1983, 06-01 Permit: 83A-4706 Repair Fire Damage PLAN NUMBER APPLICATION/PERMIT ' PERMIT NUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING &SAFETY 23 - 470�'
NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. 5- II ---r.� �� � - c ,o ff
BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. 5 BLI 2P - PAN 115121\i- 3 Z I I
3. OW, NER'AWI�iV,� (,)7.. I
7v PHONE
17,- KoOS
M IIAIJ NNNG A D (E•SS� ZIP Actual Set Backs in Feet to: cj�'` 5'r�
�` � 47
North 'South East I West
CO!JTRACTO /... LICENSE EXPIRES � IS�4 Size of Parcel Z lassifica ion Residential E v G * * 9 �' 0 u
4. N Ge ==t I' ✓f 0�'? 1.-' -� ,.O✓S Commercial❑ * c; U U
ADDRESS r ZIP ,7 TTy s Occupancy - Sprinklered 9, /
Kr" r5 7"� 2`�O �6 ❑Yes 0 N ❑Reg'd.
DESIGNER PH NE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
5. - 4 `705 .-
ADDRESS ZIP Main Floor Upper Floors 'Garage/Storage Greenhouse
„ f;— u I
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement / 4 '7 9
6.
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE ❑NENEW ALT. 0 AD'N. 0 RPL. 0 MVE.
7. OF
WORK..2"61--..D."`D. ❑ PLMB. 0 MECH. 0 M.H. ❑ POOL 0 OTHER Certifi.of Exempt. Required Yes❑ No Number
or Variance Received Yes ID No
DESCRIBE WORK Shorelines/Flood Hazard Plans Required El
8. rr `ie Yes Not Applic.❑ Received ❑
y+q/'L�U�TI'rON SOURCEOGAS ELECTRIC PUBUC� SEPTAC.i3 Ownership FEES COLLECTED
9.
IV G�/� UTILITIES PRIVATE❑ SEWER❑ 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 Building 7(o-
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 F REGU ED INSPECTIONS Plumbing
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE �� Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env.Health
SEPA
Planning Modular/
MFG.Home
Fire d
Prevent. p
Engineer Other(Specify) _ W
9
J_
Utilities
_ 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 7 p z Q 7
Tech Building ` �i J IN 180 DAYS DATE ISSUED 1 —U J PERMITNO.O'6 a *9 6. 0 0 SAL