1983, 11-04 Permit: 83B-1327 AdditionPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY
NORTH 811 JEFFERSON / SPOKANE, WA:ThINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE
NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1.
`1�� OT
12
OWNER
BLOCK
C 4 Z3
PARCEL NO.
2 35 '3"Z t (cC5-7
SUBDIVISION
(AC •,z. oA,`CL.O0v
3ri
MAILING ADDRESS
G 441z;5 320
PHONE
PHONE
LEGAL DESCRIPTION:
ZIP
cta2.o(=
Actual Set Backs in Feet to:
North 1South
t•-4 5
East N(
CONTRACTOR
4. it.CXZ`r bi ccs -r CvS-'r-
ADDRESS
C• 'Z2--1. r.c'r.E
LICENSE EXPIRES
DESIGNER
5' ADDRESS
CHANGE OF USE FROM
6.
7.
PHONE
53s— �4sc.
ZIP
PHONE
ZIP
TO
TYPE ❑% EW ❑ ALT. "AD'N. ❑ RPL. E MVE.
OF FJ BLD. ❑ PLMB. 0 MECH. ❑ M.H. ❑ POOL
WORK
OTHER
Size of Parcel
tO J K tis
``
Zone Classification
West
Residential 02(
Commercial C1
Type Const.
Occupancy
Sprinklered
❑Yes CNo ❑Req'd.
New Const. Valuation
c� tv
Main Floor
�L7t
Remode ed Valuation
Total Bldg. Floor Area
Upper Floors
Garage/Storage
Greenhouse
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
No. Baths
No. Floors
Certifi. of Exempt.
or Variance
No. Fin. Rooms
Required Yes❑ NoV(
Received Yes❑ No Cl
No. Dwellings
Nu
8.
1 -)SCRIBE WORK
IDD
got rs... =.
VALUATION
9.
SOURCE
UTILITIES
GAS
ELECTRIC
(LBX
ERSEWAGE/
.2.v.SEPTIC ❑
E ❑ SEWER ❑
PUBLIC
PRIVATE
Shorelines/Flood Hazard
Yes- NotApplic. C
Ownership
Public 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-
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
SIGNATUR
OF
OWNER ORE GENT t '� DATECATION/f �/ .73SPECIAL APPROVALS /_'7
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
u)K
"1't
ECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
I: -1C -z23 C-14# -
'r,c, 6Ns.c tE tn15Pt.�-re.
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plans Required E
Received C
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
Q(0.0c-
TOTAL
0.0 -
TOTAL $ 'f'3C
PERMIT NUMBER
8313- )5z—I
02* *96.00
*9600
A *0.00 u
132-
11-04-83
6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
•
DATE ISSUED
4 _ 8 3
13275
PERMIT NO.
*96.00° 1-
TOTAL
w•
J ; n\ 44-01 r L g
ia`
1.11,1/41
outtybot
Twic
0
�iL57lb,
` -1^^ ITN
lt�(A
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r
i
Kt