1983, 08-29 Permit: 83A-8290 ResidencePLAN NUMBER
APPL ICAC' 1014 /PERMIT
SPOKANE COUNTY — DEPARTMENT,OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
Utilities
SEPA
Plans PERMIT IS NONTRANSFERABLE
Exam. x PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building 'r IN 180 DAYS
Tech.
PERMIT NUMBER
83 H ;ZR 0
TOTAL $ _te�'Cb
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT. n p
8
DATE "ED 2 .9 8 � PERMIT NO� 9' O z * � 2' O 0 Tb,tAL
CL
O
V
W
J
LL
or Variance
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
Shorelines/ Flood Hazard
Plans Required
PARCEL NO.
Yes El Not Applic. ❑
1.
.f--ii,BC'4
33 YJ
GAS
w csi
-7_57511541-ejco ,
SEPTIAGE
C ❑
LOT
I BLOCK
I SUBDIVISION
9•
LEGAL DESCRIPTION:
PRIVATE ❑
SEWER
Public ❑ Private
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included on
OWNER
PHONE
PHONE
3.
FLZL .t'a--A
G� ,
of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
C12-6- _S3c- G•
-D
OWNER OR AGEN DATE 7
Mech.
MAILING ADDRESS
01PECIAL CONDITIONS: (SREVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
ZIP�?a
m t Backs Feet to:
Env. Health
y�
V"0 0 A W W_
�Gi2 Si
N: ZM South
East West +y�
Planning
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential
4.
E-
MFG. Home
Fire
g15 kc t
2--1 1
Commercial ❑
ADDRESS
ZIP
Tvpe tint.
Occupancy I
Sprinklered
Other (Specify)
S#n.rbLL-
.JJN I
NZ nl,'—�I
❑Yes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
Cosi
5.
1$
ADDRESS
ZIP
MainFloor
Upper FloorsGarage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
6.
TYPE
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
7
C�NEW
❑ ALT. ❑ AD'N. ❑ RPL.
ElMVE.
❑OTHER
Certifi.ofExempt.
Required Yes El No❑
Number
WORK R BLD. 11PLMB. ElMECH. ElM.H. ❑ POOL
Utilities
SEPA
Plans PERMIT IS NONTRANSFERABLE
Exam. x PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building 'r IN 180 DAYS
Tech.
PERMIT NUMBER
83 H ;ZR 0
TOTAL $ _te�'Cb
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT. n p
8
DATE "ED 2 .9 8 � PERMIT NO� 9' O z * � 2' O 0 Tb,tAL
CL
O
V
W
J
LL
or Variance
Received Yes❑ No❑
DESCRIBE WORK
8.t�
Shorelines/ Flood Hazard
Plans Required
Yes El Not Applic. ❑
Received �y
VALUATION
SOOUFCE
GAS
ELECTRIC
P ATEUBLICRL;,,
SEPTIAGE
C ❑
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
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
Plumbing
SIGNATURE OFAPPLICATION C ` a
-D
OWNER OR AGEN DATE 7
Mech.
SPECIAL APPROVALS
01PECIAL CONDITIONS: (SREVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Plan Check
Env. Health
y�
SEPA
Planning
Modular/
MFG. Home
Fire
Prevent.
Other (Specify)
Engineer
Utilities
SEPA
Plans PERMIT IS NONTRANSFERABLE
Exam. x PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building 'r IN 180 DAYS
Tech.
PERMIT NUMBER
83 H ;ZR 0
TOTAL $ _te�'Cb
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT. n p
8
DATE "ED 2 .9 8 � PERMIT NO� 9' O z * � 2' O 0 Tb,tAL
CL
O
V
W
J
LL
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