1983, 06-28 Permit: 83A-5913 Insert PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING &SAFETY 83A 5°I l3
NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
/
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS � PARCEL NO.
1. • 424 6t. .
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER . - PHONE PHONE
.
b35-7666
MAILING ADDRESS J• 4424 6th. ZIP''y ,206 Actual Set Backs in Feet to:
4v
North 'South !East I West
CONTRACTOR Valley Fireplace L19 PIRES m'122278O Size of Parcel Zone Classification Residential E
Commercial E
4. ADDRESS . . 16610 Sprague Ave. ZIP99O37 Type Const. Occupancy Sprinklered 0 4 * * 2 0 0 0
❑Yes 0 N ❑Req'd.
Verttd211 e, '.'fl.. - 6Y
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area * 2 0.0 0
5. 1't A *0.00 0
ADDRESS :Urit;r. Ly..:� .♦ „ .11. ,ud—S26..aa ZIP Main Floor Upper Floors Garage/Storage Greenhouse
591.2
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
6. 06-28-83
No.Baths No.Floors No.Fin.Rooms 'No.Dwellings o 4 7 9
TYPE NEW ❑ ALT. ❑ Ajd'�N. ❑ RPL. ❑ MVE. z
7. OF WORK ❑ BLD. ❑ PLMB. MECH. ❑ M.H. 0 POOL GI OTHER Certifi.of Exempt. Required . Yes❑ No❑ Number
or Variance Received Yes❑ No❑
DESCRIBE WORK - ""-%0.11 1s1aze .'.'rinceSS Stove and .1-'ipe Shorelines/Flood Hazard Plans Required e
8. 17Stomer did hearth). Yes Not Applic.❑ Received ❑
VALUATION SOURCEOGAS ELECTRIC PLWATER SEWAGETIOwnership FEES COLLECTED
9. UTILITIES PRIVATE❑ SEWER❑ Public❑Private 1
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
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 NSPECTIONS Plumbing
SIGNATURE OF ) ----- �j APPLICATION t /L() _
OWNER OR AGENT •C � I (y 1" , loci- .moi DATE .t ' 4 Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:(SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health
SEPA
Planning
Modular/
Fire MFG.Home
Prevent. a
O
Engineer Other(Specify) V
W
JEC Utilities 20
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 (� 6 2
Building �/ I N'180 DAYS DATE ISSUED 8 —Sa 3 PERMIT N0. 1.3 5 *2 0.0 0 TOTAL