1982, 02-08 Permit: 83A-0900 ResidencePLAN NJMBtER APPLIC.AT;ON/PERMIT
03A – 2 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 PARCEL NO.
1. r�, i\ -►C>q 54Z -•—\CX::>' -I
LOT BLOCK I DIVISION LEGAL DESCRIPTION:
2. C( \ttV E�:r �P.i�O1TIdN
OWNER PHONE PHONE
3. )"I C.0 L'L Li' L C +- CtZ-C- - lS6. I
MAILING ADDRESS
ZIP
Actual Set Backs In Feet to:
T{�.Sr�T
` ��yy Z-d)G
North ISCD South East ec> West
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel Zone
Classification
Residential
4. 5t4YYNIF
i 0G YC t(,(p ACX'
R--( I
Commercial ❑
ADDRESS
ZIP
.
T ConstOyu
Cy
Sprinklered
�
a —�
Dyes ❑No ❑Req'd.
DESIGNER
PHONE
Const. Valuation
Remodeled Valuation
Total Bldg; Floor Area
(.0. 1,564-`–^
1 Z+9
5.
ADDRESS
ZIP
Min Floor Upper
Floors Garage/SStt�of,,ge
Greenhouse
CHANGE OF USE FROM
TO
Covvetr Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
s.
_
TYPE EW ❑ALT. El AD' N. ❑RPL. El MVE.
No. Baths No.
Flo rs
No. Fin Rooms
No. Dwellings
7•
lRequired
❑OTHER
VLD.PLMB.
❑ MECHM.HPOOL
WORK ❑ . ❑ . ❑
Wor
Certifi.ofExempt.
Yes❑ No
Numberr
variance✓
Received Yes❑ Nov
s DESCRIBE WORK -�
Shorelines/ Flood Hazard
Plans Required ./
�Y�/� L ICErZ \ fl k1e: GC5:
yea Not Applic. ❑
Received �f
VALUATION
9.
I SOURCE
OF
GAS
ELECTRIC I
WATER
PUBLIC
SEWAGV
SEPTIC LL77
Ownership
FEES COLLECTED
UTILITIES
PRIVATE ❑
SEWER ❑
public ❑Private
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-
Building
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction. SEE REV SIDE FOR REQUIRED INSPECTIONS
Plumbing
SIGNATURE OF
OWNER OR AGENT
APPLICATION
DATE l l
Mach.
SPECIAL APPROV
PRELIM. FINAL
Env. F�Idalth
_V/
Planning
Fire
Prevent.
Enakeer
Utilities
Plans / n, (r0� f
Exam. ,/
TecBuih mg Jai
NDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
PERMIT NUMBER
13�5A – cr-k
TOTAL $�'
WHEN MACHINE VALIDATED IN THIS
THIS BECOMES A PERMIT.
DATE PERMIT — 8 2 PERMIT NO. 0' O z * O %YAL
u
40 N
t4- c1 J
7.