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1983, 10-12 Permit: 83B-330 Insert
PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER e) SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY f '2 - ?' � NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675 APPLICANT: COMPLETE NUMBERED SPACES— PRESS HARD TO MAKE 3 COPIES STREET iADDRESS / PARCEL NO. '' 1. N - 1 I LOT BLOCK SUBDIVISI LEGAL DESCRIPTION: 2. OWN P-IO E PHONE 3. 14 • is. i ,4' 7 MAILING ADpRE 'y�A ' Actual Set Backs in Feet to: N . 7 i S v"7 ' 7 � 7�' North 'South East I West CONT ACe. 1 ( WND LICENSE EXPIRES72-1 pV / I "' Size of ParcelZone Classification Residential❑ 4. Commercial❑ ADDR�S>}S . 16 1O©�v ZIP Type Const. Occupancy Sprinklered IY,_�I V ❑Yes ❑No ❑Raga. DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area 5. i. L A , 0 (C; ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unfin.Basement 6. 1 ,. - l i__ ;' S No.Baths No.Floors No.Fin.Rooms No.Dwellings TYPE 0 NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. 7. OF ❑ OTHER WORK ❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. El POOL C ari.oExempt. Required Yes❑ No❑ Number Received Yes Nor] 8 DESCRIBEnIV K_ �U�� 1 NI 5 ‘2"‹ ‹ Sesrelinesl lood otApplic.rd0 Plans Required❑ lV) Yes❑ Not Applic.❑ Received ❑ VALUATION SOURCEDGAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED 9 PUBLIC❑ SEPTIC❑ UTILITIES PRIVATE❑ SEWER❑ Public 0 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 Building 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 Plumbing SIGNATURE OF L�/ ,Q i WL) DATECATIO OWNER OR AGENT s� �) 'c( -3 Mech. �„f . SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) PRELIM. FINAL DATE Plan Check Env.Health SEPA Planning Modular/ MFG.Home )- Fire a. Prevent. 0 Engineer Other(Specify) W J Utilities Li TOTAL $ SEPA WHEN MACHINE VALIDATED IN THIS SPACE, Plans PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT. Bing PERMIT IS NULL AND VOIN 180 DAYS DIF WORK HAS NOT COMMENCED 1 0 —1 2 -8 3 3 3, 0 z *2 0, 0 0 2 i Tech. DATE ISSUED PERMIT NO. TOTAL