1983, 08-01 Permit: 83A-7227 Residence PLAN NUMBER APPLICATION/PERMIT .0,1PERMIT NUMB
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY I ,` l - 117)-a-)
GNORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS - e PARCEL NO.
1. , 1621 1 Ill• 1- 1711;1\f e• 2.554H -alrosq8
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. ) Rtpra✓►nIvI4-1- gsT/-r s- No. 2
OWNER PHONE PHONE
3. N—rI4 w -r I4OME-5 4'�C.,-07a:'
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
e. 7 S 7 O BEV &-LV DR- _ y )6 North 65' (South 35 ' East f 5 I West 5O
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Clas iff c tion Residential Zy1"fv►AE 5 9- 8' /Pi:/-:' X 2/0 / F/ZOK l' T�t" ' Commercial El4. ADDRESS ZIP Type Const. Occupancy Sprinklered
t/ -N P.- 3 ❑Yes 0N ❑Req'd. _ ., = 3F200
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
CO �5 1 ':` L',c. JOc'
5. ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse 1' * C i'
IO(0 I 12.1,0 55O( --
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement f, ' f>
6. '—� ci6.
1.; - 21 - :s3
No.Baths No.Floors No.Fin.Rooms No.Dwellings I
TYPE ('NEW 0 ALT. 0 AD'N. 0 RPL. 0 MVE.
7. OF ❑ OTHER - G
nli
WORK LD. 0 PLMB. 0 MECH. 0 M.H. 0 POOL Certifi.of Exempt. Required Yes❑ No❑ Number
or Variance Received Yes ID No El
8. DESCRIBE WORK Shorelines/Flood Hazard Plans Required I
gEsi E cei.��ArMGE- unwise-, PEciCs 4TTACI-EP Yes❑ Not Applic.❑ Received
VALUATIONSOURCE GAS ELECTRIC PUBLIC SEPTISEWAGE/ Ownership FEES COLLECTED
9 }}�UTILITIES PRIVATEEEEEE❑ SEWER L�7' Public❑Privat
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 • .- state or local law regulating construction or the performance
of construction.SEE REVERSE SIDE FOR • • • INSPECTIO S Plumbing
SIGNATURE OF—7APPLICATION.
OWNER • - • ENT DATE 7 Z �' 6:-_,3Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) ,
Plan Check
PRELIM. FINAL DATE 0I i '-
Env.Health C �( L I - � rI� -14
I�y 13 r1,Z )�I SEPA
Planning
Modular!
Fire MFG.Home )-
Prevent. Q. T
0 :
Engineer a179 Other(Specify) LU
Utilities 2,_, 6,- ti
- TOTAL $
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
PlanslI 4 /,�3 PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
/ PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
' ° 7 Building IN 180 DAYSTech. _ 1 _o5 d * 382.0 0 pO -
J
/ DATEUEQ PERMIT NO.,2z 1OTAL
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