1983, 07-12 Permit: 83A-6403 Pool PLAN NUMBER APPLICATION/PERMIT PE IT UMBER
. SPOKANE COUNTY — DEPAP MFNT OF BUILDING &SAFETY — (4447'3
(-,
NORTH 811 JEFFERSON/SPOKAN!WA HINGTON 99260/(509)456-3675
•
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
�y
STREET ADDRESS PARCEL NO.
1. 6 - i 5- 2..., Imo. .. '3 a4--- p/ 02--
LOT BLOCK SLI 'VISION LEGAL DESCRIPTION:
2. I I9
OWNER P ON PHONE
3. G 1�f4 rci c (L01n� 1+ —�- � c *
MA�t�4NG AD RESS Actual Set Backs in`Feet to:
Cf -. �� , �� (��� �D� North 'South lEast l West ; * �, C
CONT O LICENSE EXPIRES HONE Size of cel zqpeClassiff1ication Residential"
0 6 6 . Commercial❑ ,l1 * C
4. ADDRESS ZIP Type-ccyl$.l Occ ncL Sprinklered -
V t t ! V N ❑Yes ❑No ❑Req'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
- 1 L:
5. - f h 4 ;/ c;.
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse .
CHANGE OF USE FROM TO Cover Deck - Uncv.Deck Fin.Basement Unfin.Basement
6.
TYPENo.Baths No.Floors No.Fin.Rooms No.Dwellings s
JB1 EW ❑ ALT. LI AD'N. ❑ RPL. ❑ MVE.
7. OF � ❑ OTHER
WORK
El BLD. ❑ PLMB. ❑ MECH. ❑ M.H. •FI F OOL CeV�� Exempt. Required Yes❑ No❑ Number
or Received Yes Non
DESCRIBE OR Shorelines/Flood Hazard Plans Required❑
8. Sy�i Ml�� p Yes CI Not Applic.❑ Received ❑
V LUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
9 ,l _ LI PUBLIC LI SEPTIC Public❑Private
GNU UTILITIES PRIVATE❑ SEWER❑
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 FOR REQUIRED INSPECTIONS Plumbing
SIGNATURE OF _, '"'. APPLICATION
OWNER OR AGEN -- ,% DATE Mech.
SPECIAL APPROVA ' SPECIAL CONDITIONS:(SEE REVERSE SIDE F OTIC 7
PRELIM. FINAL DATE Plan Check
Env.Health
SEPA
Planning Modular/
MFG.Home a
Fire
Prevent. .m2I 0;
Engineer Other(Specify) W
Utilities LL
_ TOTAL $
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
Plans PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building V IN 180 DAYS 7+,, z ��jj QQ d * O J
Tech. `� �� DAT�SSUE� - 3 PERMITNO.O' 3 z 2 5.O O 4�Ti4L
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