1983, 09-15 Permit: 83A-9074 Residence PLAN NUMBER APPLICATION/PERMIT .. PERMIT NUMBER
_SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY v aa74-
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APPLICANT: NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
COMPLETE NUMBERED SPACES— PRESS HARD TO MAKE 3 COPIES
DDRES
1. STI REET A100 0 R.Of"9 PARCEL NO. 1. 05+4— 1 I C
2. LOT B�op►c SUBDIVNIOri asG T"(� pt.^� LEGAL DESCRIPTION: i sV� 4� ) I
OWNER - vl�� PHr ��. ONE PHONE
3. 1901\I MAILING ADL1)F �7 i A Actual Se s In Feet to:
`� / �' / J t
772_00 , North " ISouth.L 1 East �j 7 I WestCONTR TO LICENSE EXPIRES PHSize of Parcel ne lassifica ion Residential!
4. �� I o)G 7 -�-.4 pj • Commercial❑
ADDRESS ZIP Type,Cyr(st]N. Occupancy Sprinklered
V 21 ❑Yes ❑No DReq'd.
DESIGNER PHONE New Const.ValuationRemodeled Valuation Total Bldg.Floor Area
5. 4'70 -
ADDRESS ZIP Main Ijpr pper Floors Garage/Storage Greenhouse
�40 — I .-.I.
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement j 6
6. - _____
No.Baths No.Floors No.Finms No.Dwellings
TYPE 4.EW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. I I
7. OF O OTHER
BLD. ❑ PLMB. ❑ MECH. ❑ M.H. El POOL Certifi.of Exempt. Required Yes No❑ Number °s
WORK or Variance Received Yes No❑
DESCpRIB . (Of1K G.� Shorelines/Flood Hazard Plans Required
8.
'l `�1I ff�� WATER/ Yes❑ Not Applic.❑ Received ❑
VALUATION SOURCE GAS ELECTRIC PUBLIC SEPTIC Ownership / FEES COLLECTED
9 OF
UTILITIES - PRIVATE❑ SEWER❑ Public❑Private d
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions Included on I
reverse side,and know the same to be true and correct. All provisions of laws and ordinances governing this type of Building gbi
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 4. APPLICATION 'R
OWNER OR AGENT _ +- ��a '�� DATE ' j Mach.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
9
Env.Health t cf.-4 j
1 nck SEPA
Planning
Modular/ •
Fire MFG.Home d
Prevent.
0
Engineer C'/l ' = Other(Specify) W
Utilities
_ TOTAL $
SEPA
PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE,
Plans / 9(�� THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building / IN 180 DAYS n o' " 9 0 7,4 z *2 8 10.0 a H
Tech. c-1 � DATE ISSU€Dl 5 8 3 PERMIT NO. TOTAL
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