1983, 07-07 Permit: 83A-6260 ResidencePLAN NUMBER APPL ICAT 104; /PERMIT
SPOKANE COUNTY — DEPARTMENT,OF BUILDING & SAFETY
- NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES —PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. x._11808 Zd.T 7_8%q, 64-09
L/O-T BLOCK SUBBD1IIVISION` LEGAL DESCRIPTION:
2.OWNER PHONE PHONE
3.
if �1 � 5cu '� c� i �- 0 6CZS
Main Floor Upper
+5S — '7
Garage/Storage
Greenhouse
MAILING ADDRESS
ZIP
ua t ks in Feet to:
CHANGE OF USE FROM
TO
_-6G�,0(�P_A1QOQL64A)
Uncv. Deck
QL(X04
North_!�,5 South
East lC7
West 8}
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential itf
No. Baths No.
LS&MG-
I
80 k
I R
Z„
I Commercial ❑
4
7. OF El
ADDRESS
Certifi. of Exempt.
ZIP
Type Const.
Occupancy
Number
Sprinklered
or Variance
Received
Yes❑ No❑
xN
-I
❑Yes
❑No ❑Req'd.
itUG.IE FAM Q tZfi`s%ZX--^'L-'--
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation --j
GAS
Total Bldg. Floor Area
5.
SEWAGE
SEPTIC
Ownership
(ov 44
1
UTILITIES
ADDRESS
ZIP
Main Floor Upper
Floors i
Garage/Storage
Greenhouse
480
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basem(
6.
—
---
—.
4 -::Lo
TYPE 13 ALT. ❑ AD' N. ❑ RPL.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
Pd EW ElMVE.
Z„
St
7. OF El
WORK BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
Certifi. of Exempt.
Required
Yes❑ No
Number
or Variance
Received
Yes❑ No❑
DESCRIBE WORK
8'
Shorelines/ Flood Hazard
Plans
Required It/
itUG.IE FAM Q tZfi`s%ZX--^'L-'--
Yes❑ Not Applic.❑
Received fd
VALUATION
SOURCE
OF
GAS
ELECTRIC
I WATE
PUBLIC
SEWAGE
SEPTIC
Ownership
FEES COLLECTED
9•
UTILITIES
PRIVATE ❑
SEWER ❑
Public ❑ Private �el
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.Z
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 APPLICATION
gzn2L I gAeA"+�
Mech.
OWNER OR AGENTX DATE
SPECIAL APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Plan Check
Env. Health
�jL1� Yom'/
SEPA
Planning
Modular/
MFG.Home
Utilities
Plans �� PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS
Other (Specify)
TOTAL $'Z'�
WHEN MACHINE VALIDATED IN THI
THIS BECOMES A PERMIT.
►-
PERMIT NUMBER
�j _0�0
DATEYs6uEW 7— 8 3 PERM176NQ. 6. 0 z * 4 0 2, 0.0 VAL
O
C.)
W
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LL