1983, 04-15 Permit: 83A-2953 Addition PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY S-3A– .��
,' NORTH 811 JEFFERSON/SPOKANE,V:liSHINGTON 99260/(509)456-3675
(...7 APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO. 1.i
1. E. .lCa5a--, �aPazI�G -L 0 0:÷:,-/-k— Q‘08
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION: 0\P
2. a I -PeKffdit'�'r1 3u,3 i(z.M. i:•-‘‘..-=t o i Ci - ._ - .
OWNER PHONE PHONE
•
3. Jbt*Ns4t—st....,-r_ �t z4l-•-if3r_,c1- r: t. /
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
° l0` �."5 -:s?i't,NC,t+tf:-_Cr c--tzc)G. North ID3 !South East `West t4- -4
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential tel
4. L:ft-4(JF -.-\s t.+N`-.aYQN a']!.(.-{ ca 42)c)X “:70 Commercial❑
ADDRESS ZIP Type Const. Occupancy Sprinklered
�^q --y- ❑Yes ❑No ❑Req'd.
DESIGNER PHONE N Const.Valuation Remodeled Valuation Total Bldg.Floor Area t
5. "TVZ,il 3 eZ
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse I
02- __„--
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
6.
TYPE ❑ EW ❑ ALT. E'1 AD'N. ❑ RPL. El MVE. No.Baths No.Floors No.Fin.Rooms No.Dwellings
1 I 7I ,, l
7. OF
WORK BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL ❑ OTHER Certifi.of Exempt. Required Yes Nor?'
o Number , i
or Variance Received Yes❑ No❑
DESCRIBE WORK Shorelines/Flood Hazard Plans Required . r l
8. °I�p 0 i Tt. iIV —Cr)—CC) 5% Or-NGE (CoX t- /-. ' Yes Yes❑ NotApplic.❑ Received
VALUATION SOURCE GAS ELECTRIC WATEP .-" SEWAGE/ Ownership FEES COLLECTED
9. LI PUBLIC[7 SEPTIC Public❑Private
UTILITIES PRIVATE❑ SEWER❑ 1 -
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 .C/Ci
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 per ormance
of construction.SEE REVERSE SIDE FOR REEUIRE INSPECTIONS % Plumbing
SIGNATURE OF [ APPLICATIO�1 �f Mach.
OWNER OR AGENT�� :‘,2'"" ` ,,c---` ..2/14,& rvj DATE A,
SPECIAL APPROVALS SPECIAL/CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE ` Plan Check
Env.Health
' o 444' SEPA
Planning
Modular/
MFG.Home
Fire
Prevent. a
O
Engineer Other(Specify) V
W
• J_
Utilities LL
TOTAL $ �.f '
SEPA
WPlans �,' /� PERMIT IS NONTRANSFERABLE HEIS BECOMES A PERMITEN MACHINE TED IN THIS SPACE,
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Budding ((�� aa 7 Q 7 11
Tech. 'C I-)- 4� I N 180 DAYS DATEQS&UEI� 5 -8 3 PERMITYJO.5 3 5 * 4 /' 0 0 ;OITAL
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