1983, 08-24 Permit: 83A-8227 Residence I PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
I , SPOKANE COUNTY - DEPARTMENT OF BUILDING &SAFETY -, c - ' '��
C-- NORTH 811 JEFFERSON/SPOKANE��,,,NASHIINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS ` 2C / PARCEL NO.
1. �-i - Q+1 --
I: ' r�1 �� O�� W'} r�I; 2.-1\/t:› �r5r 6
2. 40T OCK ( SUBDITIS a LEGAL DESCRIPTION:
ct\tr
OWNER PHONE PHONE Gk!h
3. ,6/' / 4 e/15" 7�8-3yg9 "Y89--0,5-00ZIP Actual Set Backs in Feet to:
MAILINGADDRES3/ /
"yegQ‘ North -2x.:2South East I West
LICENS EXP}�ES PHONE Size of Parcel Zone Claassiif�icatiQn Residential
CONTRACTOR 1.2o/75/
� / §§ U0 �7 !)�j l'„ 1?JL7./I I Commercial❑
4. FR. 17e/7/O 1.o/5 � /�/ ' Z19a7-09573TYPe1 ns. f l/Ocouspancy f/NYS_Prinklered
ADpKESS h / U� I p I ❑Yes ❑No ❑Req a.
DESIGNER PHONE New Const.Valuation Remodeled Valuation I Total Bldg.Floor Area
5. 9a/-3j� 9 I,1 _ , v CZIP Mai/nn�F,loor I Upper Floo:s Gara 1�e,S or}e 1 Greenhouse �,
ADDRESS �+ 4V7 1 f 1.2,6"- ��aa
CHANGE OF USE FROM TO Cover Deck I Uncv.Deck I Fin.Basement I UnfiI Basement
6. I No.�Baths No.Floors No.Fin.Rooms No.Dwellings _ _.
TYPE f..NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. ❑ OTHER I t 0 I _ '
7. OF '!K1 BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL Certifi.ofExempt. I Required Yes❑ No❑ Number
WORK or Variance Received Yes❑ No❑
Shorelines/Flood Hazard Plans Required 7/
8
DESCRIBE WORK
0 , / Ot,r '41 // Yes Not Applic.❑ Received ���
VALUATION SOURCEDGAS ELECTRIC WATER / SEWAGE/ Ownership t FEES COLLECTED
I PUBLIC lid' SEPTIC❑ Public❑Private
9. I UTILITIES PRIVATE 0 SEWER
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included onkit_„_
reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this type of Building 4�-1J.`}��i
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
Plumbing
of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
SIGNATURE OF . e,,'2DATE APPLICATION `tte.
�t� Mech.
OWNER OR AGENT
SPECIAL APPROVALS G#AL CONDITION : (SEE REVERSE SIDE FOR NOTICE) Plan Check
PRELIM. FINAL DATE :.(...4\11.1 LLC, If PGO7 Gtr
Env.Health ) SEPA
Planning Modular/MFG.Home
O
Fire {� v
Prevent. L� ^�___ Qf� Other(Specify) J
Engineer /, 013-411—.'_ c� � �CV dd""��."»
CA
Utilities ` TOTAL $ ?e-)
SEPA WHEN MACHINE VALIDATED IN THIS SPACE,
0 1` PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Plans ` �A; ��
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED nn w.
Building '� IN 180 DAYS DATEYS3UED2 PERMIT Nf 2, 7 0 *4 7 8.0 0 ,tAL
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