1983, 08-10 Permit: 83A-7574 Insert PLAN NUMBER APPL ICAT 1(>4/PER M IT PERMIT NUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING &SAFETY f7-0 - 7 ----
ClORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
C APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
4
STREET ADDRESS PARCEL NO.
1. 1712— o J
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. II ii''^ i(�
3. OWNER 11Vi✓ r7z2� P,130N 7�ClG'HONE (� * ,t L G, Q
'ANG Actual Set Backs in Feet to: 7 5 7. 3
MAILING ADDRESS
`/ North South East West
Iii is ��—f9 . ,)� 08- 10-83
CONTRAC�TO� LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑
�/ ,� Commercial❑ 4 7 9.
4. ADDRESS Y ZIP Type Const. Occupancy f Sprinklered
❑Yes ❑No ❑Req'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.FioorArea
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.
TYPE "NEW ❑ ALT. Jd MECN. ❑ RPL. ❑ MVE. No.Baths No.Floors No.Fin.Rooms No.Dwellings
7. OF WORK ❑ BLD. ❑ PLMB. H. ❑ M.H. ❑ POOL ❑ OTHER Certifi.of Exempt. Required Yes No Number
or Variance Received Yes❑ No❑
8 DESCrR,B ORK ._ , / 1 Shorelines/Flood Hazard Plans Required❑
yy�J �7�'!� l/ Yes❑ Not Applic.❑ Received ❑
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
9OF
UTILITIES PUBLIC❑ SEPTIC❑
PRIVATE 0 SEWER❑ Public❑Private❑
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.SE VERSE SIDE FOR REQU 'ED INSPECTIONS Plumbing
SIGNATURE` APPLICATION 2 �-7�
OWNER OR AG NT • =s A/�— DATE �e �` -✓ Mech. 'C/-*
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health
SEPA
Planning Modular!
MFG.Home a
Fire
Prevent.
O
EngineerOther(Specify) u
-J
Utilities .
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 U 8 _1 Q _$ 7 5 7. 4 0 * 2 0.0 0 a F-
Building —, :J IN 180 DAYS
Tech. r. 0 DATE ISSUED PERMIT NO. TOTAL
V"