1983, 12-14 Permit: 83B-2517 ResidencePLAN 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
STREETADDRESS PARCEL NO.
�. S. '3Z/3 RoBig_ Poop 354- - ;:Zoa�.
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
Z.
1,,t12j .-6MF 2ND APPMcN
OWNER
PHONE
PHONE
0AI✓S WC
<7 z - 7+1
MAILING ADDRESS
/O 112 FM r4 i (S'?q-267.North
ZIP
Actual Set Backs in Feet to: Y
3,) � �
—�G I 1 �
.Z South East
L l West to
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel i
Zone Classification
Residential��
4.
i f X 153.E
51NC LJi FAMY1
Commercial ❑
ADDRESS
ZIP
Type Occupancy
Sprinkl red
`C'onst.
Y -N
P__ 3
❑Yes El No ❑Req'd.
DESIGNER
PHONE
N7 Co t. ;� IO&
Remodeled Valuation
Total Bldg. Floor Area
/
5.ADDRESS
ZIP
Main Floor, Upper
Floors
Garage/Storage
Greenhouse
00
62-
o
CHANGE OF USE FROM
TO
Cover Deck
Unci. Deck
Fin. Basement
Unfin. Basement
6.
"_
'�.
"r.
00
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TYPE ❑ ALT. AD'N. 11 RPL. 11MVE.
7.
❑OTHER
,/NLDEW
WORK p 4. 11ElElPLMB. MECH. M.H. ❑ POOL
Certifi. of Exempt.
Required
Yes❑ No❑
Number
or Variance
Received
Yes❑ No❑
8
DESCRIBE WORK
Shorelines/ Flood Hazard
Plans Requir
$ iVERZE — %Q- Q%F_ uNM — PiEC S A-IrrAC HED
Yes❑ Not Applic. ❑
Receiv ❑
9•
VALUATION
I SOURCE
I GAS
ELECTRIC
I pWA E O
SEEP ICGE
Ownership
FEES COLLECTED
UTILITIES
PRIVATE ❑
SEWER
Public ❑ Privat
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.provisions of laws and ordinances governing this type of
33
,XI
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au-
Building r�' "v�
thority to violate or canc rovisions of any_44he state or local law regulating construction or the perfo mance
of construction. SEE PXVERSk'S_jbE owl INOEeTms
Plumbing
SIGNATURE OF �'L°E�, APPLICATION /
OWNER OR AGEN DATE
I f�
Mach.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE ow M he
Env. HealthA, Ip>� I
/N
Planning A �7
Prevent
r1�
Utilities
SEPA
Pians PERMIT IS NONTRANSFERABLE
Exam. /%
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building 1' IN 180 DAYS
Tech.
Plan Check
SEPA
Modular f
MFG.Home
Other (Specify)
PERMIT NUMBER _
�5
crc
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
22 -L4 -8X1.76 *338.�G`C�TAL
DATE ISSUED PERMI
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