1983, 04-19 Permit: 83A-3082 PoolN NUMBER APPL LCAT ION /PERMIT PERMIT NUMBER
r/� = 3a�
-- 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 P� PARCEL NO. J ✓�J ��O /
ILII
BLOCK _Z1
su�gl�lsl �� �V��
LEGAL DESCRIPTION:
2
6;
PHONE
Iva (LING ADDR1ESS / _
�
Actual Set Back Feet to:
'7 ,
I 4�/
North South East West
CO�RA�JA���
LICENSE EXPIRES N 1.!
SiZe Parcel /^
Zo�''Classification
Residential
[�� �j
�
JJ tC/
f
Commercial ❑
4. AD
RES-
_ ^
f°cO
Ty n Occu
n
f-
Sprinklered
❑Yes ❑No ❑Req'd.
DESIGNEK PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
J. ADDRESS ZIP
Main Floor Upper
Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
s.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TYPE NEW ❑ ALT. ❑ AD'N. El RPL. El MVE.
7. OF 1:1 OTHER
El ❑ PLMB. ❑ MECH. ❑ M.H. ;WOOL
Exempt.
Required Yes❑ No❑
Number
WORK .
or Variance
Received Yes❑ No❑
DESCRI E
8.
Shorelines/ Flood Hazard
Yes Not Applic. ❑
Plans Required ❑
Received ❑
VAAL/U�ATION//��
SOOURCE
GAS
ELECTRIC
WATERF PUBLIC❑
SEPT CGS/
ownership
FEES COLLECTED
9• St / 0
UTILITIES
PRIVATE ❑
SEWER k7
Public ❑ Private
f hereby certify that I have read and examined this application and have read the "NOTICE" provisions included on
reverse side, and know the s e to be true and correct. All pr visions of laws and ordinances governing this type of
Building
work will be compiled wit ether specified herein or not he granting of a permit does not presume to give au-
thority to violate or canc t provisions of any other st or local law regulating construction or the performance
of construction. SEE RE SE SIDE FOR RE RED ECTIONS
SIGNATURE OFION APPLICAT�+
Plumbing
3MTE l
Mech.
OWNER OR AGENT
SPECIAL APPROVALS
SPECIAL, ONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
PRELIM. FINAL DATE
Env. Health
SEPA
Modular/
Planning
MFG.Home
Prevent.
Engineer
Utilities
Plans PERMIT IS NONTRANSFERABLE
Exam' PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
BuildingIN 180 DAYS
Tech.1,4/,q
Other (S ify)
TOTAL $
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE-1SSUEJ 9_ 8 3 PERM146.8. 2 z
* 2 5.0 0 adTAL