1983, 07-18 Permit: 83A-6631 ReroofPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
STREET ADDRESS
tv ow
1.
LOT
2.
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
BLOCK
SUBDIVISION
OWNER
3 LARta-% 'Teel
MAILING ADDRESS
N . W tt:.L,-D
CONTRACTOR
3 s T WAS{ C.>aivs-r
ADDRESS
1�'r 1 R ox .5c15
DESIGNER
5.
ADDRESS
PHONE
PHONE
C.11-41 fir..
PAROL NO.,
i 1 r -t 3 - Va-e-t
LEGAL DESCRIPTION:
LICENSE EXPIRES
ZIP
PHONE
Actual Set Backs in Feet to:
North [SouthEast I West
Size of Parcel Zone Classification
Residential i '
Commercial 0
CHANGE OF USE FROM
6.
TO
ZIP
GG t4
PHONE
Type Const.
Occupancy
Sprinklered
❑Yes ❑No ❑Req'd.
ZIP
New Const. Valuation
Remode ed Valuation
Total Bldg. Floor Area
Main Floor
Upper Floors
Garage/Storage
Greenhouse
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE 0 NEW
7. OF /
WORK >YBLO.
0 ALT. 0 AD' N. LPL. ❑ MVE.
0 PLMB. ❑ MECH. 0 M.H. 0 POOL
0 OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required Yes No0
Received Yes CI No❑
Number
IMSCRIBE WORK
8. i '-EBF tZ, o1✓tx
VALUATION
IWT-Z-.`jQf%
SOURCE
F
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC 0
PRIVATE 0
SEWAGE
SEPTIC 0
SEWER 0
Shorelines/Flood Hazard Plans Required 0
Yes❑ NotApplic. 0 Received 0
Ownership
Public 0 Private 0
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
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au-
hority to violate or cancel the provisions of any other state or local law regulating construction or the performance
construction. S REERSE SIDE FOR REQUIRED INSPECTIONS
SIGNATURE OF
OWNER OR AGENTa
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
APPLICATION—)� 1
�-�-- DATES
SPECIAL CONDITIONS: (SEE RSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building 40,00
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $ 7/ coo
PERMIT NUMBER
83A -CQCd31
02* *47.00
*4700
A *000
663.0
07-18-83
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEYSSUED1 8 — 8 PERMIT444..5 1
z *47.004AL