1983, 08-08 Permit: 83A-7454 Addition PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY 5 A ' 4GA-
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NORTH 811 JEFFERSON /SPOKANE,WASIiINGi!'li 99260/(509)456-3675 r e
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. t . io zz.. ��" 7-0`504-1 - tBIC 0 * w 5 i 0 0
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. 6 iCAtz. LAT-0 3:�4c-Z30 ow. • 5/' n 0
OWNER PHONE PHONE n C '^
3"m/}6) AC,b;�C.t)A —MAILING ADDRESS ZIP Actual Set Backs in Feet to: 7 4 r. ;3 _7
,
C .k 04;13- ( V kl C Q 7..C, North I South East P,, `West {
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential E7
/ 0�,tL1. Co/%39Yf2..x .Z
ctON 4— (oo 4 r -75 !c IPx) Commercial❑ ' (i. 7 `i.
4. ADDRESS ZIP Type Const. Occupancy Sprinklered
.%-273 tZ\Vts QS-ltCj 4q)-(:) .. ---v-,-) m.4 ❑Yes ❑No ❑Req'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bl`dg. IoorArea
5. Skc._ rT '
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
6. —
No.Gams No.Floors No.Fin.Rooms No.Dwellings
TYPE ❑ NEW ❑ ALT. VAD'N. 1=1 RPL. CI MVE.
7. OF ❑ OTHER , t
I(BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL Certifi.of Exempt. Required Yes Noll Number
WORK or Variance Received Yes No❑ r---.
°. DESCRIBE WORK Shorelines/Flood Hazard Pans Required[V'
/ADO t-T-LO c'\) Tc ---P_S i OEj C. v/
�/ Yes❑ Not Applic.❑ Received
VALUATION SOURCE GAS ELECTRIC WATER SE
1 Ownership FEES COLLECTED
9• UTILITIESVAT14
LIPUBLIC U'
PTIC
C1
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 Building -.E7"
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 e pr.vis'•ns of any oth� state or local law regulating construction or the performance
of construction.SEE RE L4 E l• �;OR RE•, aa
ti n INSPECTIONS Plumbing
SIGNATURE OF OWNER OR GENT- Inite M. DATE Mech.g �3 Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health Oftte°le, /_�
SEPA
Planning Modular/
MFG.Home >-
Fire d
Prevent. O
ca
Engineer L Other(Specify) LU
9 J
Utilities ii.
TOTAL $ �dr"-'
SEPA
PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE,
Plans THIS BECOMES A PERMIT.
Exam. t � 6 PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED Q ? n p 4.00
Building /� ' IN 180 DAYS 927— DATEiS9t1EDO PERMITMd `f z * S `k O O ip}AL
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