1983, 03-25 Permit: 83A-2254 ResidencePLAN NUMBER APPLICATION/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, W/ HINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
LOT I BLOCK SUBDIVISION LEGAL DESCRIPTION:
2. 16.- 4 1 S k4 --4',J L45W AL62-105--,
SPECIAL APPROVALS
PHONE
PHONE
ANER
-a,",
-V�S6- ckecs
3.
TL
330.00
CK
MAILING ADDRESS
'
ZIP
Actual Set Backs in Feet to: �y� .
A
�k'1 AArl I
%W O C
North South East West
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel_ Zone
Classification
Residential
trso
'
Commercial ❑
4.
Prevent.
ADDRESS
ZIP
Ty Const. Occupa
y
Sprinklered
ePW44
ML
-3 Z RA -1
❑Yes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
Q
s9
5.
=�`j-�
`L
Utilities
ADDRESS
ZIP
Main Floor Upper
Floors Gars
/Storage
Greenhouse
r2l %v
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Q
DATIPIsIUE� 5 - 8� 3 PERMI o QOTAL
2'x.5,42
Building
Tech.
�'
7
No. Baths No.
Floors
No. Fines ms
No. Dwellings
TYPE L� EW ❑ ALT. 1:1AD' N. El RPL. C3 MVE.
i
I
7. OF El OTHER
WORK �' OLD. ❑ PLMB. ❑ MECH. ❑ M. H. ❑ POOL
Cyifi.of empt.
Required Yes❑ No
Number
Received Yes❑ No❑
DESCRIB;WORK
Shorelines/ Flood Hazard
Plans Required
8. ,*5It aGt_F_
Yes NotAPPlic. ❑
Received
VALUATION
SOURCE
GAS
ELECTRIC
I WATER
PUBLIC
SEWAGE/
SEPTIC CCaall
Ownership
FEES COLLECTED
9
OF
OF
PRIVATE 13
SEWER ID -1
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
I
of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
Mach.
SPECIAL APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT NUMBER
"6 — zz sq
02-- 330.00
330.00
TL
330.00
CK
A 0.00
CH
9
SPECIAL APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env. Health
417
SEPA
Modular/
Planning
MFG. Home
Fire
Prevent.
p
(Specify)
W
E ineerOther
3'
=�`j-�
`L
Utilities
TOTAL $
SEPA
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
U� W,% ?,Akf`i PERMIT IS NONTRANSFERABLE
Plans
Exam.
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Q
DATIPIsIUE� 5 - 8� 3 PERMI o QOTAL
2'x.5,42
Building
Tech.
�'
7
*33.0.0.0al-
8C%I'QM
qA
r
I
l�