1983, 08-17 Permit: 83A-7890 Addition PLAN NUMBER APPL ICAT pN/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY 63A "1 S°
C,,
- NORTH 811 JEFFERSON/SPOKANE,WAR INGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO. `t
1. t• , Q1 2.4, —7 T1-1 `Z I 4-9--t.
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION: T' -
2. 5 4- ex,O c c-t-ssal 5 Lktia,-274.4C— Ly s OFR?. ;
OWNER PHONE PHONE
34i
MAILING ADDRItSS , �ZIIP _/�4 Actual Set Backs in Feet to:
E. - toi t4 '7 Tb.k- a ei V-6(p North 'South C i East '3 ( l West
CONTRACTORl
LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential
1 ' oft.,L -i'2- ' S'T- C07-4- 6-3�C ( commercial❑
4. ,/y
ADDRESS ZIP Type Const. Occupancy ❑Yes Spr❑Norte ❑Req'd.
t,5.`t�lb3 Ci T-t QG 261- "iv `"e 3
DESIGNER PHONEnst.Valuation Remodeled Valuation Total Bldg.Floor Area
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement UnfiBasement
6. �—
TYPE ❑ EW ❑ ALT. [ 'AD'N. El RPL. ❑ MVE. No.Baths No.Floors No.Fin.Rooms No.Dwellings
7. OF ❑ OTHER ` 1 `
be LD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL Certifi.of Exempt. Required Yes❑ Noi�J Number
WORK or Variance
Received Yes No❑
DESCRIBE WORK Shorelines/Flood Hazard Plans Required El8. pA Yes❑ Not Applic.❑ Received ❑
s i
VALUATION SOURCE GAS ELECTRIC WATER SEWAGel Ownership / FEES COLLECTED
9. PUBLIC SEPTIC Lf
PRIVATE UTILITIES PRIVATE❑ SEWER❑ Public 0 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 S ,to
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 APPLICATION
OWNER OR AGENT DATE P Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE C01J • L.'C. "Ir ONCE Plan Check
T
Env.Health
SEPA
Planning
getli
/// f
Modular/
MFG.Home t
Fire d i
Prevent. C °
V
Engineer Other(Specify) uJ
9 J
u.
Utilities TOTAL $
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
PlansPERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Exam. 55;li%),If PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building t� � IN 180 DAYS DATE I$€Ee 1 � �p 3 PERMIT NO g 0 z * 8 2.O O a F
Tech. �'7
TOTAL
j\____
. r;,<1 9141,
-I 'VP-.0 'et 1 -14
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