1983, 03-29 Permit: 83A-2346 ResidencePLAN NUMBER APPLICATION/PERMIT
133 SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORYH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREETADDRESS PARCEL NO.
1. T_ . ®� 3.�-T� Rv c 33�' - crcc"_
L T I BLOCK I SUBDIVISION LEGAL DESCRIPTION:
2. k IihIliiUY"f 114
OWNER
3. Ra (u. C:.,
MAILING ADDRESS
S: 314.
CONTRACTOR
—5ds G
ADDRESS
PHONE IPHONE
ZIP I Actual Set Backs in Feet to:
LICENSE EXPIRES PHONE Size of Parcel
ec' k ob'
ZIP Type T.Const. d
"S,
liMEMI
OV East & Zi� Wast �t
ZoneClassification Residential R(
ppb, �—i Commercial C
:yy Sprinklered
❑Yes ❑No ❑Req'd.
DESIGNER
PHONE
st. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
'X+40
ADDRESS
ZIP
Floor Upper
Floors
Garage/Storage
Greenhouse
o
�--
54o
--�
CHANGE OF USE FROM
6.
TO
eck
Uncv. Deck
Fin. Basement
Unfin. Basement
[0.
T7. YPE VIEW ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
s No.
Floors
I
No. Fin. Rooms
4
No. Dwellings
El OTHER
�'
WORK BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
fExempt.
Required
Yes❑ N
Number
nce
Received
Yes❑ No❑ESCRIBE
WORK
horelines/Flood Hazard
Plans
Required
8' l. L FAIL �� t ®c ►.�C-3
es❑ Not Applic. ❑
Received B'
VALUATION
9•
SOURCE
GAS
ELECTRIC
/
pUBLICREI
SEPTIC C /
Ownership/
FEES COLLECTED
UTILITIES
PRIVATE ElSEWER
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
L�.��•Or
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 REQUIRW INSPECTIONS
Plumbing
SIGNATURE OF OWNER OR GENTV�L DATECATI0111 n f 2-,-,, �G" j5
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health I i
Planning
Fire
Prevent.
Utilities
SEPA
Plans PERMIT IS NONTRANSFERABLE
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Tech ing IN 180 DAYS
Plan Check
SEPA
Modular/
MFG.Home
Other (Specify)
TOTAL $ t=� I
WHEN MACHINE VALIDATED IN THIS
THIS BECOMES A PERMIT.
PERMIT NUMBER
S3r� - Z3� L
X:
C
DATIASSUE� 9- 8 5 PERMIT �. 4 6 z * 4 5, O' 0 *pITAL
r
� Nn Avr-,.
2 y'
29`