1983, 03-17 Permit: 83A-1986 ResidencePLAN NUMBER
APPLICATION/PERMIT
Main Floor
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SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
Greenhouse
Iv
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
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APPLICANT: COMPLETE NUMBERED SPACES —PRESS HARD TO MAKE 3 COPIES
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STREETADDRESS
TO
PARCEL NO.
Uncv. Deck Fin. Basement
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pry+ of 35 ►-uddz
2.
LOT BLOCK
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SUBDIVISION
N1,rZ�1WM>�,
LEGAL DESCRIPTION:
OWNER
3. M I�Scc1 B. t ��rJEQ s
PHONE
PHONE
45B -q 8D7
MAILING ADDRESS
ZIP
Actual Set Backs in Fet to:
e
Number
\
vv . B,— 0
8 A" jo lcj
clg 2.Q4-
North South 3�t East 15� West
8. DESCRIBE WORK
CONTRACTOR
'E�:A rt TE
G k k_X%L,E a m..�� ( � �
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential
4.
SEWAGE
SEPTIC �
Ownership
FEES COLLECTED
S G K F
Q_- `
Commercial ❑
ADDRESS
,!&A
ZIP
Type Const.
Occupancy
Sprinklered
ME-Yi
- M_I
❑Yes ❑No ❑Req'd.
DESIGNER
PHONE
ewConst. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
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54-(0 1
-
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv. Deck Fin. Basement
Unfin. Basem
PE NEW ElALT. ElAD N. El RPL. ElMVE.
7•
No. Baths No.
-r_WORK
Floors
No. Fin. Rooms
No. Dwellings
OF ❑OTHER
ED/BLD. ❑ PLMB. ElMECH. ❑ M. H. 1:1 POOL
Certifi.ofExempt.
Required Yes❑ No
Number
or Variance
Received Yes El No❑
8. DESCRIBE WORK
Shorelines/ Flood Hazard Plans Required
G k k_X%L,E a m..�� ( � �
Yes Not Applic. ❑ Received B�
VALUATION
9
SOURCE
OF
GAS
ELECTRIC
WATER ,
PUBLIC in
SEWAGE
SEPTIC �
Ownership
FEES COLLECTED
UTILITIES PRIVATE ❑ I 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
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 OF APPLICATION
OWNER OR AGENT !� � �—-�-�'"� DATE
SPECIAL APPROVALS I SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech. Q -�
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Building * 42 =60
Plumbing
Mach.
Plan Check
SEPA
Modular/
MFG. Home
PERMIT NUMBER
t
Other (Specify)
TOTAL $ �=a
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE tSSUEDl 7_" 3 PERMITLl 8. 6 62 k 4 0 9, 0 0 0 -AL
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