1983, 12-22 Permit: 83B-2721 Siding, Soffit, Fascia PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY 0. F.F. _ 2-11 1
NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HAN,TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. C . 16,101 Lici / c f
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OW ER T ll / _ PHONE PHONE
�.La ii -.J , 13(ti-1-41..' et,?4—.Zl 7-3
3. MAILING ADDRESS C ZI Actual Set Backs in Feet to:
COERACTORI Oq ����l,1 v LIC SE XPI S Z 9 037 North !South [East i West 01-
X � ���il � rC ONS Size of Parcel
Zone Classification
Residential❑
'L�r,> 5 1 f Gj�� Commercial❑
4.
ADDRESS /�,_ n / ZIP Type Const. Occupancy Sprinklered
/t 3/o 6'a !'T/�Zi ii ri /2/!AiL 4/e4)/3- ❑Yes ❑No ❑Req'd.
DESIGNER d 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 ❑ NEW D ALT. 0 AD'N. ❑ RPL. ❑ MVE.7. OF OTHER
WORK 0 BLD. 0 PLMB. ❑ MECH. ❑ M.H. ❑ POOL CertifLofExempt. Required Yes No Number
L 1 L.�(C fi/ or Variance Received Yes 0 No❑
8. DESCROE WORK _ Shorelines/Flood Hazard Plans Required El
Si( / t / '�1tV YesO Not Applic.❑ Received ❑
VALUATI •
O SOURCE f GAS `'/ ELECTRIC WATER SEWAGE Ownership
9. C I OF I PUBLIC 0 SEPTIC❑ public❑Private❑ FEES COLLECTED
/ / UTILITIES PRIVATE 0 SEWER❑
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 511---
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 'EOUIRED NSPECTIO. f Plumbing
SIGNATURE OF APPLICATION
OWNER OR AGENT // //`/ <<1 f DATE /�" �0j Mech.
SPECIAL APPROVALS SPECIAL CONDIT.I6NS:(SE' REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env.Health
SEPA
Planning
Modular/
Fire MFG.Home ›
0..
Prevent. a
O
Engineer Other(Specify) v
W
-z
Utilities 0j W
TOTAL $ 554
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
Building IN 180 DAYS 11 - < .77 1 r{
Tech. il,/2/42 DATEIS�UEI� 28 5 PERMII2Nb.�' 1 ° 5 4. �� u COITAL