1983, 01-28 Permit: 83A-0676 Residence [PLAN NUMBER APPL IC 4 ION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY aS A ' -"7(..,
0) NORTH 811 JEFFERSON/SPOKANE:WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. r. 5`7 15 CI<IU►+-r 2'6"5r r II t 3&
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:—Cc-5.A5-if,iNU 5 G[.oGK i
2.4,1,5 iP`°'111- Of $t_k /2- M�iP i3 M D � ii -w 1`.
OWNER PHONE PHONE
3.
ivlAsco PuDRs ..4 4t98-916'07fKct-uSt�� OPBwc�c /r oP Etoi-rwooa�s
MAILING ADDRESS I ZIP Actual Set Backs in Feet to:
W . -30/D 4RA(rPI)IE() 20Y- North (0` 'South'J0' East I West
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone ClassificationLr it i� 1 G U0 Residential f -
4. SMC 8K19 ' APePa X Commercial❑ :, 1 0 G
ADDRESS ZIP Type Const. Occupancy Sprinkler
U-isi 12-3 ❑Yes ❑Req'd. * t, U
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
#47�GO l i lla II
5. ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse : 1 —2 0 ??
1232 494 / c
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unfin.Basement < 7 9•
6.
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE C'NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7• OF ❑ OTHER - 5 I
WORK CSD. ❑ PLMB. ❑ MECH. ElM.H. ❑ POOL GaAiftofempt. Required Yes No❑ Number
or Variance Received Yes No❑ fe•__)74_$Z
8 DESCRIBE WORK Shorelines/Flood Hazard Plans Required❑
SiMC±Llr. F-AlYtti4 g. .5i1cNCf. Yes❑ Not Applic.D Received ❑
VALUATION SOURCEOGAS ELECTRIC PUBLIC O SEPTICSEWAGE
O Ownership FEES COLLECTED
9. Public❑Private❑
UTILITIES PRIVATE❑ SEWER D
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included on p0
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 OFP"ft APPLICATION I
OWNER OR AGENT Mi`�j 1-1.-- DATE ! -"' "Ci Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env.H h
1/01"1"
/ -1 '
SEPA
Plann' g
Modular)
Fire MFG.Home
Prevent. a.
O
0
Eng' r Other(Specify) W
Utilities � � ��
CC
SEPA TOTAL $ .. i
WHEN MACHINE VALIDATED IN THIS SPACE,
Plans ` PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Exam. NM (j.(ClSI
!! PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building l IN 180 DAYS
n 7
Tech. Q/gZ DATE ISsixD 2 8- 83 PERMIT Nc 7'6 z * 316. 0 01b+AL
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