1983, 05-12 Permit: 83A-3980 Residence PLAN NUMBER APPLICATION/PERMIT . . PERMIT NUMBER
E53 -occs SPOKANE COUNTY - DEPARTMENT OF BUILDING &SAFETY S.AE)0
0/ NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO. --
1. / Gly'/6 /C/2! ,2C',5-1// - /E-r,i
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. -- ! _Lx=<<rPi it)or./44,S ,7 Oki -
OWNER
" r7 /� PHONE
(, PHONE c // l/ v7d J1 ` ,�1
•
3. !C . /L c 7- /ms sS'c°' /9 V£( y ADDRESS �Ip /0% .✓ fese-6< / e-5 ii) 4 !!�s>AeS !1 lL(
eet to:
P C?
MAILING
t/c L� Fsf G{y K L CJS [/ Actual Backs in iSouth . East L t I West 22C.Dt
CONTRACTOR T LICENSE EXPIRES PHONECSize of Parcel Zone Classification Residential qv ; ;
4. /if?/ E-- _ %(,,-6- X 1"1`3 0--1- Commercial 0
•
ADDRESS ZIP T t. Occupancy ❑Yes �rinklered
❑No ❑Req'd.
1, _ 3 rK A
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
5. 1 ).S4fz 4 1 LA.
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse
i v • — q 3(.
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
6. -- t 5'30
No.Baths No.Floors rNo.Fin�ooms No.Dwellings
TYPE XNEW El ALT. El AD'N. 0 RPL. 0 MVE.
7. OF WORK XBLD. 0 PLMB. ❑ MECH. ❑ M.H. 0 POOL ❑ OTHER Certifi.of Exempt. Required Yes Not Number
or Variance Received Yea❑ No❑ ---
DESCRIBE WORK,. _ /M"C Shorelines/Flood Hazard Plans Required��
8. r «t /-
pt/A.' "NLS /c
, l-t(()trr c* u-/ � �JfYes❑ Not Applic. X
Received
VALUATION SOURCE GAS ELECTRIC (`WATE SEWAG Ownership /
9 OF
UTILITIES PUBLIC SEPTIC?
PRIVATE 0 SEWER 0 public 0 Private�l FEES COLLECTED
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 4,2'.
.O�
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 REQUIRED INSPECTIONS Plumbing
SIGNATURE OF ----.7---
F ---.7� /�f APPLICATION // 1-3
OWNER OR AGENT '`t-- ��'_ DATE Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:(SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
Env.Health
70tleef0 S 5 SEPA
Planning
Modular/
Fire MFG.Home !
Prevent. a
O
Engineer Other(Specify)
.tet W
'p, ...-
Utilities 21kLL
eV
TOTAL $ �-
SEPA
PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE,
Plans THIS BECOMES A PERMIT.
Exam. ‘,4Y'',/;,,,,'--
.s PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building
//4;9?Tech. IN 180 DAYS DATEYSSUEtil 2 -8 3 PERMIT .8. 0 z * 418, 0 0 R ;AL
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