1983, 12-14 Permit: 83B-2513 ResidencePLAN NUMBER APPLICATION /PERMIT PERMIT NUMBER
SPOKANE COUNTY - DEPART TMENT OF BUILDWIG & SAFETY 3 ''
NORTH 611 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
,. �. 3 <—�."7 ��r 7:5-�>54-1- c:) as G CST
L T BLOCK SU
2. 4
OWNER
3.- -C
MAI I NG ADDRESS
. 101 l2.,
4. Wit_
ADDRESS
DESIGNER
5.
ADDRESS
;ION
21 2-140 A%Opt-r-
P ONE PHONE
s ZIP
LICENSE EXPIRES I PHONE
ZIP
ZIP
North I C% South 10 East West 3 0
S1 of Percel Zonlassification Residential
Commercial ❑
Type upa yy � Sprinklered
❑Yes ❑No ❑Req'd.
New Const. Valuation i I Remodeled Valuation I Total Bldo. Floor Area
Floor ' I Upper Floors
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. eITS
an
Unfin. Basement
TYPE ❑ALT. ❑ AWN. El RPL.
❑ MVE.
�• Baths No.
Floors
No. Fin. Rooms
No. Dwellings
7•
El
BLD. ❑ PLMB. ❑ MECH. ❑ M.H.
OTHER
❑ POOL
CertifiExempt.
Required
YesO No❑
Number
W
WORK
or Variance
Received
Yes❑ No❑
DE 18E VI/K
8•
_ ,+
G'j
Shorelines/ Flood Hazard
Plans Required
l
Yes Not Ap lic. ❑
Received
VALUATION
9•
I SOURCE
GA
ECTRIC I
PUB ICER
SEPTISEWAGE
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 rovisions of laws and ordinances governing this type of
work will be complied with whether specified herein or no . The granting of a permit does not presume to give au-
Building
thority to violate or cancel t ov' ions of any othe st
a or local law regulating construction or the performance
of construction. SEE RE E D FO QUI
SP
Plumbing
SIGNATURE OF
APPLICATION
OWNER OR AGENTY�L-L�
// DATE jd /.
Mech.
ECTAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL . DATE
Env. Health 1
Planning �V
Utilities
Pians PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building) IN 180 DAYS
Tech. I I
Plan Check
SEPA
Modular/
MFG.Home
Other (Specify)
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
a
c
c:
LL
LL
4.