1983, 05-18 Permit: 83A-4203 Sink PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY 6.- A -4)-03
_
NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. N. '51% WRri.r.
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER PHONE PHONE
R6ct IA , L4—U•4 0 A2s--ca�c #
3. MAILING ADDRESS ZIP Actual Set Backs in Feet to:
t4• '. 1 t i....) .NZ1'T Ga'2.a, North 'South East I West
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential El
4 .11•Yx16 Commercial CI
ADDRESS ZIP Type Const. Occupancy Sprinklered
SvoAAE ❑Yes 0 N ❑Req'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
5 -
ADDRESS ZIP Main Floor 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.Rooms No.Dwellings
TYPE ❑ NEW ®./ALT. ❑ AD'N. ❑ RPL. ❑ MVE. ,
7 WORK iBLD. II PLMB. ❑ MECH. ❑ M.H. El POOL ❑ OTHER Certifi.of Exempt. Required Yes No Number
or Variance Received Yes El No❑
DESCRIBE WORK Shorelines/Flood Hazard Plans Required❑
8. • 0 ) Zi,.; kG- Yes❑ Not Applic.El Received ❑
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
9 PUBLIC CI SEPTIC❑
PRIVATE❑ SEWER❑ Public❑Private❑
UTILILITIES _
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 other state or local law regulating construction or the performance
of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS PlumbingSIGNATURE OF
�`�
OWNER OR GENT q DATECATIAPPLIat 5 _1 •7 3 Mech.
SPECIAL APPROVALS SP IAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health
SEPA
Planning
Modular/
Fire MFG.Home y.
Prevent. a'
O
Engineer Other(Specify) LU
W
J
Utilities
.00
TOTAL $
SEPA
PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE,
Plans THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS
� nn r�` 188O ' o * 7' O OO J
Tech. c9-E ] /7 DATE ISStl — ) PERMIT QO7 z 404-A
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