1983, 06-09 Permit: 83A-5061 Remodel PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY k ` -50(a )
(J NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS . _..e NO.
1. 5 . -7c I 1-1'' Z1. 34— — 17t7
LOTOCI SUIBDDI IX SIGN Acovt — LEGAL DESCRIPTION:
2. 57 J�ls
3. JINEFS M r,I� PHONE p)��PHONE
M LINGeADP 2S� �y.t ZIP Actual Set Backs in Feet to: i N'T
,,//GG��r I I North 'South East I West
CONTR•CTQR LICENSE EXPIRES PHON= 2 Size of Parcel Zo•elassifi -tion Residential
K dlj, OK r G _,3. ?J !/ . Commercial❑
4.
ADDRESS��� I/7� TYPe� JO
Oxup - Spklered ( G * * 68, 0
722_02....... ❑Yes No ❑Req'd.
* 68, CCc,
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
5. ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse A
* C 0
5C6,C
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
6. _ 06-C9-83
No.Baths No.Floors No.Fin.Rooms No.Dwellings 6 4'7 p
TYPE ❑ M t// 2J ALT. 0 AD'N. ❑ RPL. 0 MVE.
7 WORK ZBLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL ❑ OTHER Certifi.of Exempt. Required Yes❑ No❑ Number
or Variance Received Yes 0 No❑
DESCRI BE WORK Shorelines/Flood Hazard Plans Required?
8. "'f I7n•.0 '`� el4 / Yes❑ Not Applic.0 Received g
VALUATION SOURCEDGAS ELECTRIC pUBLICRL�" SEPT C Ownership FEES COLLECTED
9. 00UTILITIES PRIVATE 0 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 �'
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 L
OWNER OR AGENT"'-- DATErr Mech.
SPECIAL APPR15VALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
_ Plan Check
G
PRELIM. FINAL DATE {.2N14‹. 1/+C . (2,..23 _C)I "J I l�"`1 � 7 I FK )
Env.Health Ji-
IOC 5- SEPA
Planning
Modular/
Fire MFG.Home
Prevent. a
O
Engineer Other(Specify) C.3
W
J_
Utilities CZ, Lf_
TOTAL $ t�
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 o
Budding t - IN180DAYS 06 -09 -83 506. 12 *68,00a�
Tech. fly DATE ISSUED PERMIT NO. TOTAL
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