1983, 05-05 Permit: 83A-3693 Pool PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
eJSPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY B3 NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. 5 91 Zz- TI AvNAV oc4H z - t8o1
L T BOCK SUBDIVISION LEGAL DESCRIPTION:
2. (AAI(2.tm 5 s 1• rES -' (-42OWNER P-IONE PHONE
3. C_oIU �U .t 0(J W2.R-35-4=iS
MAILING ADDRESSp }}�� ZIP Actual Set Backs In Feet to: +
l 1 Z 2_ TiTt c v Ay North e)'W 'South `p East I West t 1 /
CONTRACTOR , LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential H
4. too I VUorLD ` t IY‘�., ( ' /5 of GI it (vSS I'5 00 K ) t� 741P- I Commercial❑
A DRESS _ Z, L
IPP Type Const. Occupancy Sprinklered
T6' I3tSZ4 Vi-01 Li,_, 419 I (.G 1fI11 If ❑Yes 0 N ❑Req'd.
DESIGNER t PHONE New Cont.Valuation Remodeled Valuation Total Bldg.Floor Area
5. 111000 6 f& n
ADDRESS ZIP Main Floor Upper Floors Garage/Storage 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 - /1, 7 ''
TYPE C(EW 0 ALT. ❑ AD'N. 0 RPL. ❑ myE. -- /
7 OF ❑ BLD. 0 PLMB. 0 MECH. 0 M.H. OOL ❑ OTHER Certifi.of Exempt. Required Yes❑ No[�' Number
WORK or Variance
Received Yes Na❑ a—
DESCRIBEp WORK ` Shorelines/Flood Hazard / Plans Required❑
8' Ie) v 3� 5 w 1 O o k--- Yes ID Not Applic.�/ Received ❑
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership
9 OF PUBLIC❑ SEPTIC❑ 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 Building ray --
work will be complied with whether spq¢ified herein or not. The granting of a permit does not presume to give au-
thority to violate or cancel the provis's s of any other state or local law regulating construction or the performance
of construction.SEE - VE: E . FO- R •, RED INSPECTIONS Plumbing
SIGNATURE OF � _ //�. ; AATEAPPLICATION - P Mach.
OWNER OR AGENT ��r.�,i A __ �'
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env.Health Sr
SEPA
Planning ///
Modular/
Fire MFG.Home >-
Prevent. a-
O
Engineer Other(Specify) V
W
_J
Utilities
LS'
TOTAL $
SEPA
PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE,
Plans THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS _
Tech. ft* C/Li EYS
DATSUEIwO(� Ia.5 —8 3 PERMIT 9. 3:z * 2 5. 0 0 W1rAL
. .........•••..................r... --ann.. .-.--svpmr11.0.1•10,
i f .
1 r /
, .
1 ) ) ) ) / ) / i ) ) 1 I / ) ) ) ) / / i i i / i / ) / / I / / i i IP I / i i
) ) )
• "'4dk(-4
Ir---7
1
;
i
: r--- ' ------------1,
i ! .
1
,v... i
N\
7C--- 16-?'---
\
, !
11%4,
... i
f ...
,17
. _ .
•
—O-7 I-7
,,.. -ye•-k7-6,,,//......z --? z
(/0-7