1983, 12-05 Permit: 83B-2248 Siding PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY c?? —2.74:1-
NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO. i { 2–°1. 5 . 4 1 1 Uercier
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
NERPHONE PHONE
3.
t`chard e • C'T=rok Lai, _Li ciO4
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
5 i !Jrit v cyc L.Q-r ei q,l( (, North I South East I West
CONTRACTOR n ._ (, LICENSE PIR S PHONE �r { Size of Parcel Zone Classification Residential
M C Val 1 Ern-1—P l_Y.-rS .5/1.3184- I c2g—'�t g-lL, Commercial❑ * 0 G
4. A DRESS / Z(ILP Type Const. Occupancy Sprinklered
k)i SIcl[% �VIYI..e, c)�� [`7�� � ❑Yes ❑No ❑Req'd. x DC'
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
5. ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse C ',. /
CHANGE OF USE FROM 'TO Cover Deck — Uncv.Deck Fin.Basement Unf in.Basement — 0 3
6. i, r, 7
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF WORK ❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL OTHER Certifi.of Exempt. Required Vest: No NumberLk��.(.,V-- or Variance Received Yes ID No
DESC I E WOR 1 Shorelines/Flood Hazard Plans Required❑
8. �Gi�, 5� 'a/I.-1-w/ Yes❑ Not Applic.❑ Received ❑
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
9 �. 3 OF PUBLIC❑ SEPTIC❑ Public❑Private❑
/5 UTILITIES PRIVATE❑ SEWER❑
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included on -7
reverse side,and know the same to be true and correct. All provisions of laws and ordinances governing this type of Building / l
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 IN • CTIONS Plumbing
SIGNATURE OF APPLICATION
OWNER OR AGENT /i DATE /)..// k.5Mech.
SPECIAL APPROVALS SPECIAL CONDITIO S: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health
SEPA
Planning
Modular/
MFG.Home
2-
Prevent. O
Other(Specify) v
Engineer W
-1
LL
Utilities TOTAL $ 47 °---'-1-
_
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
(1f
Building fIN 180 DAYS I —0 5 - 3 ,� a ° z * 4 7 G O �B4 DATE ISSUED PERMI ,, , roAL