1983, 12-23 Permit: 83B-2762 Insert PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY 0313 - 7CG'
NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
/ APPLICANT: COMPLETE NUMBERED SPACES— PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS �, J PARCEL NO.
LOT / BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWN R PHONE PHONE
3. /1%7 LYA-,9U,/ ,L Y /may
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
;9/1,&-- i ,62�d j/ .-- North 'South East I West
CO TRACTOR LICENS /E(PIRE ,/PHO Size of Parcel Zone Classification Residential C
4 .E_�.57 /t,�Z7-7 11,/A r. •6/3 . /'Y/ `J—/G/',_ Commercial
A,DDDRESS,SpG,/�/J � r„e�G, 7/, 4 �,E/t/7 2IP Type Const. Occupancy Sprinklered
/Y >.,i74..6-- Z)> ✓/_5/e?/✓ 972-'G��{..- ❑Yes OW ❑Req'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor 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.
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE R'NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ OTHER
WORK
CI BLD. ❑ PLMB. ZMECH. ❑ M.H. CI POOL Certifi.of Exempt. Required Yes El No ' Number
or Variance Received Yes IE No❑
�sCRIBS WORK / `y/ Shorelines/Flood Hazard Plans Required❑
8.� <i T /Ht/dn/ /d,D , fit, _L A/J E 7 YesE Not Applic.❑ Received ❑
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
9OF
UTILITIES PUBLIC❑ SEPTIC❑
PRIVATE C SEWER❑ 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 SID, OR REQUIRED I •PECTIONS Plumbing
SIGNATURE OFAPPLICATION
OWNER OR AGE a.� .' DATE -----��� � � Mech. vE�i e'
SPECIAL APPROVALS S','CIAL CONDITION . (SEE REVERSE SIDE FOR NOTICE) '
PRELIM. FINAL DATE Plan Check
Env.Health
SEPA
Planning Modular/
• MFG.Home d
Fire
Prevent. 0
Engineer Other(Specify) W
J_
Utilities l� LL
TOTAL $ ?/0 t •
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 qM IN 180 DAYS 11 0o J
Tech. ,z1,' DATEIISiUE& 3 — 8 3 PERMITrJd6.6. 2 * 2 O.0 0 COITAL