1983, 07-13 Permit: 83A-6433 Pool PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
.SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY . aS A Loci -
NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. t� • 145 1 ba T t-4 ZQa -C7f:::
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. 5 "7--e›-- .:a tce Aces 7-.+4‘..:
OWNER PHONE PHONE
3.-Dfa tv%EA- M . Ga t 421:),-Z.-7.1
Set Backs in Feet to:
MAILING ADDRESS ZIP Actual S ,/, /�J� 4-7—1602-t '•'J�
e- . eZn 0 8 1.04-1-t.' QC10- 7 North ,�c/ � South [East — I West..-1-er
-`_ NTRACTOR LICENSE EXPIRES PHONE Size of Pl. Zone Classification Residentialoa
4. cc, 1A.Do2i_,0 l•1/4.)4._• GI3•Es' r ; 1W2C ` 4047 Commercial❑
ADDRESS ZIP Type Const. Occupancy Sprinklered
1✓• k. ?.._"- rL$eal�l.E QQ7-1.C,, 317) INt--2.- ❑Yes 0 N ❑Req'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
5. ).C1 r
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
6. /
NEW ❑ ALT. 0 AD'N. ❑ RPL. ❑ MVE. No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE (i
7. OF OTHER
❑ BLD 0 PLMB. ❑ MECH. ❑ M.H. 11/1300L Certifi.of Exempt. Required Yes El Noe' Number
WORK or Variance
Received Yes❑ No❑
DESCRIBE WORK ' Shorelines/Flood Hazard Plans Required❑
s• A t r...{.n,v„bC, Test:5f-- GG--CX44J Yes❑ Not Applic.❑ Received ❑
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE, Ownership
�d�,XPUBLIC SEPTIC / FEES COLLECTED
OF
9 "rU Public❑Private ll) 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 .rovisions of any other state or local law regulating construction or the performance
of construction.SEE RE E- "SIDE FOR R•CURED INSPECTIONS Plumbing
SIGNATURE OF - 01111117171- APPLICATION i
OWNER OR AGE � �� .4.-Al:- - DATE Mech.
SPECIAL AP•ROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env.Health
Vi)P\ 1I� SEPA
Planning Modular/
MFG.Home >-
Fire G.
Prevent. O
C-.)5•aO
Engineer Other(Specify) zNJ
J_
Utilities Li.
TOTAL $ ZS'.en
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
Tech in9 s-2i).... IN 180 DAYS 15 —8 3 “ 5,) z *2 5.0 0 TOTAL
DATE 6D PERMIT
cLcvMI uN :
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5S1C: : Sq. rt. Scale: _ .500'.� Legal
1A-Case .
."'. Address. .�, •i/.
)rtgage Co.
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