1983, 03-30 Permit: 83A-2361 Addition PLAN NUMBER
- APPLICATION/PERMIT PERMIT NUMBER
SPI,KANE COUNTY — DEPARTMENT-OF BUILDING &SAFETY 33/1'236/
NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES ('
STREET ADDRESS PARCEL NO.
1. `� 4-').7- \I O2C-LE2 '2.24-2. — t•-o .
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. 4 -SA, .vvv j uta.
OWNER PHONE PHONE
3. CA,A QL€tea C.c> n.2.Co'--r7
Actual Set Backs in Feet to:
MAILING ADDRESS ZIP , 1
S. 4-r).. .. 'JC 42_ i.E G(- -c)C. North 'South 9-e" East I West Z (
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residentiall3"
.j Arne _ ee X 4 E INPFear Commercial❑ '
4. ADDRESS ZIP Typf ill. �Ox�tpaany Sprinklered
SA e N 1<. ❑Yes ❑No ❑Raga.
DESIGNER PHONE i�.V
tValuation Remodeled Valuation Total Bldg.Floor Area
eaJ 44
5.
ADDRESS ZIP Main Fl�r Upper Floors Garage/Storage Greenhouse
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
6.
No.Baths No.Floors No.Fin.l[looms No.Dwellings
❑
TYPE EW ❑ ALT. [AD'N. ❑ RPL. ❑ MVE. t
7. OF 0 OTHER
WORK �' OLD. 0 PLMB. 0 MECH. ❑ M.H. 0 POOL Certifi.of Exempt. Required Yes❑ No/ Number
or Variance Received Yes ID No El
DESCRIBE WORK / Shorelines/Flood Hazard Plans Required i
8• y"�i�(p� it0 R r,t7trtlUC�u LG_% /C3-� Yes Not Applic.❑ Received
VALUATION SOURCE GAS ELECTRIC WATEij� SEWAGE Ownership FEES COLLECTED
9 LI PUBLIC u7 SEPTIC Public❑Private
UTILITIES PRIVATE❑ SEWER❑
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included on jj
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 other state or local law regulating construction or the performance
of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
SIGNATURE OF APPLICATION --, Z9 _ (7 4
OWNER OR AGENT f Ls t . � z.01s1t?IZi/ DATE Y Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check i
PRELIM. FINAL DATE
Env.Health
Way
3-4 SEPA
Planning Modular/
MFG.Home >
Fire • a- -
Prevent. p ,
Engineer Other(Specify) W 1
9 —A
Utilities 00
TOTAL $
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
PlanSs PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED ((�� ��jj L l p
Building IN 180 DAYS DATE.0,,,,E 0 -8 PERMIT.6' ` z * 1 0 o' 0 0 .0,.%AL
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