1982, 12-29 Permit: 82B-2365 Residence PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING &SAFETY P2'.- 6- 2__ 5
NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREETA DRESS PARCEL NO.
. 9 1,4,020r2 i 4'r 3 4 4 `— i )-0 5..1, 74-116K1/
2 LOT `� B Ot,K susD IsION � �`� - �� � LEGAL DESCRIPTION:/s . Iz5 l �� to c.r
OWNER ya I ON PHONE Nl (� OF �id o �er3
�� N/. Actual Set Backs in Feet to:
3. ef.....48783
MAILING I ADDRESS j '1 + I ' (r., North South
'' i'JEast west
CON RACTOR r� LICENSE EXPIRES HONE Size Par I Line CI ification Residential Cilr. b , - r. i i�1 U
6. .' 13L I VI � 1 �,�^� 14' �2, ?_ C 17,5 f� -' Commercial❑ f '� i� �r
4. ADD SS ./ �C�, /� J � IP O Type�C/g,nyp Ocqu ncy Sprinred --
• I ���I",fi`�I!'cIti1 �'V ❑Yes C�TNo ❑Req'd.
DESIGNER I PH NE New Const.Valuation Remodeled Valuation Total Bldg.Floo,rea �z
5. . '3750 1-rj_ 117
ADDRESS ZIP Maig Floor Upper Floors Garage/Storage Greenhouse
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement U(nnffin.�ert
6. No.Baths No.Floorso.Fi -ooms Nowellings
TYPE idW ❑ ALT. ❑ AD'N. ❑ RPL. ElMVE. �� -. ;ir (e,7• OF ❑ OTHER
WORK D. ❑ PLMB. El MECH. ❑ M.H. ❑ POOL Certifi.of Exempt. Required Yes No❑ Number
or Variance Received Yes No Qom,^` 2[4.
DESCRIBE WORK ,/� Shorelines/FloodHazard Plans Required■'
8. t 15d i t,1" i 1i W �" � Yes❑ Not APPIic.❑ Received
VALUATION SOURCE GAS ELE I WA—ER / SEWAG Ownership
9. LI PUBLIC ci SEPTIC Public❑Private I FEES COLLECTED
• 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 stater local law regulating construction or the performance
of construction.SEE RE ,;.,•SE SID: OR •EQyIRED IN/CTIONS Plumbing
SIGNATURE OF / APPLICATION/
OWNER OR AGEN A/i/ �. , . . DATE t Mech.
SPECIAL APP' •VAL' ONDITIONS:(SEE VERSE SIDE FOR NOTICE)
PRELIM. FINAL DAT 4 ico �� r® / Plan Check
Env.HealthPIA 11�JJJ����" ��/r— IG �
Planning
t'V t A.1: 1 4- ( " �I . fr.7M'1 r 1 SEPA
Fire F Modular/ �,/�
MFG.Home leo
a
Prevent. p
Other(Specify) v
Engineer -ssi? (kt' J
�'i LL
Utilities jj Qy
_ TOTAL $ I �a
SEPA
PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE,
Pram. \�0 t2r THIS BECOMES A PERMIT.
Exam. �� I/ PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCEDBuildi11 •R //,� S
Tech. IN 180 DAYS DATE-4S�UE� _ 2 PERMII �.U J Z *1 5 4 0 0 `gin AL
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