1983, 11-22 Permit: 83B-1945 ResidencePLAN NUMBER APPLICATION/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.
LOT
BLOCK
SUBDIVISION
LEGAL DESCRIPTION:
2.
I V_0V
OWNER
PHONE
PHONE
I
3. cr=, vz c+ I
- 6_68
MAILING ADDRESS
ZIP
Actual Set Backs in Feet to:
c l kA, Z S t 1
Q
North South Z46 East
i' West
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential
4. SArAC
% Cr Z 1c. k acs
1!�Cx . 5 u
Commercial ❑
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
=
—3-1'1
_=� VU
Dyes ❑No ❑Req'd.
DESIGNER
PHONE
wConst. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
i. t5ZH 7—
1 -ZL C>Co
ADDRESS
ZIP
Main Floor Upper
Floors
Garage/Storage
Gre nese
IA—
6149-1
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
6.
�--
•^
l 34-
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TYPE L°INEW El ALT. ❑ AD'N. 1:1 RPL. 1:1 MVE.
-Z
�
t
7. OF ./ 11 OTHER
WORK N BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
Certifi. of Exempt.
Required
Yes❑ NoN1
Number_
or Variance
Received
Yes ❑ No ❑
DESCRIBE WORK
8.-ac-t,!,oruvc.
Shorelines/ Flood Hazard
Plans Required
Yes❑ Not Applic.
Received tT
VALUATION
SOOURCE
GAS
ELECTRIC I
PUBLICRCI�)
SEPT CG
Ownership
FEES COLLECTED
9•
I
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
Building :Tpqb•vc�
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 INSP&gTIONS
Plumbing
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
—
Mech.
SPECIAL APP V LS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. F AL DATE
Env. Health
►L
(
SEPA
Planning
Modular/
MFG. Home
Fire
Prevent.
Fnnir
Other (Specify)
Plans c•ni PERMIT IS NONTRANSFERABLE
Exam. Ft Le PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Buildingtit IN 180 DAYS
Tech. l _� -7
PERMIT NUMBER _
�,. 101��
TOTAL $ i� I
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ] ED� 8 3 PERMITL . 4 5 23 * 3 9 0, 00 1olrAL
10- G
900 4A. L 5 EPT I- TA, N W.
-- -r
-r-4.,4 LIIE
10
14WT- IL
*
C�-
ova- oft