1983, 05-19 Permit: 83A-4292 Barn PLAN NUMBER APPLICATION/PERMIT - PERMIT NUMBER
s-3-k4-1 SPOKANE COUNTY - DEPAf#TIVi NT OF BUILDING &SAFETY ei3A - .61'-7.$37-
& NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/ (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
1 STREETADDRESS -r PARCEL NO. 7-4 5�1, -
7oS -
LOT
BLOCK SUBDIVISION
SUBDIVISION �`� LEGAL DESCRIPTION: / �1
1,..e, in,tel<ki )
2. OWNER PHONE P Otjr (�
3' R � r .r P---o 1 7� Actual Set Backs in Feet to:
MAILINGAP/RESS,..r,"4,10
�- „,FlG. North 'South I East 1 West--70 .
CONTRACTOR
LICENSE EXPIRES PHONE Size of Parcel Z ne CI ��,f' ion Residential.F
/�- : Commercial❑
4. ADDRESS ZIP Typefgngt. Occ4pan Sprinklered
{f IiVf IA�I ❑Yes ❑kl ❑Req'd.
DESIGNER PHONE New Const.Valuation , Remodeled Valuation Total Bldg.Floor Area - _
5. ADDRESS ZIP Main Floor Upper Floors Garagel/Aag� ` Greenhouse ,
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
6.
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER
WORK BLD• ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL orvaarianExempt. Required Yes❑ No❑ Number
Received Yes El Non //
8 DES lRI�EWORK Q r Shorelines/Flood Hazard Plans Required /
J \ , X ) N r-- Yes Not Applic.❑ Received B/
VALUATION S RCE GAS ELECTUC WATER f SEWAGE/ Ownership / FEES COLLECTED
9•
OF
UTILITIES PUBLIC H SEPTIC®
PRIVATE El SEWER❑ Public❑Private�l
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 REVERS IDE FOR REQUIRED�/ INSPECTIONSI ` Plumbing
SIGNATURE OF G�e(1)--_ „l3 f✓�X41 -�t APPLICATION r /
OWNER OR AGENT/ �( DATE 7 Mach•
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIML DATE///
Env.Health f �/7 SEPA
Of
Planning v`/ '" Modular/
MFG.Home
Fire O
Prevent. V
Other(Specify) LuEngineer
LL
Utilities
TOTAL $
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
Plans _/ PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Exam. ,t! '5I! PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED (J R /�
Building (1 - � IN 180 DAYS DATE4SSUEL ,/ —U i PERMI7Na.9 2 z *7 5. 0 0 ¢,,JTAL
Tech. `j
ad JXJ 17./ MS j0 j0 3VSL ' ES JO Z/ V3 NIHWIM 0Ve,M
DVSL ' 2S JO . 02N 'k? '17/ IN JO t)../ N JOAYSMS 3V.J / LE
014-frA
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412 tlt:'T-
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