1982, 12-02 Permit: 82B-1590 Addition PLAN NUMBER _ •
APPLICATION/PERMIT ' PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY 52.5 ` 15ge,
NORTH 811 JEFFERSON/SPOKANE,WASHINGTON 99260/(509)456-3675
(-1‘
'
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. E - 116 4-- .2-2.4`1' Z SSA — -.:1 CA n
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. 1 exLEA..1Q i w A<c-eto- `
OWNER PHONE PHONE I ! -
3. E- S �><... 2,7_--"Bot
MAILING ADDRESS ZIP Actual Set Backs in Feet to:
E • 11B24- 2a '1 Cli North . t 'South East I West 5
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residentialte".
4. AWE 11 o '- I.j- Commercial❑
ADDRESS ZIP Ty=Const. Occupancy Sprinklered
i4=XrYIL SI.(Q WI-% ❑Yes 0N ❑Reg'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
5. ti 4-E:58 1Z-•
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse
- — 7L
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
6. - .._-
No.Baths No.Floors No.Fin.Rooms No.Dwellings
7.
TYPE L7/�NEW El ALT. 'AD'N. ❑ RPL. ❑ MVE. ❑ OTHER i
WORK ta1BLD. ❑ PLMB. 0 MECH. ❑ M.H. ❑ POOL Certifi.of Exempt. Required Yes❑ No❑ Number
or Variance Received Yes❑ No❑ /
DESCRIBE WOR f` Shorelines/Flood Hazard/ Plans Required
8. -.�-1. E tcmn'.;L04.1 -'�4 -Rts:4EN C.E-tqc Si,,. eAU Yes Not Applic. Received
VALUATION SOOUFCE GAS ELECTRIC WATpUBLICR@f SEPTIC la OwnershipFEES COLLECTED
9. UTILITIES PRIVATE❑ SEWER 0 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 Building 'it 30,00
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 FO' • . i RED INSPECTIONS Plumbing
SIGNATURE OF e'__ /> APPLICATJpN a Mach.
OWNER OR AGENT- — "� DATE
SPECIAL APPROVALS SPECIL 'ONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE \\. Plan Check
Env. Ith t
}/ 2i„ '
R-0 L-•.- SEPA
Planning
Modular/
MFG.Home �,
Fire
Prevent. a
O
Engineer
Other(Specify) V
W
J
Utilities
TOTAL $ .E
SEPA
PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE,
Plansi �/„ THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED 1 p 1 S n
Building n� IN 180 DAYS DATE I IEDO 2 o PERMIT Nd r'0 z *3 O' O 0 °i
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