1983, 08-02 Permit: 83A-7280 Residence PLAN NUMBER. APPLICATION /PERMIT PERMI NUMB R
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY e---A " 1-tc60
NORTH 811 JEFFERSON/SPOKANt,-WASAINGTON 99260/(509)456-3675
L APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
1.
STREETI I IRI i� PARCEL NO. 4. —:2 — Z300
LOT BLOCK SCJ zap ION LEGAL DESCRIPTION: L
2. 7 �o o MO -ciAll•�i f6 W �- / - 9
OVyNfRLa, .��� PHONE PHONE
3. M I NG Dp RESS , moi nI 3 pZLP_�n Actual Set Backs In Feet to: r
- I 1 . 1, �Qf/�.9 0( North /j [South East 1 5 I West t0 Li I0
C� RGACT_ OF] LICENSE EXPIRES �1''"r 7 Size o--7 . I �� Zgs. . Lion ' Commercial❑ ' !..
4. ADQRE$l N ' "riot,
l/ Ia. _ a, Type VII. 1 Sprinklered
Qi�F ` ❑Yes ❑No ❑Req a.
DESIGNER PHONE Newconst.ValuatioFgarpi
Remodeled Valuation Total Bldg.Floor Area �--..
5. `t6 2-0 G --
ADDRESS ZIP Malg..Elogr Uppgl 9rss Garage/$tpraD._ GreP berme
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement�'r `' Unfi�Base t
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE24/EW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF
WORK BLDPLMB. ❑ MECH. M.H. OOL ❑ OTHER
? . ❑ ❑ . IDCertifi.ofExempt. Required Yes No❑ Number
or Variance Received Yes No❑
8 DEI _Il3E i KZ / Shorelines! otAppazard Plans Required
I kv C7 R
Yes El Not Applic.0 Received
VALUATION SOURCEOGA L� PUBLIC SEWICGE Ownership FEES COLLECTED
9. F
UTILITIES PRIVATE 0 SEWER❑ Public 0 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 32I
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au- Building
thority to violate or cancel the provisions of any other -tate or local law regulating construction or the performance
of construction.SEE REVERSE SIDE OR REG IRE 0 NSPECTIONS Plumbing
SIGNATURE OF 43
OWNER OR AGENT . _ /.ter _I/V.-_ /_ DATE APPLICATION n_2-Zw P Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: (- E REVERSE SIDE FOR NOTICE)! a
/ 14A -2.-:;2.,
2 p�) Plan Check
PRELIM. FINAL DATE ]N C
(��
Env.Health �(�
$ I� !/dC1 SEPA
Planning
Modular/
Fire MFG.Home y,
Prevent. 0
O
Engineer IRq�7 _ FOL)�.) kA7'® Other(Specify) v
W
J_
Utilities Lam/
TOTAL $ I i+-
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
Plans / T PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Exam. yir /�'1 PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED ((�� RRz 7 ?
cBuilding �, •y IN 180 DAYS DATEYS,UEC 2 —8 3 PERMI 7N9.8. 0 z *3 2 1. 0 0 ;OITAL
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