1983, 06-15 Permit: 83A-5311 Residence PLAN NUMBER APPLICATION/PERMIT PERMIT UMBER.
' 1 - SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY 0t - 5311
CNORTH 811 JEFFERSON/SPOKANE,ANASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. It.14A-'Z3 Cart“ 2' .3. _ A t t i
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. C, ”1 G - 1,t$
OWNER PHONE PHONE `''
3. IMA t,bi•Act.. C-. 1(1/14orVoQ Co 2.8
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
'6_E4 '5'24 4.--t-1.4 c1.24C North (South '3S East i west is' i, _-
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential(
4. .2.►C- LA/ - Sas-c -.3 I) cis X L �>c 1�bs ApP6. sce rs. Commercial❑ , ; —
ADDRESS ZIP Type Const. Occupancy Sprinklered
C Coco c:) t�� Q.ci /\-1 '32-- /hn--, ❑Yes ❑No ❑Req'd. !4, / C
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
5. 4Z,SG46I
ADDRESS ZIP Main Floor tier? Upper Floors Garage/Storage Greenhouse
-.12211A 4444,0 A V2—
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unfp.ament
6. _ s _
No.Baths No.FloorstNo.Fin.Rooms No.DIlings
TYPE 'fvf EW 0 ALT. 0 AD'N. 0 RPL. 0 MVE. 3 l4
7. OF ❑ OTHER /
BLD. 0 PLMB. 0 MECH. 0 M.H. ❑ POOL Certifi.of Exempt. Required Yes❑ NofS Numbed,
WORK or Variance Received Yes No
DESCRIBE WORK Shorelines/Flood Hazard Plans Required
8. G iNCD LE r-4w►LLy Rcs t.oc Jc Yes❑ Not Applic.❑ Received gAll
VALUATION SOURCE GAS ELECTRIC WATE 1P / SEWAGE/ Ownership FEES COLLECTED
9 LI PUBLIC 1E SEPTIC LD public❑Private
UTILITIES PRIVATE❑ SEWER❑
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 ''"---a1(-6
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 Plumbing
SIGNATURE OF // APPLICATION / J �-�
OWNER OR AGENT .....-71.7 .e:::% "–.71. -y' DATE !Q� y Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env.Health 'PO)
(rr^
6.7 I SEPA
Planning Modular/
MFG.Home )-
Fire a
Prevent. 0
Ca
Engineer Other(Specify) W
Utilities A 3 i�Y Q� LL
TOTAL $
SEPA
a WHEN MACHINE VALIDATED IN THIS SPACE,
Plans ILLI PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Exam.
/•� PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Budding
Tech. IN 180 DAYS DATEYSSUED` 5 —8 3 PERMIT-W.1. 1 z * 316 0 frdrAL
a 8'
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