1983, 02-18 Permit: 83A-1174 Finish Basement PLAN NUMBER APPLICATION/PERMIT PERMIT NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING &SAFETY 0-3A - 1� 1-
Oi -NORTH 811 JEFFERSON /SPOKANE,WASHINGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. I . 11 22 2 �'zis..:: 2 e, Z- Sz. *
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION: Lo-c 1 4 E.3'7' o r LOT 1 k3sJ4•2
2. OF iKoicO;�O -VOLA fres * -'
OWNER PHONE PHONE
�at'v\. COLL- cy�e,-e���.-
3. MAILING ADDRESS ZIP Actual Set Backs in Feet to: alk t '1 tr. 1 1 r,
E : \\4-Z: "2-,,74 Ci "D.QG. North 'South East `West — 1 — t
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential Ec
�RYY\E _ Commercial❑ ' C
4. ADDRESS ZIP Type Const. Occupancy Sprinklered
Y1'tE r31J 12—'7:-.. ❑Yes ❑No ❑Req'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
ADDRESS ZIP Main Floo„r�„ Upper Floors Garage/Storage Greenhouse
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
6. - Code,
TYPE El NEW I f ALT. ❑ AD'N. ❑ RPL. ❑ MVE. No.Baths No.Floors No.Fin.Rooms No.Dwellings
7• OF /� ❑ OTHER
WORK I3BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL Certifi.of Exempt. Required Yes II Not ' Number
or Variance Received Yes❑ No[V7
DESCRIBE WORK Shorelines/Flood Hazard Plans Required❑
128. � Yes❑ Not Applic.❑ Received Is /
IfU.�=r-+ B��MiENT ��bTtiIOYV hF�
VALUATION SOURCE GAS ELECTRIC WATER • SEWAGE Ownership
OF PUBLIC❑ SEPTIC❑ FEES COLLECTED
9 �t^J tt� UTILITIES PRIVATE ElSEWER❑ Public 0 Private
k
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 REVERSIDE FOR REQUIRED(/ INSPECTIONS�TPlumbing
OWNER OR AGE,,T �L '�1SIGNATURE OF �k w / ���"� DATECATI _t s7_ Mecn•
i •
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
•
PRELIM. FINAL DATE Plan Check
•
Env.Health
t• SEPA
Planning
Modular/
MFG.Home r
Fire d
Prevent.
0 )
Other(Specify) C)
Engineer 111
Utilities W
:Z. .Ori
. TOTAL $
SEPA
PERMIT IS NONTRANSFERABLE WHEN MACHINE VALIDATED IN THIS SPACE,
Plans THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building X24/% IN 180 DAYS (� -,1 8 _8 3 1 4 0 0
Tech. //��'' DATEYSSUED� PERMIT�I<�.7. Z * 2 O. 0 0 &AL