1983, 06-07 Permit: 83A-4951 Insert PLAN NUMBER APPLICATION/PERMIT PERMIT BER 51
(') SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE,WASHINGTON 99260 / (509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. (W) i -I LEGO& DESCRIPTION - SEE ATTACHED
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2.
OPHONE
t(CIV'6,(2
3. c_r\r\ 4a, l i cl -
ADDRESS ZIP Actual Set Backs in Feet
North 'South East (West
CONTRACTOR
PHONE Size of Parcel Zone Classification
Ottel
4' DD _ �� Z a Type Const. Occupancy Sprinklered C 4 *
1c , 6i't22 0.0 0
�� ( ulA_k� ❑Yes ❑No 0 Req'd.
DESIGNER PHONE Valuation Building Area in Sq. Ft.5.
* c c
ADDRESS ZIP Main Floor Upper Floors Garage Area Storage _
495.c
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6. Gt --J7-83
No.Baths No. Stories No. Rooms No. of Dwellings z 6 4 7 9
TYPE KNEW 0 ALT. 0 AD'N. 0 RPL. 0 MVE.
7, OF ❑ OTHER
WORK ❑ BLD. 0 PLMB. MECH. 0 M.H. ❑ POOL CERTIFICATE Req'd. Recd. Not Req'd.
Dof EXEMPTION
ESCRIBE W RK Enum. Dist. I Location (Area)
� � J - FEES COLLECTED
I
VALUATION SOURCE GAS EL TRIC WATER SEWER Ownership USE CODE
OF
9. UTILLITIES Public 0 Private D
Single $
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 Building
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or local law regulatine construction or the
performance of construction.SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing -
. di
DATE OF APPLICATION Q��X( SIGNATURE OF APPLICANT .)_*,i S. t. `i Z.I( k f Mech. ®'
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check _
Env. Health
SEPA
Planning Q
Fire Marshall Mobile Home '
a
iii:
Co. Engineer Other(Specify)
Utilities TOTAL $ -0.
Plans Examiner
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA Checklist THIS BECOMES A PERMIT.
0`6 -07 -83 495. 1'z *20.00 °
:yy n.ician r PERMIT IS NONTRANSFERABLE
1 PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL