1983, 08-04 Permit: 83A-7352 Insert PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY ' N -7 352-
G l$j'
NORTH 811 JEFFERSON/SPOKANE,WASHGTW1 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. E. 11112 - 17th
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
OWNER PHONE PHONE
Tom Hoye 924-3793
3. MAILING ADDRESS ZIP Actual Set Backs in Feet to:
E. 11112 - 17th Ave. Spokane 99206 North (South East I West
CONTRACTOR LICENSF EXPIRES PHONE Size of Parcel Zone Classification Residential❑
4 Valley Fireplace, Inc. 1/1/84 922-2780 Commercial❑
ADDRESS ZIP Type Const. Occupancy ❑Yes SprinkleredNo ❑Req'd.
E. 16610 Sprague Veradale, WA 99037 0 4 * * 2 0 0 0
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area * 2 0.0 0 6
5 Contr. License # VALLEF-177CG
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse F * 0 0 0 3
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement 7 5 J' 1
6. 0 — 0u-83
/ No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE VNEW ❑ ALT. ❑ ,,D'N. CI RPL. E MVE. E /i 7 9.
7. OF WORK ❑ BLD. ❑ PLMB. MECH. ❑ M.H. ❑ POOL ❑ OTHER Certifi.of Exempt. Required Yes❑ No❑ Number
or Variance Received Yes❑ No❑
DESCRIBE RK Shorelines/Flood Hazard I Plans Required❑
8. Ins-calatlon of Lopi - SX Insert. Yes Not Applic.❑ Received ❑
VALUATION SOOURCE GA.., ELECTRIC PUBLICWATER❑ SEPAGE TIC ElOwnership FEES COLLECTED
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 REOU : D INSPECTIONS Plumbing
SIGNATURE OF '� �`�- 0� APPLICATION �� 7-0_
OWNER OR AGENT - �J" - DATE Mech.
' SPECIAL APPROVALS SP IAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE!
PRELIM. FINAL DATE f� Plan Check
Env.Health
SEPA
Planning Modular/
Fire MFG.Home
Prevent. 0-
d
O
Engineer
Other(Specify) C.3
LU
J_
Utilities W
TOTAL $ 2
SEPA
MACHINE
Plans PERMIT IS NONTRANSFERABLE HEIS BECOMES A PERM TTED IN THIS SPACE,
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS DATE ISS — QM PERMIT NO/ "5' 2 z k O'Onn TOTSAL�
Tech.
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