1983, 10-06 Permit: 83B-0054 Addition PLAN NUMBER APPL ICAT ION/PERM IT PERMIT NUMBER
- . SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY e35 ooS'
NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675 -
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
simara
STREET ADDRESS PARCEL NO.
1. C.. (.05k O i CG-'tA 2•4"G. 3.--(- --36-?
LOT I BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. `7 I 2. V.) WC.....ip.C,cS ;atm>,Tic,t'L.i
OWNER _ PHONE PHONE
t,i. - t lox vv.. rya,4 hJ c Tao--e,-,Net
3.
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
Cr a l V i T t C Ct 1'�- North Z ,South [East .5 j I West /
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcgl Zone Classification Residential Ll
4. S F or,A,c. 1\c Commercial❑
ADDRESS ZIP Type Const. Occupancy Sprinklered
S- V'ti. =N fa /ryt-I ❑Yes 0 N ❑Req'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
5. 0-0,02.0 — q AC -
ADDRESS ZIP Main F } e/$tgr
Upper Floors Garagage Greenhouse
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
6. — t7C?
/ No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE El NEW ❑ ALT. FIAD'N. ❑ RPL. ❑ MVE.
7. OF / ❑ OTHER /
WORK
ALD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL Certi i�.o�Exempt. Required Yes Nok Number
or Variance
Received Yes ID No El
DESCRIBE WORK Shorelines/Flood Hazard Plans Required f/I
8. Ao D ITC C'ev -Co ' Ci t)Cc'C. Yes LI Not Applic.❑ Received !j/
VALUATION SOURCE GAS ELECTRIC WATER/ SEWAGE/ OwnershipFEES COLLECTED
9 OF
UTILITIES PUBLIC SEPTIC C7
PRIVATE CI SEWER❑ Public ID
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 I(ci2•Cm'
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 alrifib.m..-
APPLICATION •, ��OWNER OR AGENT '.- • DATE Mech.
•
SPECIAL APPROVALS SPE AL CO DITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health
jatin /0-Le >- 4 �V`'— [--[(0.-45 -.6_(2 •.0433 SA) SEPA
Planning
`J Modular/
MFG.Home
Fire a-
Prevent. O
C.)
Engineer Other(Specify) W
9 —J
Utilities
TOTAL $ (G-.).`er
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
Plans ,) LG/c PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Exam. (( PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building f� IN 180 DAYS p (l
Tech. ! DATE l*LiEC O U — U 1 PERMIT NO.� ' z * 16 2. OTOTAL
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