1983, 05-19 Permit: 83A-4300 Addition PLAN MBER •. APPLICATION/PERMIT PERMIT NUMBER
/TO-- SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY E35/ - 1.3a.D
( NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. 6 ( ( opo Zo - 85y2 2-30
LOT BOCK SUBDIVISION LEGAL DESCRIPTION:
2. I, Co I I Co Vv‘c, To w f1S i 4-G
OWNER ONE PHONE
3. VJ'tL.sd>t\t Wh'l4-c1nelR 421a-MSD
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
I(O2-t 2) North 'South S East — I West
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential❑
4.
( aw(A 5 1 1. _c{�acz'Z.1 i 1 k 0 It I> V Commercial❑
ADDRESS ,� , 1, ZIP Type Const. Occupancy Sprinklered
N (l`oS C>54}1015‘o-Ne) pe N.)
❑Yes OW ❑Reg'd. 62 j
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area * Q (: U 0
5. 900)3 "_ 'VA 2-
ADDRESS ZIP Main Fl ,oorn Upper Floors Garage/Storage Greenhouse
L. ...-- _— £. L
� _ L
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
6. — I < :,
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE KNEW ❑ ALT. AAD'N. El RPL. El MVE. 1
- ,
7. OF ❑ OTHER
WORK ❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL C aid. Exempt. Required Vest: NoeNumber
or ReceivYesE No❑
WShorelines/Flood Hazard/ Plans Required❑
8. DESC i IBE�ORK- �- QatX to
Yes Not Applic. Received ❑
VALUATION SOURCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
PUBLIC❑ SEPTIC❑
9•
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
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 I Z. APPLICATION Ay/ gt
OWNER OR AGENT l: 4--,r DATE v Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:(SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE Plan Check
nv.Health {{fi�fth
t' -1 SEPA
Planning ,,, Modular/
MFG.Home ).,
Fire a
Prevent. p
Engineer • Other(Specify) _ _ W
J_
Utilities 01 i 5 ....
TOTAL $
SEPA
PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE,
fplans led 7 .45 THIS BECOMES A PERMIT.
Exam. �,((� PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED 4 j
ecBuilding itit t _'- / "? IN 180 DAYS TIL 19 —8 3 PERMIT NQ. —O z * 9 6• O TOTAL
41 DATE I`O" ED
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N y
E. JFb .o 20T4
36 SCALE: ' APPROVED BY: DRAWN BY '
DATE: REVISED
it
P .� 2.55 Li M„?c701 ~ Or Site laa x 130
DRAWING NUMBER
Lep) LOT I , Z BRI1NIK TOWNS Tr E:
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