1983, 05-27 Permit: 83A-4574 Piping PLAN NUMBER APPLICATION/PERMIT ' PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY &9/6\ zi-574-
(_. NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO. F
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2.
•�j - PHONE PHONE
3. Ill wie
s h-
rING ADDRESS ZIP Actual Set Backs in Feet to:
3 0' LI 2_,s d.. v North I South East I West
4. CQN� i TrOR, ` t^ iC LICENSE EXPIRE417E8-91
/1 .f Size of Parcel Zone Classification Residential❑ 9 0
jf�\ C. `\T X't .�C� Commercial❑ ) * * 1 / U C'
.—ADI/RE*S$ C 1 j ZIP J, Type Const. Occupancy Sprinklered * 1 9 0 0
A-V I-c k �+lP -- (lc'2- Z_ ❑Yes ❑No ❑Req'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area A * 1. C i'
5. - Li- 57.3
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse
5-2 7- :` 3
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
6. E 4 '7 9.
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TYPE ❑ NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OFElOTHER
WORK ❑ BLD. ❑ PLMB. L.-Mt-CH. ❑ M.H. 1=1 POOL Certifi.of Exempt. Required Yes No❑ Number
or Variance Received Yes No❑
DESCRIBE WORK Shorelines/Flood Hazard Plans Required❑
8• C p Icer- cote__ _c.-3(p/A-- k^} Yes Not Applic.❑ Received ❑ f
VALUATION S RCE GAS ELECTRIC WATER SEWAGE Ownership FEES COLLECTED
9 OF
UTILITIES PUBLIC❑ SEPTIC❑
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.SEER ERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
SIGNATURE OF - >7, - APPLICATION _ a 0
OWNER OR AGENT .CA DATE /
L Mech. 172L_
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) �
PRELIM. FINAL DATE Doi
I I l�i Plan Check
Env.Health IV 1 ^e ID 6Q, i wz 4n 11e d
SEPA
Planning
LO WP'
Modular/
Fire L * led
MFG.Home �.
Prevent. C) ,^ ^ —Fr be_ I rQ S IA f lel! I I
Engineer 00 Other(Specify) _ W
J
Utilities 1"--" c, 1.0c)te5V11 + ,
LL
SEPA 1 %41r I-7 Mc� TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
Plans - PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building 1�7 IN180DAYS 05 -27 -83 457, 4 ° * 19, 00a_
Tech. z DATE ISSUED PERMIT NO. TOTAL