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1983, 05-17 Permit: 83A-4190 Residence
1 2 3 PLAN NU BER APPLIICATION /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 PARCEL NO. j ++ — 13C ,K s BDIVISI N LEGAL DESCRIPTION: PHONE PHONE Cif r work wl I be comp led i wt w et er spec fled erein or not. T e granting of a permit does not presume to give au- MAI ING ADD�SS I thority to violate or cancel the provisions of any other state or local law regulating construction or the performance / t0 Actual set Backs in Feet to: 3 Plumbing SIGNATURE OF APPLICATION G OWNER OR AGENT DATE North ?�� South East West SPECIAL APPROVALS CON�f R LICENSE EXPIRES PHONE Size© ;� i Z�Classif. _ icatioP Residential 4. r 1� 1 �j�/� Com mercial C SEPA ADDRESS ZIP TypgCp t. Occu nc Sprinklered v ❑Yes ONO ❑Req'd. DESIGNER PHONE New Const. ValuaYon Remodeled Valuation Total Bldg. Floor Area Prevent. aD 5. Other (Specify) ADDRESS ZIP Main Floor Upper Floors Garage/StorageGreenhouse "? C CHANGE OF USE FROM TO Cover Deck Uncv. Deck Fin. Basement Unfin. Basem TYPE ❑ALT. El AWN. ❑RPL. ❑ MVE. W No. Baths No. Floprs t No. Fin. pooms No. Dwellings 7. OF El OTHER ' `Ai�— Certifi.ofExempt. Required Yes❑ No❑ Number WORK BLD. ❑ PLMB. 11MECH. 1:1M.H. El POOL or Variance Received Yes❑ No❑ 8. DESCRI WnRK Shorelines/ Flood Hazard Plans RequiredZr Yes❑ NotApplic. ❑ ReceivedA VALUATION SOURCE OF AS ELECTRIC WATER PUBLIC SEWAG SEPTIC Ownership FEES COLLECTED 9 UTILITIES PRIVATE ❑ SEWER ❑ Public ❑Private i� 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 2.; V I 1' h h h i' h h Building work wl I be comp led i wt w et er spec fled erein or not. T e 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 SI REQUIRED INSPECTIONS Plumbing SIGNATURE OF APPLICATION G OWNER OR AGENT DATE Mech. SPECIAL APPROVALS SPECIAL COND IONS: (SEE REVERSE SIDE FOR NOT PRELIM. FINAL DA Plan Check Env. Health Q01 r SEPA Planning Modular/ MFG. Home Fire Prevent. Other (Specify) Engineer v y. lities Plans i i I I PERMIT IS NONTRANSFERABLE Exam. I I PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED Building A-_ IN 180 DAYS PERMIT NUMBER 83A y1°IQ TOTAL $ WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. �Z nl9fl' *958.000n