1983, 09-06 Permit: 83A-8620 Residence PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
y SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY - . L"%
NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES— PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. 6 (Ss2.•"? �`.�pcoLc c t o sSk-t ^' O l-7
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. W \lso Vi- of 324 P 1 Tar S V2_ cF serq
OWNER PHONEHONE CF Ski`�� OF Se.),4tXc. l�,t=T OV S IS-2 pi-
3.
3. 'Se 4,0,3 �C'Y\+z1 LtZ(v-(.o1`(Z e -6,41c-. 2O,4.D.
MAILING ADDRESS jj � /� ZIP Actual Set Backs in Feet to:
1.r' -7 1f 03 �t 2ty A _ North Z.P0 'South 8Z East _j Z I West 3
)
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zope Classi i tin ' Residential Cis s ` �'
/"�� Commercial❑
4 SM,G l �i L 3 Z�{ . 1 0 C
ADDRESS ZIP Type Const. Occupancy Sprinklered
J N rsi PA.t ❑Yes ❑No ❑Req'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Areal ,5
5. 1'` s L 0 R c f z-
ADDRESS ZIP Main`Fl`r Upper Floors GaraaggeZtorage Greenhouse C. — + i --
R 'Z e.
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement .
6. /at 8, _
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE SEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. 7i jS (
7. OF /� ❑ OTHER
E3 /
WORK 'BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL Certifi.ofExempt. Required Yes Number
or Variance Received Yes No /
ESCRIBE WORK i Shorelines/Flood Hazard Plans Required 13
8. Fqw. ® (2.5104, .A)) 6,0%-e._ ievrE// Yes Not Applic.❑ Received ❑ `
VALVA ION SOURCE GA ELECTRIC PUBLICR/ SEPTIC E Ownership FEES COLLECTED
9. UTILITIES PRIVATE❑ SEWER❑ Public❑Private
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included on 1
reverse side,and know the same to be true and correct. All provisions of laws and ordinances governing this type of 2 I —
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au- Building
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 I SPECTIONS Plumbing
SIGNATURE OF APPLICATION
OWNER OR AGENT',-- --itf DATE -- � 1 /� Mech.
SPECIAL APPROV7eS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINA ATE Plan Check
7\Env.Health ,,
ft WO V/241
As / / `/ SEPA
76 Planning /0✓ ` �tl9,2_5-3 , �«,26/ > '(,1 �C�/���7�. Modular/
Fire "/J f/- MFG.Home >-
Prevent. a'
O
Other(Specify) V
Y Engineer ^ g q� Z
s�-, 'V's gilt('
/7 J
Utilities
281--
TOTAL $
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
1i Plans'
h#C(*e3 PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building I d i IN 180 DAYS n Q 6 L p
8
Tech. 1,� DATE I SED O — 3 PERMIT I06 2. 0z *2 8 1. 0 ()TOTAL