HomeMy WebLinkAbout1983, 03-24 Permit: 83A-2215 ResidencePLAN NUMBER APPLICATION/PERMIT
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
STREETA DRESS PARCEL NO.
1. . t 19�� -3-3
LOT I BLOCK IYLEGAL DESCRIPTION:
2. -;-7>Su ISION
din v -2Ad
OWNERI fPHONE1PHONE
3. V
MAµ ING ADDRESS _
Set Backs in South
��
North East
West
CONTR O
�
LICENSE EXPIRES
PHONE
Size of Parcel
x �
ZoneClassificati n
Residential
4.
d
-3
�-
Commercial ❑
ADDRESS
ZIP
Type s
.
u ncy
Sprinklered
I
❑Yes ❑No ❑Req'd.
DESIGNER
PHONENew
Const. Valuation I
Remodeled Valuation
Total Bldg. Floor Area
5.
70 5�
I
1
ADDRESS
ZIP
loot Upper
Floors
Garage/ rage!
Greenhouse
CHANGE OF USE FROM
TO
Cover CfeGc
Uncv. Deck
Fin. Basement
Unfin. Basement
No• Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TYPE EW ❑ ALT. ❑ AWN.
❑ RPL. ❑ MVE.
71'*N
OF 7.
❑OTHERifi.ofExempt.
WORK LD. ❑ PLMB. ❑ MECH.
❑ M.H. El POOL
Required
Yes❑ No❑
Number
or Variance
Received
Yes❑ No❑
DESC IB WOR
8. USPO I
Shorelines/ Flood Hazard
Plans Required
v
Yes❑ Not Applic. ❑
Received
VALUATION
I SOURCE
GA
ELECTRIC
pUBLICR�
SEWAGE
EPWTIC
Ownership
FEES COLLECTED
9•
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 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 REVERS SIDE FOR R
SIGNATURE OFENT
UIRED INSPECTIONS
APPLICATION /
Plumbing
� ��
OWNER OR AG
DATE~
Mach.
SPECIAL APPROV LS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plan Check
SEPA
Modular/
MFG.Home
Other (Specify)
TOTAL $
PERMIT NUMBER i
i5
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEYjUEt 4—" 3 PERMIA2. 15 z * 4 0 9. 0 0 100E -FAL
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