1983, 06-03 Permit: 83A-4772 ResidencePLAN NUMBER APPLICATION/PERMIT
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON/ SPOKANE, WASHINGTON 99260 / (509) 456-3675
1 . LOTLO I
2. 2 -
OWNER OWNER
3. MAILIMAILI GG ADDRES
CONTRACTOR
4. -S
ADDRESS
DESIGNER
5.
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
PARCEL NO.
Stu DIVISION LEGAL DESCRIPTION: X111
PHONE PHONE
S _ 5SL
ZIP Actual t Backs in Feet to:
itis?.
LICENSE EXPIRES
North j 0 South Si East S West i S
PHONE Size of Parcel Zone Classification Residential
' 8 S x , 1? i Commercial ❑
ZIP Type Const. Occupancy Sprinklered
❑Yes ❑No ❑Req'd.
PHONE New Const.VVal uation Remodeled Valuation Total Bldg. Floor Area
H
ADDRESS
ZIP
Main Floot Upper
Floors
Garage/Storage Greenhodse
t0 Z4
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basem,
TYPE W ❑ALT. El AD'N. 11 RPL. 11 MVE.
�
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
7. OF El OTHER
�—
WORK LD. ❑ PLMB. ❑ MECH. ❑ M.H. ElPOOL
Certifi. of Exempt.
Required
Yes❑ No
Number
or Variance
Recei ed
Yes❑ No❑
DESCRIBE WORK
8'
Shorelines/ Flood Hazard
Plans Required
�r LQ
Yes❑ NotApplic.
Received p�
VALUA ON
9•
SOOURCE
GAS
ELECTRIC
WATER
PUBLIC
SEPTIC
Ownership
FEES COLLECTED
UTILITIES
PRIVAT ❑
SEWER
Public El 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 compiled 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 OF APPLICATION
��
OWNER OR AGENT — DATE
Mach.
SPEFI'ALAPPROVALS
SPE AL CONDITIONS: (SEE 5EVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Plan Check
nv. Health
SEPA
Planning
Modular/
Fire
MFG. Home
Prevent.
nginear
�(0
k
Other (Specify)
Utilities
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
TOTAL $ 3!g&
WHEN MACHINE VALIDAT
THIS BECOMES A PERMIT.
DATE fUY600 3 —8 3
PERMIT NUMB
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PERMIT OT % 2 z° * 3 5 8. o 0'@01.
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