1983, 02-22 Permit: 83A-1235 Barn PLAN NUMBER APPLICATION/PERMIT . . PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY ,t - 1�. �
0_} SPOKANE
811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. : 1'Z‘c> Ttyvvc•b 02. .. .i."e- 24=5d-`3—c.,>.,f
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. i‘ "Z OTS,v.V0i2.4"-
OWNER PHONE PHONE
3. MAILING ADDRESS CIAO'
Actual Set Backs in Feet to:
'S, I-2-A,t.D `�l t vv%i-.- cg. L. CIAO'3--) North 1Q' I South [East t I West
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential l3 '
►U 3'TLo �{':-Q7,- 21.' , �' X-73 00 �[s.Rl Commercial❑
4. ADDRESS ZIP Type Const. Occupancy Sprinklered --
-0. QAC 1f-vt.:05Z l0-1 ]I !J t'A-k ❑Yes ❑No ❑Req'd.
DESIGNER PHONE hew Const.Valuation Remodeled Valuation Total Idg.FloorArea
9Y' 4'5�. '. 7 (.
5. ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse
4
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unfin.Basement
6. —
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE 'NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. _
7• OF -/ 10OTHER
WORK ® BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL Certifi.of Exempt. Required Yes ID Noll Number
or Variance Received Yes NoIS'
DESCRIBE WORK Shorelines/Flood Hazard Plans Required t/
8. Yes❑ Not Applic.❑ Received
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE,/ Ownership
9 PUBLIC 17 SEPTIC VFEES COLLECTED
UTILITIES PRIVATE In SEWER❑ Public❑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
Building '4-1,
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 REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
SIGNATURE OFAPPLICATION_ �
OWNER OR AGENT I �-"`- J DATE _ r� Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE ...,..>1
Plan Check
11.n 1"�- w i ��
Env.Health
SEPA
Planning Modular!
MFG.Home y
Fire a
Prevent. O
/ Other(Specify) v '
Engineer SLI
J_
frr.
Utilities
TOTAL $ �`�
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
Plans Flo-EW''rfA PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building
IN 180 DAYS Z —u 5 Z k7
OO0 J
Tech. � � 2fj, ,-5 DATE I SEDPERMIT OaF
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