1983, 11-28 Permit: 83B-2058 Siding, Soffit, Fascia PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER '
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY 15 .: u95
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 . IOt 3— j( 1-DI-ds- N
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER PHONE PHONE
3. Carr F. 7c)hn.‹,, Jr-. class-& 4
MAILING ADDRESS �.dd ZIP Actual Set Backs in Feet to:
' J o I, � — I L=) Ci`Le(ci North 'South East `West
CONTRACTOR (� LIC NSE EXPIRES PHONE Size of Parcel Zone Classification Residential El
4. i c' 11 act Int L rs 51 131 9-1- 60 -- /, S Commercial❑
ADDRESS ZIP Type Const. Occupancy Sprinklered
N: 3/O(,� , C fYlx.. Roo A Ctcj � I c;,.. ❑Yes OW ❑Req'd.
DESIGNER ( PHONE New Const.Valuation Remodeled Valuation Total Bldg.Fioor Area
5. _ ._ * * c, 0 0
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse
* 6x00
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement 'Unf in.Basement A * 0 ,, c.
6.
TYPE ❑ NEW ❑ ALT. I=1 AD'N. ❑ RPL. ❑ MVE. �{ 'No.Baths No.Floors No.Fin.Rooms No.Dwellings c' ( 7 -
7 WORK ❑ BLD. El OF PLMB. 121 MECH. CI M.H. ❑ POOL r``jOTHER Certifi.ofExempt. Required Yes❑ No❑ Number s C. `'t—
ricY c Y or Variance Received Yes❑ No❑ ( /� 7 ,Q
8 DESCRIBE WORK r� 7 ! C Shorelines/Flood Hazard Plans Required El
.SIcU.t' i ) f"❑'1. 4 T7(_Sl / Yes❑ Not Applic.D Received ❑
VALUATION' SOURCE GAS ELECTRIC WATER SEWAGE Ownership
9 C 3 J`• c-. OF PUBLIC E SEPTIC❑ FEES COLLECTED
J �- UTILITIES PRIVATE❑ 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 60 :0 )
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 REO 1 D INSPE ONS Plumbing
SIGNATURE OF APPLICATION `/45-.
OWNER OR AGENT DATE Mech.
SPECIAL APPROVALS SPECIAL COND IONS- (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health
SEPA
Planning
Modular/
Fire MFG.Home
Prevent. d
O
Engineer Other(Specify) V
LU
—J
Utilities //__ ty
TOTAL $r�• c_>
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 \, I/
Tech. 11 11 )) ((�� R d Q O J
IN 180 DAYS DATEfS3UED2 8 -a 3 PERMIT
5, 8 z * 6 "' 0 O tot-4
V