1983, 08-11 Permit: 83A-7677 Residence PLAN NUMBER APPLICATION/PERMIT FrERMITNUMBER
SPOKANE COaNIY — DEPARTMENT OF BUILDING & SAFETY exp -7621-7
') NORTH 811 JEFFERSON/SPOKANE,,.WASt44NGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES ,
STREET ADDRESS PARCEL NO.
1. :.31i2 1,0.,=, tit-.FE 7,154't--'-Z.--2__C,-
LOT
3LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. 3 Z i'✓(406 A ST)}
OWNER PHONE PHONE
3. .,4 r r1/45 u: -`r iv1Fc\J - (moo. -i'n4
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
.--P.0 ( Cit. it QOG a'-'1:1.1A North 'South Ltz.4 East ZS' I West ' /
CONTRACTOR LICENSE EXPIRES PHONE Size P33arcel Zone Classification Residential
4. � - 1, Ak5-0 e.-1 Commercial El
ADDRESS ZIP Taw Const. Occupancy Sprinklered
I6- 41 1,4 Q..0,ItK-1 ❑Yes ❑No ❑Req'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
5. -- G,ZSR 1,6-38
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse
I-5(16 =L' O
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
6. ti_—
r2-88
TYPE P( EW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. No.Baths No.Floors No.Fin.Rooms No.Dwellings
7• OF Le BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL 11 OTHER Certifi.of Exempt. Required Yes Nol Number
WORK or Variance Received Yes Non — -
D SCRIBE WORK Shorelines/Flood Hazard Plans Required V
8. l 0s-Ws(. Yes Not Applic.❑ Received tie
VALUATION SOURCE GAS ELECTRIC WATE SEWAGE/ Ownership .19 UTILITIES
OF
PUBLIC SEPTIC
PRIVATE SEWER❑`7 Public❑Private FEES COLLECTED
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-Z1.zx/
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 BIDE FO CURED INSPECTIONS Plumbing
SIGNATURE OF 7,, I . APPLICATION
OWNER OR AGENT DATE �J�` �( Mech.
SPECIAL APPROVALS ! PECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health Q/1
��// SEPA
Planning
Modular/
Fire MFG.Home )i.
Prevent. CIa
O
v
Engineer sv/R 1(V‘
Other(Specify)
W
J
Utilities LL '
27.(S
_ TOTAL $
SEPA
Plans v���
Exam. � PERMIT IS NONTRANSFERABLE THIS B WHEN COMES A PERM TTED IN THIS SPACE,
� PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building �/� IN 180 DAYS �{
DAT U sgurf l —p 3 PERMIT
6 �. / *4 2 /. IJTOTAL
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1017,90
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