 0(G North - 'South t`' (East `. O1 l West
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential Cf
6- (04.,K;t ' r2-.t Commercial❑
4. ADDRESS ZIP Type nst. Occupancy Sprinklered
x(116 -� Q ,,.( ❑Yes ❑No ❑Req'd.
cC. Y els y�J,
DESIGNER PHONE New Const.Valuation I Remodeled Valuation Total Bldg.Floor Area
5 c47-cr t u 3c1 .. 0
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenroy;se
1460 ‘+S6. Co'2-Y
CHANGE OF USE FROM TO CoverDeckUncv�seck Fin.Basement Un Basement
6.
/r No.Baths No.Floors No.Fin.Rooms No.Dwellings -- i_ I - ;,>
��
TYPE EW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. Z — 4, I
7. OF ❑ OTHER C I
BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL Certifi.of Exempt. Required Yes❑ Noe( Number
WORK or Variance
Received Yes D No❑ /
DESCRIBE WORK ` / Shorelines/Flood Hazard Plans Required 1YJ
8' j f cvG (F-44",t G,"7 ,C-.,s.c ) CE / Yes Not Applic.❑ Received la
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE/ Ownership FEES COLLECTED
9. LI PUBLI SEPTIC CC1I Public❑Private❑
UTILITIES PRIVATE 0 SEWER❑
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 ta
work will be complied with whether specified herein or not.The granting of a permit does not presume to give au-
Building f fa
thority to violate or cancel the p`.visions of any other state or local law regulating construction or the performance
of construction.SEE REVERS•IDE FOR REOUIR,-D INSP•CTIONS Plumbing
SIGNATURE OF / /- APPLICATION y 2�
OWNER OR AGENT --' - /® DATE 7/74 7 Mech.
SPECIAL APPROVALS SPECIAL CONDI '•N SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env.Health /
'C (\Ny SEPA
Planning
Modular/
MFG.Home
Fire d
Prevent. O
Other(Specify) C.1
Engineer W
�� g3 � J
UtilitiesS
TOTAL $
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
Plans PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT. o
E ildiExam.
✓`/ c.r PERMIT IS NULL AND VOILA I10 WORK
S HAS NOT COMMENCED O,8‘_ O 1 _ l 1 '� 8 _ ,r 3 9 8.0 0 a (-
Tech. 5,P- DATE ISSUED PERMIT NO. TOTAL
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