1983, 08-26 Permit: 83A-8260 Addition PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
, S_ POKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY b3 A 63'2..Q20
CNORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1 �O ,`'r r +t -
( O 5o"i g � - 0
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION: oc-E,.,,h i 4 v • IF t/z e p w l/Z d*
2. -- ,--1 A—� S 3l5-OF S t/L $ 22,B3. OAN ER e .?4\ PHONE citzb_-1-74'
MAILING ADDRESS QAZIPActual Set Backs in Feet to:
t O S O 9 y 1 l 20 CP North a-- I South ,— East I West S
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential Pr
PIS 3 X al Commercial El4. ADDRESS ZIP Type Const. Occupancy Sprinklered , c; ;,
V N r?-1-
3 ❑Yes ❑No ❑Req'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Hoar Area 0
5. tt k.t t \1 i-L 17-to 7.x- 2 "S3°1 Z ( Z g
ADDRESS ZIP Main Floor —Upper Floors Garage/Storage Greenhouse
VZ-e, - -.
J c_
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
6. — - c -
� No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE Er<W ❑ ALT. &k-/(D'N. ❑ RPL. ❑ MVE. I I t
7- OF �`� ❑ OTHER /
WORK Lti'BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL orVarianExempt. Required Yes❑ Noel Number
Received Yes 17 No 17
DESCRIBE WORK \ Shorelines/Flood Hazard/ Plans Required�/
$• ADD
Tt S (`os X t 2/` / E Yes❑ Not Applic. IQ' Received [/f
VALUATION SOURCE GAS / ELECTRIC WA ER[e SEPTAL E. Ownership FEES COLLECTED
9• UTILLIITIES PUBPRIVATE❑ SEWER❑ Public❑Private.
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included on li
reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this type of Building S'T"
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 . cel t : provisions of • er state or local law regulating construction or the performance
of construction.SEE •EVERS=L IDE FO; R-CeITli.1-D INSPECTIONS Plumbing
SIGNATURE OF ( WINCII7 APPLICATIO2 OWNER OR AGENT � ., �� DATE 4 _,,c-u Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env.Health ' T
1'` SEPA
Planning 'V Modular/
f
MFG.Home ),.
Fire d
Prevent. 0
.+ V Other(Specify) YJ
Engineer f
'ins$1eL `Ca AP?to ai- $�1 TEt b Z�15?. a,'-IVM-e
Utilities T'b 1- 9?,
c /l TOTAL $
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
�/Plans I PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
r`�"'m ®IZ� PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building . �\ i', ���� IN 180 DAYS (� ,` 2 6 -8 3 �a 6,0 z * 5 4.0 0,t„t,,,L
VA. DATE ED PERMIT
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