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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