1983, 08-30 Permit: 83A-8358 SolariumPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WAS-.:NGTON 99260 / (509) 456-3675
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APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1.
LOT
2.
BLOCK
SUBDIVISION
OWNER
3. LEO GQ- b.i)
MAILING ADDRESS
G ((7 -S,1-
CO TRACTOR
o tAA':ESTeAD k1Mti DEu
4.
5.
PHONE
PHONE
3E3.
Z I , P ZIP
PARCEL NO.
LEGAL DESCRIPTION:
t.,I/z Lo -t S-
Actual Set Backs in Feet to:
North ISouth
LICENSE EXPIRES
PHONE
Lfb`—S7!j
Size of Parcel
I
EastLI
Zon Classifi 'on
West
Residential
Commercial E
A DRESS
CO 5) Z ka - A \AOY.-r
DESIGNER
ZIP
` 4, Zc3`7
Type trt
ADDRESS
CHANGE OF USE FROM
6.
PHONE
ZIP
TO
TYPE 9-1(W ElA
ALT. f D' N. ❑ RPL. ElMVE.
7 WORK 3LD. ❑ PLMB. 111 MECH. ❑ M.H. El POOL
❑ OTHER
�
°12:7t -
New Const. Valuation
Spr'nklered
:Nes No Req 'd.
Remodeled Valuation
Total Bldg. Floor Area
I S -�
Main Floor
Upper Floors
Garage/Storage
Greenhouse
Cover Deck
Uncv. Deck
Fin. Basement
No. Baths
Certifi. of Exempt.
or Variance
No. Floors
J
No. Fin. Rooms
Unfin. Basement
No. Dwellings
Required
Received
YesC No
Yes❑ No7
Number
8. D SCRIBE WOR .2otan wt
,�f' 40
O
VALUATION
SOURCE 1 GAS ELECTRIC PUWATER
BLIC ❑
UTILITIES PRIVATE 0
9.
Shorelines/Flood Hazard
Yes❑ Not Applic.
SEWAGE
SEPTIC E
SEWER ❑
Ownership
Public 0 Private
I hereby certify that 1 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
SIGNATURE OF
OWNER OR AGENT
SPECIAL APPROVALS
Env. Health
Planning
Fire
Prevent.
PRELIM. F/»AL
DAT
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
APPLICATION
DATE
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
ttttE-P rbg- Mta ii2- e AECCSW -
1 I t o i t-
Cryk: 1.1A -SP
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plans Required
Received
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $ 20
PERMIT NUMBER
02* *20.00
*2000
A *000
835.7-f
08-30-83
6479•
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
I 3y n r t
DATELISkED"
•
PERMI8,5 T nu: 5- z
*20.00'OTAL
L
4
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