1983, 08-10 Permit: 83A-7545 ResidencePLAN NUMBER APPL ICAT ION /PERMIT PERMIT NUMBER
SPOKANE COUNTY - DEPARTMF-NT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREETADDRESS PARCEL NO.
LOT BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. 17
OWNER PHONE PHONE
3. M A ti col
MAILING ADDRESS
ZIP
Actual Set Backs in Feet to:
W, ✓c> t > oQ , C5,,�
North I South `� East
7_C'r West Z, ---
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential
4 s-Amr—
1?,oX
TZA
Commercial ❑
ADDRESS
ZIP
Type
Occupancy
Sprinklered
,skW,%£
•Const.
-�h)
+"Z'3 ✓ I -I
❑Yes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
ADDRESS
ZIP
Main Floor Upper
Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
UncvyDeck
Fin. Basement
Unfin. Basement
6.
--
-
__
TYPE
No. Baths No.
Floors
t
No. Fin Rooms
No. Dwellings
NEW El ALT. 11 AWN. 1:1 RPL. ❑ MVE.
Z
5
1
OF % El OTHER
WORK BLD. ElPLMB. ❑ MECH. 1:1 M. ❑ POOL
Certifi. of Exempt.
Required
Yes❑ No
Number
or Variance
Received
Yes ❑ No ❑
DESCRIBE 4.'DRK
8 �kY
Shorelines/ Flood Hazard
Plans Required
c : C nJ Cs f F 04 n a.� { r E (-C
Yes Not Applic. ❑
Received
VALUATION
9•
SOOUFCE
GAS
ELECTRIC
WATER PUBLIC 1:1SEPTIC
AGE 11Ownership
I
FEES COLLECTED
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
r-3z'-cx-
work will be complied with whether specified herein or not. The granting of a permit
does not presume to give au-
Building
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
SIGNATUREOF�,C /J APPLICATION
OWNER OR AGENTS } ,&Oluli - �i�d_A_ -- - DATE
Mach.
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health I I n
Planning
Engineer
Utilities
SEPA
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plans l,Ai�.c PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
�- r00
J 0 0 0 1
i 1 J,
C C—C' 3
64.7E
TOTAL $ I
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEWS )LI 3 O_ PERMfT/Nd. z* 3 3 0. O 0 fOrrAL
CL
O
V
W
J
LL
M
I 60
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--� 2 sem'
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