1983, 03-21 Permit: 83A-2054 AdditionNUMBER APPLICATION/PERMIT
SPOKANE COUNTY — DEPART 'FNT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, .v^SHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES —PRESS HARD TO MAKE 3 COPIES
STREETADDRESS PARCEL NO.
LOT I BLOCKSUBDIVISION LEGAL DESCRIPTION:
i�r, � '"Cow �•c� ATE
OWNER PHONE PHONE
3. y eQ C 0 wcz_ � 4(--c cno I,
MAILING ADDRESS
r. , k C>CA t.'2. 4� `i
CONTRACTOR
4.s� r�
ADDRESS
C- - iS-S�C
-T4�
ZIP
qei -6(.%
LICENSE EXPIRES PHONE
J Z el C-( 24�
ZIP
4ggc l/+
North South East 122 1 West
Size of Parcel Zone Classification Residential L�
t C'a v i.ZS Commercial C
Type Const. Occupancy Sprinklered
. V—;30 ❑Yes ❑No ❑Req'd.
tb
DESIGNER
PHONE
N wConst. Valuation
Remodeled Valuation
Total Bldg. Floor Area
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 (-bt;. �
lt<.-324-
—"
(et ( .
5.
Plumbing
SIGNATURE OF APPLICATION
OWNER OR AGEN DATE em
Mech.
SPECIAL APPROVALS
SP IAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
t j � 't
ADDRESS
PRELIM. ,FINAL DATE
ZIP
Main Floor Upper
Floors
Garage/Storage
Greenhouse
o(�
Planning
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basem
6.
Prevent.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TYPE ❑ N, W ElALT.
�AD' N. ElRPL.
11MVE.
-L
7.
OF
Imo!" . ❑ . ❑ . ❑ H.
WORK BLDPLMBMECH. M.
POOL
1:1 POOL
Certifi. of Exempt.
Required
Yes No
Number
or Variance
Received
Yes 1:1 No❑
8•
DESCRIBE WORK
—V-1
Shorelines/ Flood Hazard
Plans Required
-AC);DyT,Oka -ZO
j
Yes❑ Not Applin ❑
Received
VALUATION
I SOURCE
OF
GAS
ELECTRIC
WATER
PUBLIC 11
SEWAG
SEPTIC ;€/ 0
Ownership /
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 (-bt;. �
work will be complied with whether specifipT, herein or not. The granting of a permit does not presume to give au-
thority to violate or cancel the provi ' nsny of state or local law regulating construction or the performance
&f
of construction. SEE RE E SI EQUI D INSPECTIONS
Plumbing
SIGNATURE OF APPLICATION
OWNER OR AGEN DATE em
Mech.
SPECIAL APPROVALS
SP IAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
t j � 't
Plan Check
PRELIM. ,FINAL DATE
Env. Health
j
SEPA
Planning
Modular/
MFG. Home
Fire
Prevent.
Other (Specify)
F,,, i—
Utilities
SEPA
Plans PERMIT IS NONTRANSFERABLE
k Exam. &, PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building 1 IN 180 DAYS
PERMIT NUMBER
i , - ;a-dS4-
"2 * 1 38.00
* 1 380061
A *0,00 00
205.313.&4t,7.83
TOTAL $ybs.ca I
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE "Ed 2 1— 8 3 PERMIT U5, 4 z * 1.3 S. 0 0Tob1~AL
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