1983, 02-17 Permit: 83A-1143 AdditionPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY - DEPARTMENT OF -BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1. Fi- 12 -"'?00 l.�0'
2.LOT BILQCiQ/SUBLV SI N� j���>
nNiEt:it
i [Lp11Li� '1 L
•
M
rDD€ LING
II VV )
CO
RAF
Ar 1 ?<„ Z F -
PHONE
ZIP
LICENSE EXPIRES _ 0
PARCEL NO. ZZ r�/4-z — 0704-
LEGAL DESCRIPTION: KI
.2-- 01
I Zr+ I . Ir7t
NEgr.
Actual Set Backs in Feet to:
North ""-t 'SouthLEast �) I West
DESIGNER
5.
ADDRESS
Sized Parcel
kV,(_70i
Type C,oVt n6t� I occupancy
1 I �-3
ne Classlfica
�t2l�i
Residential
Commercia ❑
pr nklered
❑Yes No ❑ Req 'd.
CHANGE OF USE FROM
6.
TYPE 17 N
7. OF
WORK - BLD.
PHONE
ZIP
TO
❑ ALT. .BAD'N.
E PLMB. '=7 MECH.
C RPL.
E M.H.
DES I WO'.K
VALUATION
9.
SOURCE
UTILITIES
PE
GAS
MVE.
❑ POOL
E OTHER
ELECTRIC
WATER
PUBLIC ❑
PRIVATE 0
SEWAG
SEPTIC
SEWER 0
New Const. Valuation
Flops, Upper Floors
Remodeled Valuation
Total Bldg. Floor Area
Garage/Storage
Cover Deck
No. Baths
Certifi. of Exempt.
or Variance
Uncv. Deck
No. Floors
Greenhouse
Fin. Basement
No. Fin. Rooms
Required Yes❑ Norr
Received Vest: Nofl
Shorelines/Flood Hazard
Unfin. Basement
No. Dwellings
Number
Plans Required
Yes❑ Not Applic. Received
Ownership
Public ❑ Private
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
SIGNATURE OF
OWNER OR AGENT
SPECIAL APPRO ALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
APPLICATION z
DATE
SPECIAL CONDITIONS:. (SEE REVERSE SIDE FOR NOTICE)
aJ /VIC - (7-34 —c)i RC1 - i 6c 14.0
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
r-5/1-
Other
4
Other (Specify)
TOTAL $
PERMIT NUMBER
1�3
\�
u2* *54.00
*54.006
A *000 0
1 1 2.0
02-16-83
6,479.
a.
C.)
LU
- J
L
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE IBSkD 1 7 - 8 5
PERMITLd 4 3 z
*5 A O 04 f-1AL