1983, 06-15 Permit: 83A-5332 Pool PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
-r) • SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY ��%�, Cj33�-
NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES `
STREETADDREES PARCEL NO.
1. I�'7 t, 6 - I,5 — I 07
2.
L T BLOCK SUBDIVISION LEGAL DESCRIPTION:
PHONE .r�� PHONE
MAILING ADD ESS 4/} ! Actual Set Backs in Feet to:
6 - I )15 c114 �1 =•' North 2.-0 I South
[East � I West
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification
4. .: l ,/' J RM Com�dmercial0
ADDRESS ZIP Type\MOccupancy Sprinklered
vN ��11 I ❑Yes ❑No ❑Req'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area UL 'T 3 ) r /., "
5.
0r
ADDRESS
ZIP Main Floor Upper Floors Garage/Storage Greenhouse ; `
CHANGE OF USE FROM TO Cover Deck ' Uncv.Deck Fin.Basement Unfin.Basement
6.
3 I
TYPE / No.Baths No.Floors No.Fin.Rooms No.Dwellings
L�f NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE. J_. _ -
7. OF � ❑ OTHER
WORK ❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. B'POOL Certifi.of Exempt. Required Yes El No El Number ,.
or Variance Received Yes❑ No❑
DESCRIBE WORK
► A I P // �/ Shorelines/Flood Hazard Plans Required❑
8. (/ /AMI Col 1 .clo ` I �% I PIP) Yes❑ Not Applic.❑ Received ❑
VALUATION SOURCE GAS ELECTRIC ATER SEWAGE Ownership
9• 'Q UTIOTIEs PUBLIC SEPTIC FEES COLLECTED
PRIVATE❑ SEWER E 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
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au- Building
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction.SEE REV 1 E SIDE FOR . !, IRED I ..PECTIONS Plumbing
SIGNATURE OF r APPLICATION
OWNER OR AGE Allb. 14WWI' `(�A ' DATE �>' ��� AI
Mech.
SPECIAL APPROVALS SPECIAL CO O ITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health t '107
Planning SEPA
Modular/
Fire MFG.Home
Prevent.
f� a0
Engineer t Other(Specify) /
IL
Utilities —.Ir
%
SEPA TOTAL $ 5
Plans PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE,
Exam. THIS BECOMES A PERMIT.
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building
Tech. N(
�., IN 180 DAYS (� �j
DATEYSS1UED` 5 _8 3 PERMITU.3, 2 2 *2 5. 0 0 O AL
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