1983, 04-06 Permit: 83A-2669 Addition PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING &SAFETY SSA-ZC
r i NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. E. 447-Ar ('‘3.-r"4 7..-- .5.-. 7.- ci
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION: Lv 1 i do E.i-.' LOT2 11;iuc11 * .`; '' 'D C:
2. !.'..i''t t3 tv rK0PE. Amts,
OWNER PHONE PHONE -
3. MAUD RA luA,,z.c) _53S-71---: ,, .h ,
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
Lc. 4-4.2.4- Cr.,--r N 442.c< North 2s I South East Iifs. `West /
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential C�
4.
''' E �yXx t'' S. Commercial❑ :�
ADDRESS ZIP Type Const. Occupancy Sprinklered t,
WIE —1,IN .1?-"'r j ❑Yes Ohio ❑Req'd. ,
DESIGNER PHONE xewConst.Valuation Remodeled Valuation Total Bldg.Floor Area
5. "f / 7c IS c
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse
l'5C? __
CHANGE OF USE FROM TO Cover DeckUncv.Deck Fin.Basement Unf in.Basement
6. ---
No.
-No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE ❑pEW ❑ ALT. 1 AD'N. ❑ RPL. ❑ MVE. \ ( i
7 WORK L' BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL ❑ OTHER Certifi.of Exempt. Required Yes No "Number
orVariance Received Yes No
DESCRIBE WORK Shorelines/Flood Hazard Plans Required 51
8. A
O 01 T( )N "TDtG.E.i.C)CNC. 6 O" VS) Yes❑ Not Applic.El Received
VALUATION SOOUFCE GAS ELECTRIC PUBLICO SEPTIC Ownership / FEES COLLECTED
9. UTILITIES PRIVATE❑ SEWER❑ Public El 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 G'{-cd5
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 REV.: -SE SIDE FOR RE•UIRE• NSPECTIONS Plumbing
SIGNATURE OF APPLICATION - f •i P
OWNER OR AGEN -Nur /JI_ __ DATE Ar A• Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env.Health
WV 4-6 SEPA
Planning
Modular/
Fire MFG.Home >-,
Prevent. 0
O
Engineer Other(Specify) W
W
Utilities LL
TOTAL $54`
SEPA
PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE,
Plans THIS BECOMES A PERMIT.
Exam. ri/P/
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
building (J Q �7 5 4 0 0
Tech. C9 A3 I N 180 DAYS DATE`sitr � 6 -8 3 PERmil N6.6 9 z * era-rm.
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