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1983, 03-16 Permit: 83A-1921 ResidencePLAN NUMBER 'o41 (7) APPLICATION/PERMIT SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 1. 2. STREET ADDRESS APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES a . 17 oA- f� 1•Ji( LOT BL K SUBDIVIS IO 15 OWNE MA LING A I 82 2-j 5 3 �. KI%6 tl 16 DRESS C^ONTjRJ AR 1.16 4. s ADDRE PHO E 72-6 -4-933 PHONE PARCEL NO. 6r (_ 01 C ros.-rrof 1 LEGAL DESCRIPTION: I J & s? - Actual Set ks in Feet to: North I I South 12-- LICENSE EXPIRES PHONE Size f,parx I Ina East >Z�G west :2.7 !cation Residential Commercial ❑ ZIP Type o Jt. DESIGNER J. ADDRESS PHONE Occupan y E. Rem Ie ed Valuation New Const. Vation l5 Sprinklered ❑Yes ❑No Req 'd. Total Bldg. Floor Area ZIP 6. CHANGE OF USE FROM TO Main Floor 1 � Cover c Upper Floors TYPE NEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE. 7 OF WORK LD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL ❑ OTHER No. Baths 3 Uncv. Deck No. Floors 2 - Garage/Storage (7Z Greenhouse Fin. ement Unfin. Basement No. Fin. Dooms No. Dwellings Certif1. of Exempt. or Variance Required Yes❑ No❑ Received Yes No❑ Number 8. DES MBE W013.1 0.1\ V G& VALUATION SOURCEDG S ELECTRIC 9 UTIF LITIES Shorelines/Flood Hazard Yes❑ NotApplic. ❑ Plans Required/ Received �/ WATER PUBLIC PRIVATE ❑ SEWAGE SEPTIC SEWER D Ownership 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- thority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS SIGNATURE OF--�--.� (� APPLICATION OWNER OR AGENT.--�' O--�-a'J DATE SPECIAL APPROVALS PRELIM. FINAL DATE Env. Health Planning Fire Prevent. Engineer Utilities SEPA Plans Exam. Building Tech. SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) 3 r A51�1: , 31®+ 3 Sp- ez -Z/5 P'i- ,6 z/243 j"1( r(ofg. 34, 5 8 PERMIT IS NONTRANSFERABLE PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED IN 180 DAYS 3 FEES COLLECTED Building Plumbing Mech. Plan Check SEPA Modular/ MFG. Home Other (Specify) TOTAL s PERMIT NUMBER )1\ 1Y% I A 19 *39800 398,006 *0.00 -16-83 6.479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 03-16-83 DATE ISSUED 19215 *598,O0aI- PERMIT NO. TOTAL