1983, 03-17 Permit: 83A-1979 ResidencePLAN NUMBER APPLICATION /PERMITPERMIT
NUMBER
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY Fo 4 /9'7
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
� PARCEL NO.
Ea 1010 '33" AVE.;
LOT BLOCK SUBDIVISION PTN of= 3.3S4 -N -cooG
LEGAL DESCRIPTION:
2. ,2, 11AIDI�`hl� 7.Nv AopaloN
OWNERPHONE PHONE
3.0 Co Z'
MAILING ADDRESS ZIP Actua Set Backs in Feet to
ZO-2'15 IlEll 551111 CM ZL 3 North 30 i 1 South S3 East 2-L)' West � � )
CONTRACTOR LICENSE EXPIRES PHONE Size of Parcel Zone Classification Residential
5
4 h 1 3 Commercial ❑
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
V -�(
Dyes ❑No ❑ Req Id.
DESIGNER PHONE
New Const. Valuation Q� Remodeled Valuation Total Bldg. Floor Area
5.
`—
ADDRESS ZIPJ
Main F r Upper Floors Garage/Storage Greenhouse
CHANGE OF USE FROM
6. TO
� r Deck Uncv. Deck Fin. Basement Unf in. Basement
._._ 25 55o o0
TYPEEW El ALT.
. ❑ AD' N. ❑RPL. El MVE.
!•
No. Baths No. Floors No. Fin. Rooms No. Dwellings
OF ❑ OTHER
WORK [3-I CD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
3
Certifi.ofExempt.
Required Yes❑ No❑
Number
or Variance
Received Yes❑ No ❑
DESCRIBE WORK
8
RE,S .
Shorelines/ Flood Hazard
Plans Required
G •Liv C {
Yes❑ Not Applic. ❑
Received
VALUATION
9'
SOURCE
GAS ELECTRIC
WATER
PUBLIC
SEWAGE
SEPTIC ❑
Ownership
FEES COLLECTED
UTILOFJES
PRIVATE ❑
SEWER
Public ❑ Privet
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 compiled
44? 6t7
Building
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 to or local law regulating construction or the performance
of construction. SEE REVERSE SIDE FOR REQUIRE I PECTIONS
Plumbing
SIGNATURE F APPLICATION
OWNER OR A e� l
DATE
Mach.
SPECIAL
APPROALS SPECIAL CONDI NS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINA DATE 17ECj(S %ES$ -rHA 1 �3z" A-6, vW_ C71ZAPF—
Plan Check
Env. Health
Planning
SEPA
Modular/
Fire
MFG. Home
Prevent.
>_
CL
Engineer
Other (Specify)
V
W-=
Utilities
LL
SEPA
TOTAL $PCZ
Plans
3/ PERMIT IS NONTRANSFERABLE
WHEN MACHINE VALIDATED IN
THIS SPACE,
Exam.
t
THIS BECOMES A PERMIT.
` PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building
Tech.
.'il IN 180 DAYS
n
17 -8 3
ll n n
7. 9 * 4 0 6. 0 0 (-
DATE ISSlIJ6 PERMIT
N0.7 TOTAL
-c4
sv'