1983, 08-02 Permit: 83A-7295 Reroof PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY A " ? 'a5
Cv NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
TE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. .4�e.)`3 _,L3cDC7-12XZ_vnc"- • C> .%44- (- q03
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER PHONE PHONE
3
Ac -c EN 00.E-4 `3ct
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
. 5 6- I, AD i2-LLFf," QCtNorth 'South [East I West
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑
CZYy Commercial❑
4. ADDRESS ZIP T st. Occupancy Sprinklered
ig 01.1g- �_ DYes ❑No ❑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 Unfin.Basement
6.
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. /
7. OF C'OTHER
WORK ❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL avifi.of Exempt. Required Yes❑ No Number
Received Yes El No❑
8. DESCRIBE WORK Shorelines/Flood Hazard Plans Required❑
Rc-'Zpcy' R.. i (>EA10..E. Yes❑ Not Applic.❑ Received ❑
EVALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
9 OF PUBLIC❑ SEPTIC❑ Public❑Private❑
Z,S0c) UTILITIES PRIVATE❑ SEWER❑
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 4 4-7 .die)
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 _ APPLICATIQQI �y ��w-
Mech.
OWNER OR AGEN _ EI` DATE �1
SPECIAL APPROVALS SPECIAL CONIOIONS:(SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health
SEPA
Planning Modular/
MFG.Home y.
Fire d
Prevent. p
Engineer Other(Specify) NA
-.d
Utilities
cso
TOTAL $ •
�
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
Plans PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED 7 29.55 k47'
Building92)' $/a IN 180 DAYS 8 2 — 8
Tech. DATE ISSUED PERMIT NO. TOTAL