1983, 05-13 Permit: 83A-4063 Pool PLAN NUMBER APPLICATION/PERMIT ' PERMIT NUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY a 1" `4C- �3
NORTH 811 JEFFERSON/SPOKANE,WAS 1INGTON 99260/(509)456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STR ADDRESSI714 o , PARCEL NO. 2,75_4-2 .Qc., I
1. �
2 LOT BLOCK sI-1UBI BION 1- , C_.•� 2-N 0 OO LEGAL DESCRIPTION:
•
3. ONNglo I'V ' ` I lj7��ri . j ✓17 PHONE .
MAI G ADDRESq Iy ✓ ,7-2i(. ' Actual Set Backs in Feet to: /'• l/% ~JNorth South 'East I West 50 /
CONTR T LICENSE EXPIRES PHONE Size oParcel Zghe�ias;riga_ ' Residential,
4. c l' = X 9, iCommercial❑
ADDRESS ZIP Type t. Occu a c Sprinklered
.+ ❑Yes OW ❑Req'd.
DESIGNER PHONE New Const.Valuation Remodeled Valuation Total Bldg.Floor Area
5.
ADDRESS ZIP Main Floor Upper Floors Garage/Storage Greenhouse
CHANGE OF USE FROM TO Cover Deck Uncv.Deck Fin.Basement Unf in.Basement
6.
No.Baths No.Floors No.Fin.Rooms No.Dwellings
TY7. OFPE NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑��VE. ❑ OTHER
WORK ❑ BID. ❑ PLMB. ❑ MECH. ❑ M.H. ,CPOOL Certifi.of Exempt. Required Yes❑ No❑ Number
or Variance Received Yes❑ No❑
DESCj318E1✓yQRK� I t Shorelines/Flood
otA Hazard Plans Required❑
8. �'�/�v���AJJ�� NrcuL/ �/� Yes❑ Not Applic.❑ Received ❑
VALUATION SOURCEOGAS ELECTRIC PUBLEIC SEPTIICL7 Ownership FEES COLLECTED
9• td C>C)cD UTILITIES PRIVAT ❑ 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 REQUIRED INSPECTIONS Plumbing
SIGNATURE OF f,/Z )/,. /� � �/ )1=
APPLICATION s—,..."( _e3 3
OWNER OR AGENT ��Q .G1Yti. ti DATE Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FIN•L DATE Plan Check
Env.Health r T
.♦!./ `'//5 SEPA
Planning ` /
Modular/
Fire MFG.Home
n.
Prevent. C
Engineer
Other(Specify) 2C.)
ff2C)1' —I
Utilities U
_ TOTAL $
SEPA
MACHINE
Plans PERMIT IS NONTRANSFERABLE HEIS BECOMES A PERMITTED IN THIS SPACE,
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building
ech Ing ` IN 180 DAYS ((�� { ' 11 _ p //�� t
I( DATEU38U!cl , 8 , PERMl4 .6,3 z * 2 5. 0 0 QOTAL
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