1982, 11-22 Permit: 82B-1303 Insert PLAN NUMBER APPL ICAT ION/PERM IT PERMIT NUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY ' Sz - 1 abs
0 y NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. E,. 1 0(D i'- 11.1- -4
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. /, i
OWNER PHONE PHONE
3. F� t I\Aie-,i C t/ L)1'tEt_n G(
MAILING ADDRESS ZIP� Actual Set Backs in Feet to: , ,,
E, r CLCD t Z. t l Tt+ Ci0(Z North I South East I West
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑
4. C AL 6/1 »`/ . 43 Commercial❑
ADDRESS ZIP/� Type Const. Occupancy Sprinklered
t_._ 14Cl --5-1-N k �cl2-0- ❑Yes ❑No ❑Reg'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Fioor Area
5.
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse -
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
6.
TYPE No.Baths No.Floors No.Fin.Rooms No.Dwellings
NEW ❑ ALT. ❑ ,9D'N. ❑ RPL. ❑ MVE.
7. OF WORK CIBLD. ❑ PLMB. 0MECH. ElM.H. IDPOOL ❑ OTHER Certifi.of Exempt. Required Yes❑ No Number
or Variance Received Yes No
8 `DE`$CRIBE WORK Shorelines/Flood Hazard Plans Required❑
WC)L I ) t I r3(., i v\150� Yes Not Applic.❑ Received ❑
VALUATION SOOURCE GAS ELECTRIC PUBLIC El SEPTIC❑WATER SEWAGE Ownership FEES COLLECTED
9 UTILITIES PRIVATE❑ SEWER D 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
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 FOk / 1I/
(WIRED INSPECTIONS Plumbing
SIGNATURE OF „ , `61 p 7OWNERORAGEN L DATE X //—02a—r3 iL Mech. 44 --"Z .QO
SPECIAL APPROVALS SPECIAL CONDI ONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health
SEPA
Planning
Modular/
Fire
MEG.Home
Prevent.
O.
0
Engineer Other(Specify) C.3
W
J
LT
Utilities
TOTAL $ '4:5'
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
Plans PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Exam.
9r4
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCEDlj zJBerrying i J IN 180 DAYS DATE iSS�ED2 2 -82 PERMIT�17. O'" z * 2 O'0 0