1982, 12-01 Permit: 82B-1550 Insert PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY ' ez-e,- 1
CI' NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO. ''' 4 * * 2 C G U
1. 0. I Z+tc.• \ N-LC"!141+411 * 2C, 0 0
LOT BLOCK SUBDIVISION LEdAL DESCRIPTION:
2. 1
OWNER PHONE PHONE 1 (i Q
37061.—C., 'fAC-- LEr4.— Oi '1 -¢r 4
MAILING ADDRESS ZIP Actual Set Backs in Feet to: i — V 1 -CC' 2
G• u4+ V ALL&`(1r+4 Ate•/ ct4t2.i ... North _I SouthEast I West /. 7 `?
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑
4. -564"""e. Commercial❑
ADDRESS ZIP Type Const. Occupancy Sprinklered
AYV1C ❑Yes ❑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 Uncv.Deck Fin.Basement Unfin.Basement
6.
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE if NEW El ALT. 0 AD'N. 0 RPL. El MVE.
7. OF _ // ❑ OTHER
WORK ❑ BLD. ❑ PLMB. C�'MECH. ❑ M.H. ❑ POOL Cor Variance empt. Required Yes❑ No❑ Number
Received Yes') No❑
DESCRIBE WORK Shorelines/Flood Hazard Plans Required❑
8. ioA 4i..aG ti,v t -r Yes Not Applic.❑ Received ❑
VALUATION SOURCEDEl GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
9. PUBLIC❑ SEPTIC
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
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 OFAPPLICATI
OWNER OR AGENT 'i- k DATE Q I / sr Z+ Mech. "Zd•
' SPECIAL APPROVALS SP CIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health
SEPA
Planning Modular/
MFG.Home >-
Fire a
Prevent. O
C3
Engineer Other(Specify) W
9 J
Utilities M:
TOTAL $aa.
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
Plans PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED 11 � p
Tech
Building
..3 l IN 180 DAYS DATE 1591JEDO 1 — 8 2 PERMITi1 . 5. 0 * 2 0,0 0 TIOFAL