1983, 04-07 Permit: 83A-2719 ResidencePLAN NUMBER APPLICATION/PERMIT . PERMIT NUMBER
S -C;7Q SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON/ SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREETADDRESS PARCEL NO.
1. E l G `tom 3 oe t tnj o f
LOT I BLOCKSUBDIVISION
2. 31ti,tL ti
OWNER
3. Mom—r tGuE
MAILING ADDRESS
_?1 D.Bc»c 1 E
CONTRACTOR
4. a•AY-
ADDRESS
DESIGNER
//
ZIIP��+,,
Qck .
LICENSE EXPIRES I PHONE
ZIP
PHONE
Actual set uwKs+in Feet to:
North '155 I South East West LO
Size of Parcel Zone Classification Residential V
Commercial E
Type Const. Occupa cy Sprinklered
'g(V I
I, —I ❑Yes ❑No ❑Req'd.
Plow Const. Valuation Remodeled Valuation Total Bldg. Floor Area
9• 1 UTILITIES PRIVATE ❑ SEWER V 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 3,-(,+. 00
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 REMIRED INSPECTIONS Plumbing
SIGNATURE OF r APPLICATION
OWNER OR AGENT DATE '\ Mach.
SPECIAL APPROVALS SPECIAL CONDITION . (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env. Health
SEPA
Planning Modular/
MFG.Home
Ire
Prevent.
Engineer Other (Specify)
Utilities -5C 4-` C
,
TOTAL $ "i
SEPA
WHEN MACHINE VALIDAT
Plans PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS �aa 7
Tech. ,g DATEnOEDO / —8 3
9JA
PERMIT NO. z 9 '� 3 4 fAAL
Z`�(C �t'�d--�
5.
ADDRESS
ZIP
Main Floor Upper
Floors
Garage/Storage
Greenhouse
1'2.-7
I
�7 '11P O
15;k -la
CHANGE OF USE FROMTO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basem
6.
No. tNo.
Floors
No. Fin.Rooms
No. Dwellings
TYPE M/NEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
L
7• OF 1�/� El OTHER
Certifi.ofExempt.
Required Yes El No
Number
WORK IIdBLD. ❑ PLMB. ❑ MECH. ❑ M.H. El POOL
or Variance
Received Yes ❑ No ❑
DESCRIBE WORK
Shorelines/ Flood Hazard Plans Required
8' i 1V<a►L�c A t�Yt 1�• �� pEYVCI�s
Yes❑ Not Applic. ❑ Received
VALUATION
SOURCE
OF
GAS
ELECTRIC
WATER
PUBLIC
SEPT CGE
Ownership
FEES COLLECTED
9• 1 UTILITIES PRIVATE ❑ SEWER V 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 3,-(,+. 00
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 REMIRED INSPECTIONS Plumbing
SIGNATURE OF r APPLICATION
OWNER OR AGENT DATE '\ Mach.
SPECIAL APPROVALS SPECIAL CONDITION . (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env. Health
SEPA
Planning Modular/
MFG.Home
Ire
Prevent.
Engineer Other (Specify)
Utilities -5C 4-` C
,
TOTAL $ "i
SEPA
WHEN MACHINE VALIDAT
Plans PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Building IN 180 DAYS �aa 7
Tech. ,g DATEnOEDO / —8 3
9JA
PERMIT NO. z 9 '� 3 4 fAAL
Ml,
CONSTRUCTION
y Noah 9429 Newport Highway Spokane, Washington 9921$ (509) 489 HO147E
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