1983, 02-22 Permit: 83A-1218 ResidencePLANW
al
1
APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
- 4
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
1.
2.
STREET ADDRESS
�.
LQT
BLOCK SUBDIVISION
3.
4.
OWN
MAIL QIRESS
r -J- .36 X:
CONTRA TO
16,
ADDRESS
ERI
INGD
S
DESIGNER
FJ. ADDRESS
LICENSE EXPIRES
CHANGE OF USE FROM
6.
PHONE
PHONE
ZIP
PHONE
ZIP
TO
TYPE ZW CIALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7.WORK 0 OTHER
BLD. ❑ PLMB. 0 MECH. ❑ M.H. 0 POOL
OF/E
PARCEL NO. 1.;,4
A r 2-i 1
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North "13'.7 _ISouth . L ' East
Size of Parcel r Zone lassification
e 1
TypeConmt.n y Spr nklered
I� u SII I ❑Yes ❑No ❑ Reg 'd.
New t. Valu I �Remode ed Valuation Total Bldg. Floor Area
West
Residential.e" -]
mmercia ,
Main
Upper F rs
Cover Deck
No.2— ('
Certifi. of Exempt.
or Variance
Garage/Stora
Uncv. Deck
No. Floors
Fin. Basement
No. Fin,Rooms
Greenhouse
Unfin. Basement
Dwellings
No.
Required Yes❑
Received Yes ❑
8.
DE RIB R
VALUATION
9.
SOURCE
UTILLIITIES
GAS ' ELE TRIC WATER/-
--- PUBLIC a
PRIVATE
SEWAGE/
SEPTIC
SEWER
Shorelines/Flood Hazard
Yes C NotApplic. ❑
Ownership
Public 0 Private CT
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-
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction. SEE REVERS FOR REQUIRED INSPECTIONS
SIGNATURE OF
OWNER OR AGENT
APPLICATION
DATE 1- 3
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
\-ht
1
L
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
NoE Number
No r7
Plans Required
Received 'r"
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
PERMIT NUMBER
83R—r2-.‘8
*40600
*406006
A *0.00
121.72
02-22-83
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEQSZlit 2
83 PERMITU.L8Z *406,00v*AL
t
io9
1000
6*t
G----.30
SO . '-!0 20 GU 0 O &tCFF
/oi-Z,BbocK
Pox Deieoro SEz/ A,00N.