1983, 04-04 Permit: 83A-2570 Addition PLAN NUMBER - APPLICATION/PERMIT • . PERMIT NUMBER
elSPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETYF�.3� –2-s-70 NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. 5t y v'Ah� p .T 08.5 f t otos_
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. I 1 6F N `
OWNER I PHONE PHONE c' 73"C • ' 5L-g- 317 '8 Z a`'f`7
3. L., C^. Pi Li- Ct2y . lE1
MAILING ADDRESS � ZIP Actual Set Backs In Feet to:
LIB t -1 V•A N I uut e'1 e- �, t Z.O(p North ,Z O?t [South Z East 'C> I West f CYO `
CONTRACTOR _ LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑ 1i
4. ' AY'�I� (4 ' Commercial❑
ADDRESS ZIP TYPe�s• Z Sprinklered
y (2.--S._ pYes No ❑R d.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area 7
qa J R . s�yi;a� 53S 9 1 isfr2ceLt — ~�� ti
5' P Main Flcbr Upper Floors Garage/Storage Greenhouse
ADDRESS ..
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
_�'N/ � � No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE 1244-EW [D.'ALT. 0 AD'N. 0 RPL. 0 MVE. ._ . l
7. OF El OTHER
WORK 0 BLD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL CeVaii Exempt. Required Yes No❑ Number
or Received Yes No❑ li 1
8. DESCRIBE WORK (/ Shorelines/Flood Hazard Plans Required❑
ADV i 1 J) Rco,v wi 'C 4 \ may'I_ "2-40) EYes❑ Not Applic.❑ Received 0
VALUATION SOUR E GAS ELECTRIC P WA
❑ SE
. Ownership / FEES COLLECTED
9. UTILITIES PRIVATE❑ SEWER❑ Public 0 Private Ll
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 ).S7-.—
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 oth= state or local law regulating construction or the performance :
of construction.SEE REVERS SID O' -EQUI' P INSPEC IONS Plumbing
SIGNATURE OFAPPLICATION
OWNER OR AGENT A - L1/� " DATE `. Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
\IQIEnv.Health
SEPA
Planning Modular/
MFG.Home )-
Fire d
Prevent. 0
Engineer Other(Specify) W
g . 1 e
117 )
Utilities l 1 3`
TOTAL $
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE, )
/ Plans ' PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Exam. 4' 4 ../4'j PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED nn n
TTBuilding IN 180 DAYS DATE)SSUEDU 4 -8 3 PERMIT�O 7.0 z * i. 3 2. U 0�t�l
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