1983, 06-23 Permit: 83A-5674 Residence PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY - 5(07,1--
NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. IQ,g65 SAe-Ca (vT
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. G ''? 8-3-Zz.-3
OWNER PHONE PHONE
3. 14 tanAL.,A1,w CoA)'-e, 446-0-1g1
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
G. Si.b S S LA N‘..t. A.(Z qq'2:13 North Z" I South 'Z,0' East -664 I West /
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential.'
�✓i�1N£ ICA x 114 Commercial 0 4. ADDRESS ZIP Type Const. I Occupancy Sprinklered
SA ms -SO -- ) -1 ❑Yes ❑No ❑Req'd.
DESIGNER PHONE NonvConst.Valuation Remodeled Valuation Total Bldg.Floor Area
3c(,4>,:6 i4-S4...
5. ADDRESS ZIP Mg; Upper Floors Garage/Storage Greenhouse
V� �+ 57 2 (pa o1CY
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
6. s+-- --- 664
No.Baths No.Floors No.Fin._Rooms No.Dwellings
TYPE ?1�EW ❑ ALT. CI AD'N. ❑ RPL. ❑ MVE. 1 4. f
7. OF
WORK' ❑ OTHER
® BLD. ❑ PLMB. ❑ MECH. CIM.H. ❑ POOL Certifi.of Exempt. Required Yes Nal Number
or Variance Received Yes 0 No /�
DESCRIBE WORK Shorelines/Flood Hazard Plans Required N7,
8. �1 NC.LE cpNt^t L..A —9-V5.OCW G,E Yes ID Not Applic.0 Received IS
VALUATION SOURCE GAS ELECTRIC PUBL Ownership FEES COLLECTED
9. UTILITIES PRIVATE 0 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 -M(
Building Z
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 tate or local law regulating construction or the .erformance
of construction.SEE REVERSE S E FOR R 0 R NSPECTIONS Plumbing
SIGNATURE OF t��� APPLICATION 6 n
OWNER OR AGENT G /'^ DATE i lrV Mech.
SPECIAL APP LS SPECIAL CONDITI NS: (SEE REVERSE SIDE FOR NOTICE
PRE . F AL DATE Plan Check
Env.Health � y ,.,
2/ SEPA
Planning V
Modular/
MFG.Home
Fire
Prevent. CD
O
Engineer Other(Specify) G.)
Utilities L
TOTAL $ 'CM-.0)
SEPA
PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE,
Plans �,� PERMIT THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS n /� i_ 55 0o J
Tech. DATE FS9UED6 3 _8 3 PERMIT R� 7, 4 z * 2 7 6.O
it ! .i!1.-i• VAC V* 4.4r,' ' it'4 `:-‘1111104'."1•1* .'''''''l ' 't - '
3/1 V -9 ' S--/-1\(-
-,
1
; 1
1
i 1 1
/I.
'J vc)eiwit=)
A ) i
s 1
1 N
/
._ _
S r
--:-. _
'71
il I -...
-..,
.
IT]
i 1
4 2-Lt
1 i
; I i
i
1 ;
I i
1 I
I
i ...
a '''' , QI
A ,
. _, • '-- • r ( N ,
) \./'
' ' ' :'' . ,- -1 ' •'