1983, 09-27 Permit: 83A-9565 ResidencePLAN NUMBER
APPLICATION/PERMIT
Main F Il r
Upper Floors
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
Greenhouse
NORTH 811 JEFFERSON / SPOKANE, _%, ASH,AGTON 99260 / (509) 456-3675
76
APPLICANT: COMPLETE NUMBERED SPACES —
PRESS HARD TO MAKE 3 COPIES
1•
STREET ADDRESS
E. 13715 28th Ave
CHANGE OF USE FROMTO
PARCEL NO.
27544-0424
2.
Lor
24
BLo K
SUBDIVISION
Mountain View 4th Addn
LEGAL DESCRIPTION:
L24 B4 Mountain View 4th Addn
OWNER
PHONE
PHONE
3.
-
DATEISS99UEQ PERMITNO.6l
-
928-1991
No. Baths
No. Floors
MAILING ADDRESS
No. Dwellings
ZIP
Actual Set Backs in Feet to:
E. 12929 Sprague Ave.
1
99216
North 64+' IS..th 30East 6' West 8'
NTRP 'TO
upper Rlnc. #TUPPEIR179DC
LIC N$ /TITES
�j/ /Z54
PH
� E8-1991
Sizeo Parcel
b0 125
Zone Classification
Residential
4.
or Variance
Received
Yes ❑ No i-1
x
SgI Fat
Commercial
Plans Reouir
DR
X929 Sprague Ave.
ZIP ZIP
99216
Tyf�g�onst.
VIV
Occu ancy
R
Sprinklered
❑Yes El No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
_
z
-
1 1 -
6.
7.
8.
9.
ADDRESS
ZIP
Main F Il r
Upper Floors
Garage/Storage
Greenhouse
-
76
O
Other (Specify)
V
CHANGE OF USE FROMTO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
-
-
-
-
-
DATEISS99UEQ PERMITNO.6l
1 1176
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
TYPE r NEW ❑ ALT. 11AD'N. _0 RPL. ❑ MVE.
2
5
1
WORK '�] BLD. ElPLMB. ElMECH. ❑ M.H. ElPOOL El OTHER
Certifi. of Exempt.
Required
Yes No
Number
or Variance
Received
Yes ❑ No i-1
DESCRIBE WORK
Shorelines/ Flood Hazard I
Plans Reouir
Single Family Residence with double garage Yes El Not Applic.❑
VALUATION SOURCE GAS ELECTRICWATER SEWAGE, Ownership
LIITIES X PRIVATE SEWER SEPTIC C
UTILITIES ❑�`
Public ❑ Privat?
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
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
SIGNATURE OF4 f #252 APPLICATION
OWNER OR AGENT (L'141'(' tiLiDATE 9-7'$3
SPECIAL APPROVALS
PRELIM. FLNAL D,
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plans ov�a I I PERMIT IS NONTRANSFERABLE
Exam. rALC PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Tech mg Cy IN 180 DAYS
Received C'
FEES COLLECTED
Building�?� C C`
Plumbing
Mech.
Plan Check
PERMIT UMBER
SEPA
Modular/
MFG. Home
CL
O
Other (Specify)
V
W
J_
LL
TOTAL $���
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECO77MES A PERMIT.
- ii� C,
5 6 * 3 2 6 0 0 0 -j
DATEISS99UEQ PERMITNO.6l