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1983, 04-01 Permit: 83A-2507 MH
PLAN NUMBER APPLICATION!/PERMIT on SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES 1 ST EETADDRE$S PARCEL NO. 2. LOT BLOCK SUBDIVISION LEGAL DESCRIPTION: ©d OWNER P QN PHONE 3. MArILLIIN/G�A /DURESS % ' ZIP j / Actual Set Backs in Feet to: 1 :J�L7 V o -- -_- - j,�';?? `p I North South 1-5 I East;G I West CONT CT LICENSE EXPIRES PHONE Size of Parcel ne Iassifigti Re id�aal O 4. �� - ADDRESS ZIP Type,C¢ns Occ nc Sprinklered �/r Oyes ❑No ❑Req'd. DESIGNER PHONE New Const. Valuation Remodeled Valuation Total Bldg. Floor Area 5. ADDRESS ZIP Main Floor Upper Floors Garage/ Storage Greenhouse CHANGE OF USE FROM TO Cover Deck ov. Dec Unk Fin. Basement Unfin. Basement 6. TYPENo. Baths No. Floors No. Fin. Rooms No. Dwellings 7• OF EW ❑ ALT. ❑ AD'N. ❑ R'�PL. ❑ MVE. ❑ OTHER _T WORK ❑ BLD. ❑ PLMB. ❑ MECH. ,E M.H. ❑ POOL Certifi.ofExempt. Required Yes❑ No❑ Number or Variance Received Yes❑ No❑ DESCR 8' BE WORK Shorelines/ Flood Hazard Plans Required ❑ r!'% Yes❑ Not Ap lic. ❑ Received ❑ VALUATION SOOURCE 9• GAS ELECTRIC pUBLICR SEPTIC E Ownership FEES COLLECTED UTILITIES PRIVATE ❑ 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 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 INSPECTIONS Plumbing SIGNATURE OF ._ APPLICATION _ OWNER AGENT ` OR DATE Mach. SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) Env. Health PRELIM. F AL DATE Planning /,5 ;—s -T C,�c Fire Prevent. Engineer Utilities SEPA Plans PERMIT IS NONTRANSFERABLE Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED Building _21/ IN 180 DAYS Plan Check SEPA Modular/ l r, MFG. Home w(� Other (Specify) PERMIT NUMBER 934 1519,1 TOTAL $ --100 "- I WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. nATEQS344l)Ff7'' 1 V 0. 7 z 4nIreI U 41 nNNZot ul i u J �x E 11812 VALLEY WY vr �� r vr" o�sr I SPOKANE WA 99206 Co;vNER ---4R0-TT— J HAASE LEGAL DESCRIPTION OPPURTUNITY PTN OF BLK 127 DAF; N113.75 • OF S443.51- OF 1+175' OF E95' & E1/2 OF BLK 127 W980 & EXC E95' C EXC 5340' E EX C N170' o