1983, 12-19 Permit: 83B-2642 Insert PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING &SAFETY %'B ' 24.4 -7-
NORTH
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. 13408 13th
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER PHONE PHONE
Kim Warner 928-3909
3. MAILING ADDRESS ZIP Actual Set Backs in Feet to:
E. 13408 E. 13th Spokane, WA 99216 North !South East I west
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑
4. Vel]ey FireplAce 1/1/84 922-2780 _ commercial❑ c'. Y
ADDRESS ZIP Type Const. Occupancy Sprinklered
E. 16610 Sprague Ave. Veradale, WA 99037 ❑Yes ❑No ❑Req'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area 1
5 Contr. License #TALLkF-177CG -
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. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER
❑ BLD. ❑ PLMB.,ZMECH. ❑ M.H. ❑ POOL Certifi.of Exempt. Required Yes No❑ Number
WORK or Variance Received Yes No❑
DESCRIBE WORK X151-V 6) Shorelines/Flood Hazard Plans Required❑
8. Installation of LOPI "SX" Insert into P1i"asonry it plaocm. Yes Not Applic.❑ Received ❑
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
9 PUBLIC❑ SEPTIC❑
PRIVATE❑ SEWER❑ public❑Private❑
UTILILITIES
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 p formance
of construction.SEE REVJL
SE DiE FOR REQUIRED SPEC IONS 1 Plumbing
SIGNATURE OFAPPLICATION
OWNER OR AGENT �J G? aZ ^ c-14, DATE ' ji ' Mech. LU
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env.Health
SEPA
Planning
Modular/
MFG.Home
Fire d
Prevent.
O
_
Engineer • Other(Specify) W
Utilities '7 ' g,...9...
. LL
TOTAL $
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
Building ii Tech. 2/// IN 180 DAYSi �+ _� rq DATEJSSU!D— : i PERMIT,&. t', TOIAL