1983, 05-03 Permit: 83A-3565 Residence PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
_3'50,-;'R-SG( SPOKANE COUNTY - DEPARTMENT OF BUILDING &SAFETY �� - JI5�
r NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 89260/(509)456-3675 —1
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. .3`a OZ. W tac- 7'v(waa. "3-34-.3---'tea
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. 5 I ViW...k.6ic A :Trow _ 9 00
OWNER PHONE PHONE
3. J4E, 1./V►C,N I ELL.i Ci -(c '. C r, C4 <:
MAILING ADDRESS ZIP Actual Set Backs in Feet to: *i
S•,t14-15 44'`{ aQ North Co' 'South t\ East `3C,7 I West
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential `) Q_ I
k.'J X t V.-3 •p. i Commercial❑ _
4. ADDRESS ZIP T nst. Occupancy Sprinklered L '
-SAry. 3)AA—' ❑Yes ❑No ❑Req'd.
ell7
DESIGNER PHONE iVewConst.Valuation Remodeled Valuation Total Bldg.Floor Area
5. 5941-I2- •v1 06,
ADDRESS ZIP Main�Flo`o,r Upper Floors Garage/Stoor�age Greenhouse
t 4-J"' CO/S
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
6. - - %4-34
,.,,/ No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE L7 NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. 2 ' k
7. OF �/ ❑ OTHER �/ -
WORK [ 'BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL aVariof
fnExempt. Required Yes❑ No( Number
Received Yes No❑
DESCRIBE WORK Shorelines/Flood Hazard Plans Required I>�
8' R �it3CNt Yes❑ Not Applic.❑ Received CT
VALUATION SOOPUBC
URCE GAS ELECTRIC LIR SEWAG Ownership
SEPTIC FEES COLLECTED
9.
UTILITIES PRIVATE❑ SEWER❑ Public❑Private(w
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 te�r�++,,
Building S"t 0- %
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 APPLICATION
OWNER OR AGENT DATE Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health
.3.-7ZA 3 SEPA
Planning t
Modular/
MFG.Home
Fire a
Prevent. O
Other(Specify) v
Engineer { "`1 i W
"r ter/ J
1 ii
Utilities
TOTAL $ y'co
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
Plans y4-E 1'pitt> v PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS -� 3 -g 3 ,� h,5 5 * 3 9 0. 0'0 °
Tech. DAT UE PERMIT �O�TAL
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