1983, 08-05 Permit: 83A-7440 MH PLAN NUMBER APPL ICAT ION;PERM IT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY OA\--24—
CNORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. i �� I 52 -- 12-1-7
LOT BLOCK SUBDIVISION / ��� LEGAL DESCRIPTION:
2.
r7 p
I f`f (
v I
O�(NER PHONE P
3. e� L.��u
mod
vl '6
MAILIN ADDRESS P ` Actual Set Backs in Feet to:
172,-0 _ C-t4" North I South 2-1.; East 5 I West
TRACTOR LICENSE EXPIRES ,,-O7-- -15°'7
HHOONE Size of Parcel Zone Clasification Residential J
4. ® 1t� �' 5° j Commercial❑
DRESS i3 � �� � TYPe�nft• ucY Sprinklered
�L��ti� ffb__--./ ❑Yes ❑No ❑Req a.
DESIGNER PH NE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
()7 , * 1 00 00
5. ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse "
Pu 0 0 c_,
CHANGE OF USE FROM ` TO Cover Deck Uncv.Deck Fin.Basement Unfin.Basement * ,^ 0 S2
6.
No.Baths No.Floors No.Fin.Rooms No.Dwellings 7 1 ;i y'
TYPE le NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. r
7. OF iC ;- - F3
❑ BLD. ❑ PLMB. ❑ MECH. ELM.H. ❑ POOL El Certifi.ofExempt. Required Yes❑ No❑ Number
WORK or Variance Received Yes No❑ li 7 c
DESCRIBE WORK Shorelines/Flood Hazard Plans Required❑
8. r n_I + 4 ���j x 7 G )WATER/ r� d Yes❑ N000d H c.❑ Received ❑
VALUATION SOURCE GAS ELECTRIC PUBLIC SEPTIC Y Ownership / FEES COLLECTED
9. �i. d� UTILITIES PRIVATE❑ SEWER❑ 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 I
Building I
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au- i
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction.SEE RE IDE FOR OUIRED ECTIONS Plumbing
SIGNATURE OF i DATECATION 6 I J-(:) Mach
OWNER OR AGENT t-c — 1
SPECIAL APPROVALS SPECIAL CONDITIONS:(SEE REVERSE SIDE FOR NOTICE)
Plan Check 1
PRELIM. FINAL DATE
Env.Health
SEPA 1
Planning Modular/ Y,7!7
MFG.Home 6c,'!/
Fire C
Prevent.
Engineer (j �1,�����`
Other(Specify) W
yM_fNll"/ J
•
Utilities i
TOTAL $ { -
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
Plans PERMIT IS NONTRANSFERABLE + THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building �i IN 180 DAYS n' rA((�� //l� o I O
Tech. \ DATE'IS0UED� 5 8 3 PERMIT7N4.IL 0 z *1 0 0, 0 0 ff1IFAL
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