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1983, 08-18 Permit: 83A-7939 PoolPLAN NUMBER APPLICATION /PERMIT SPOKANE COUNTY - DEPARTMENT OF PUILDING & SAFETY NORTH 811 JEFFERSON/ SPOKANE, WASHINGTt' tP9260 / (509) 456-3675 APPLICANT: COMPLETE NUMBERED SPACES —PRESS HARD TO MAKE 3 COPIES STREET ADDRESS FRNO. LOT BLOCK SUBDIVISION ESCRIPTION: � S y 4L �� C(L.ovvtio '=wriSi�t�. 3. MAILING ADDRESS (©43i0 E CONTRACTOR SHONE PHONE ZCn-C)� Z ZIP Actual Set Backs in Feet to: C ZQ North South East 5 West LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential © ) Commercia kl ed 4. — ZIP ADDRESS Type Const. Occupancy Sprin er El Yes ❑No ❑Req'd. New Consf. Valuation Remodeled Valuation TotalBldg. Floor Area PHONE DESIGNER �p O 1 SCS 5. ZIP Main Floor Upper Floors Garage/Storage Greenhouse �— ADDRESS Cover Deck Uncv�Deck Fin. Basement Unfin. Basm CHANGE OF USE FROM TO 6. No. Baths No. Floors No. Fin. Rooms No. Dwellings ❑OTHER TYPE CII.fQEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ =01* of Exempt. Variance Required Yes L] No C' Received Yes El Non Number 7. OFCertifi. ❑ BLD. ❑ PLMB. ❑ MECH. ❑ M.H. WORK or Shorelines/ Flood Hazard Plans Required n ❑ DESCRIBE WORKYes 8. r'� -f,'>, is CC'\jt Not Applio. . �' _ Received > u. AT 0— 1'3 C� VALUATION SOURCE GAS ELECTRIC WATER SEWAGE PUBLIC SEPTIC Ownership FEES COLLECTED 9 UTILITIES � OF �� PRIVATE ❑ SEWER ❑ Public C Private 1 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 Plumbing of construction. SEE REVERSE SIDE F02 REQUIRED INSPECTIONS OF APPLICATION 0 Meeh. SIGNATURE [l[�,TF OWNER OR AGENT SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICO Plan Check PRELIM. FINAL DATE 1Q Env. Health r Planning Prevent. Utilities PERMIT IS NONTRANSFERABLE Plans Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED Building IN 180 DAYS Tech. it SEPA Modular/ MFG.Home Other (Specify) ?C'C' I.— TOTAL $ PERMIT NUMBER Q �2* *2500 *2500 N *000 93.82 08=18-83 6.479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. 77 9 0 DATE IIB 1 PERMIT NO.� Z * TOTAL CL O V LU J_ LL