1983, 12-08 Permit: 83B-2374 ResidencePLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & rAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1. wc'���
LOT BLOCK
2. /
/7 I
SUBDIVISION
CC u, f --!i c4O rrn S cld
arae
PARCEL NO.
OWNER
3 ZN• S . 4Ss
M LING AD5 X % C.1 ?//'
PHONE
7 L.(:Cig'5.
PHONE
ZeoS4- t -2:70
LEGAL DESCRIPTION:
./c2- /
S72" -1-4-S72"-1-4-/ �a!Y) s. 74 G4
ii
ZIP
Actual Set Backs in Feet to:
North
' South % 417
East / I West
CONTRACTOR
4
ADDRESS
LICENSE EXPIRES
PHONE
Size of Parcel
% C't X P---3()
Zone Classification
Residential'!
Commercial ❑
ZIP
Type Const.
Occupancy
37'N rh
Sprinklered
❑Yes > to ❑Req'd.
DESIGNER
PHONE
N. Const. Valuation
.2.
Remodeled Valuation
Total Bldg. Floor Area
t,"<k)
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
CHANGE OF USE FROM
TO
Cover Deck
Fin. Basement
Uncv. Deck
TYPE 1)NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF WORK JBLD. E PLMB. ❑ MECH. ❑ M.H. ❑ POOL ❑OTHER
No. Baths
No. Floors
No. Fin. Rooms
Unfin. Basement
rf
No. Dwellings
Certifi. of Exempt.
or Variance
Required Yes No
Received Yes E
DESCRIBE WOR j
S-',',/, [" / -"ill, ly ieS ldt..F C.,a
VALUATION SOURCEOGAS ELECTRIC
9 UTILITIES ‘f1p y
Shorelines/Flood Hazard
Yes Not Applic.X
R SEWAGE
PUB ICC. SEPTIC:K.
PRIVATE ❑ SEWER
Ownership
Public O 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
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
SIGNATURE OF
O // APPLICATION
OWNER OR AGENT iY�l��-!T� � �.���rtr.�_� DATE 4/d ✓. l 0, I ?
'ice e
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
7
P,eV1SCr> ?t.wavv
txrft-
L .??Erz : (074`P'
-244g1 /F 3
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Non
Number
Plans Required
8. Received'\
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $ .Op
PERMIT NUMBER
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE
s 008+8,3
PERMIT NO. 7. 4 z *538.002p'
TOTAL