1983, 06-02 Permit: 83A-4766 Addition PLAN NUMBER APPLICATION,I.PERMIT PERMIT NUMBER ,
Ia SPOKANE COUNTY — DEPARTMENT 4F BUILDING &SAFETY 74.0
) NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1. - , V I, I i,v/' 61PARCEL NO. zi
sei-1- — ("31 3--•
LOT. BLOCK SUBSIDIVISIOIN
LEGAL DESCRIPTION:
2. -...2./.-R -� 19I�
- P ON PHONE
3. MAILING ADDRSS ! ��
rE +...� Actual Set Backs In Feet to: f,
. "] I� � 1 1 ( North 5 [South 2-f {East 5(-- 1 West U C *
Co. r4 1CTQR LICENSE EXPIRES NE rSizeWfParcel f Q ce/Cla_ssification C?7
4. M! ��V I L� - ?/}(,y)Q t'G, Commercial❑ i
ADDRESS ZIP TypgC� 111 ""`III��•"�� Sprinklered �t
VVVVj��`�Q ❑Yes ❑No ❑Reg'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area / 3'C
5. ADDRESS ZIP4-6
v C- v c _ 3
Main Floor/ Upper Floors Gar a/Storage Greenhouse
��6 Z.2 i j -/ ('
6. CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unfin.Basement
No.Baths No.Floors No.Fin.Rooms No.Dwellings
_• TYPE 0 5EW 0 ALT. D'N. 0 RPL. 0 MVE.
OF eBLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL fl. Exempt.❑ OTHER Certit.
WORK or Vfi.ariof e p Required Yes No❑ Number
Received Yes No❑
DAl ORK 6.c � ✓�, i yr, Shorelines/Flood Hazard Plane Required-2,-
. r
8. •� � Yes Not Applic.❑ Received B-
VALUATION SOURCEOFGAS ri\CLE RIC WATERS SEWAGEsEFric / Olp
9. UTILITIES PUBLIC 4Bi
PRIVATE El SEWER❑ Public 0 Private, FEES COLLECTED
I hereby certify teat 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 ca-nplied with whether specified herein or not. The granting of a permit does not presume to give au-
Building
� O
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 _ '/ �r / APPLICATIO
OWNER OR AGENT DATE -' � Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:(SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINA DATE Plan Check
Env.Health � `/�
Planning SEPA
Modular/
Fire MFG.Home
Prevent. 0
Engineer Other(Specify) V
W
Utilities J
SEPA TOTAL $
160 "
Plans PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE,
Exam.
DATE THIS BECOMES A PERMIT.
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building \�`•1� IN 180 DAYS
Tech. /6/
110 ( ,ED PERMIT 02 -83 id6.6z *150. 00 ° �
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