1983, 03-29 Permit: 83A-2350 Residence PLAN NUMBER ` ' APPLICATION/PERMIT PERMIT NUMBER
83/ o SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY a3A - 2350
( ) NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO.MAKE.3 COPIES l J
STREET ADDRESS
1. �, t-1 i 3 Va=Ri�1 iz �-r PARCEIfWO. ., _
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. . iec
R%O(►Eyno?.)T i� -rraTC
REEF- PHONE PHONE
3. rso-rtA CchV -1-24..t.Cr or\1 G X€',--2.4:46
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
5. zC� -Pt nl>✓`- Q1`(1-cc. North '--6.:5' 'South [East 2.0' I west I•S /
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential t�J
#7),A,.e. )c 1 6 lAPPt��v. (�.s j Commercial❑
4. •
ADDRESS ZIP Type Const. Occupancy - Sprinklered
40k4./.,45. TM i'Z' Nil ❑Yes ❑No ❑Req'd.
5 DESIGNER ` PHONE NewCor�st.Vaalua(ion Remodeled Valuation Total Bldg.Floor Area
ADDRESS ZIP M?in F`l0000rr_ ! I Upper Floors Garage/Storage Greenhouse
1�itCf 540
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
6. .� \CA LCi
/ No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE f /NEW ❑ ALT. 1=1 AD'N. ❑ RPL. ❑ MVE. 2 1 i
7.
❑ OTHER
WORK L"BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL Certifi.ofExempt. Required Yes❑ No IV Number
or Variance Received Yes❑ No❑
DESCRIBE WORK Shorelines/Flood Hazard Plans Required
8. EIwILLC Igie40.4t itis• i06raCJ Yes Not Appllc.❑ Received iff
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
9. OF
PUBLIC CI SEPTIC /
PRIVATE❑ SEWER Public❑Private l�
UTILILITIES E�
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 4.151
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 REO .i ED I SPECTIONS Plumbing
SIGNATURE OF11 ..,3APPLICATIO�i_ Z S r ,C�G
OWNER OR AGENT • DATE f'! 1 0 Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:(SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health \JU1 (� �
`t" ) SEPA
Planning
Modular/
Fire MFG.Home >.
a.
Prevent.
O
C.3
Engineer 1, Other(Specify) W
Utilities
410/1 LL
TOTAL $ '
SEPA
PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE,
a /& ; , THIS BECOMES A PERMIT.
Exam. / �/�/ PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building A �/ IN 180 DAYS }�-�-d* *175—t*AL
Tech. a. `, C1 DATE ISSUED PERMI7�Nd. T z � 7UTAL
p3 - 298,83 '��
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