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1983, 10-13 Permit: 83A-0360 Residence
PLAN NUMBER APPL I CAT ION /PERMIT SPOKANE COUNTY — DEPARTM cNt OF BUILDING & SAFETY NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 STREET ADDRESS LOT I BLOCK 2. -2_ Z CaAM11 A APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES PARCEL, Nia ?T'-- 6 F- _33 -SIO '405& SUBDIVISION LEGAL DESCRIPTION: rn('i�DS 'Z:vD PHONE PHONE _ r MAILING ADDRESSw ZIP Actual Set Backs in Feet to: `„ � , ds � 0_7 �„\d c_\Kiu: 4:5kQ) North 3 n" South East West t3 CONTRACTORLICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential 07- �y\� Y 5)c (--� -t.?-- k Commercial ❑ 4. ADDRESS ZIP Type Const. Occupancy Sprinklered -s R. :� tM-1 ❑Yes ONO ❑Req'd. DESIGNER PHONE New Const. Valuation Remodeled Valuation Total Bldg. Floor Area 5. ADDRESS ZIP Main Floor Upper Floors Garage/Storage GcwWouse IS(.,© .n S 7co CHANGE OF USE FROM TO Cover Deck Uncv. Duk Fin. Basement Unfin. Basement s. —^ •�• No. Baths No. Floors No. Fin. Rooms No. Dwellings TYPE EW El ALT. ElAD'N. El RPL. 11MVE. Z j 1 %OF El OTHER WORK BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ElPODL Certifi.ofExempt. Required Yes❑ No Number or Variance Received Yes❑ No E-1 $• ESCRIBE WORK Shorelines/ Flood Hazard Plans Required a IUL►J��E Yes Not Applic. ❑ Received VALUATION I SOOUFCE GAS ELECTRIC PUB IC SSEWAGE TIC Ownership d / FEES COLLECTED 9 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 -:2 work will be compiled with whether specified herein or not. The granting of a permit does not presume to give au- I 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 REOUIRED INSPECTIONS Plumbing SIGNATURE OF APPLICATION OWNER OR AGENT DATE Mech. SPECIAL APPROVALS I SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) Env. Health Planning PlansPERMIT 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) TOTAL $ �a PERMIT NUMBER e64 d-, WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. LL } DATE I+S�UE� — PERMIT NO.U' 0 C3 * 5 8 L' 0 0 7V I AL I ow 5oa[p- /- Qa tol ! Z 0 7nS0- C 0,-, �nAcr- leo. 22sW - 9005 l / % L/ c--, s4- 33 R d.