1983, 11-15 Permit: 83B-1691 Insert PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY 638 /'Q,
NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. 4 '6) E E. 6-HA f• ,
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER _ 4q��'-- ')/ PHONE PHONE
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
F 4 ) Ci 1=, )th SPY-, _7 qL , North (South [East I West
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑
4. �P N b1 co , l late. _355_4 X4-8. Commercial❑
ADDRESS �r1 ZIP Type Const. Occupancy — Sprinklered ` r ,
7I8 GO -' T�E yd' -4 I6(24a ( _ ❑Yes ❑No ❑Req'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
5. ADDRESS >N^(\'L_ (''IC.) j\ C l= ZIP Main Floor Upper Floors Garage/Storage Greenhouse r,
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
6- . -/c- 4\.1, (4; ?I P'L ti_ \N6F-7 t.ni Fi 0-. P`t
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE ❑ NEW ❑ ALT. k AD'N. ❑ RPL. E MVE.
7. OF
❑ OTHER
WORK ❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL Certifi.of Exempt. Required Yes❑ No❑ ' Number
or Variance Received Yes❑ No❑
DESCRIBE' WORK Shorelines/Flood Hazard Plans Required CI8. TUT I 1\14 - \ l N--0 Q II\i hk,P-YF Il'Z€PiACEI Yes❑ Not Applic.❑ Received ❑
VALUATION SOURCE GAS ELECTRIC WATICE{I SEWAGE Ownership
9• ) .— UTILITIES PRNAI ❑ SEWER O Public❑Private❑ FEES COLLECTED
F.
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 INSPECTIONS Plumbing
SIGNATURE OF �jAPPLICATION
OWNER OR AGENT -x- '' _ "'- _e- _ , e„ic_.-_-�� DATE )7~ f' / /Y 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
J_
Utilities LL
TOTAL $
SEPA
PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE,
Plans THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED • -
Budding IN 180 DAYS 1 -8 1N06. 9.1 � * 2 U.U U
Tech. DATE ISSUED PERMIT TOTAL