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1983, 09-13 Permit: 83A-9063 Residence
PLAN NUMBER APPLICATION/PERMIT SPOKANE PPLICAC'ION/PERMIT SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 v APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES STREET ADDRESS PARCEL NO. 3� 1. `w` Sl Lor BLOCK SUBDIVISION LEGAL DESCRIPTION: 2. M �'- Ab OWNER PHONE PHONE l3 f ("A) ,5159 1'- 1 474-9 4 O LQ SEPA MAILING AD RESSZI Actual Set Backs in Feet to: Plans Exam. E 'D o � #.0_ — p 17JO 60 North 10 `'{ ^' South 2 � East 20 West Z � CONT ACTOR LICENSE EXPIRES PHONE Size of Parcel �© N Zone Classification Residential i3 A ® v50 Commercial C 4. ADDRESS ZIP Type Const. ncy Sprinklered Ij 3 Dyes ❑No ❑Req'd. DESIGNER PHONE New Const. Valuation Remodeled Valuation Total Bldg. Floor Area aSZ Z o S(P 5. ADDRESS ZIP Main Floor Upper Floors Gara$e/Storage Greenhouse [ D SCP SCD® '1Bo Lo SL. CHANGE OF USE FROM TO Cover Deck Uncv. Peck Fin. Basement Unfin. Basem 6. -- p No. Baths No. Floors No. Fin. Rooms No. Dwellings` TYPENC C-1ALT. ElAD' N. ❑ RPL. ElMVE. Z 7 OF ❑OTHER WORK LD. ❑ PLMB. ElMECH. ElM.H. 11POOL Certifi.ofExempt. Required Yes❑ No Number or Variance Received Yes❑ No❑ DESCRIBE W 8• Shorelines/ Flood Hazard Plans Required 1' S pW� $"ES c,� "r yc* L Yes❑ Not Applic. ❑ Received 2 VALUA ION SOOURCE GAS ELECTRIC PURL CR SEWAGE EPTIC O 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 390 — 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 j#lovisions of any other state or local law regulating construction or the performance of construction. SEE REV S OR REWIRED 1 SPE TIONS Plumbing SIGNATURE OF APPLICATION OWNER OR A DATE Mech. SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTI E) PRELIM. FINAL DATE Plan Check Env. Health ri I�Q SEPA Planning Modular/ MFG.Home Fire ` Engineer i l3 f ("A) ,5159 Utilities 04 ,s SEPA Plans Exam. PERMIT IS NONTRANSFERABLE PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED lT 3 BuildingI Tech.�— N 180 DAYS Other (Specify) 3Sca — TOTAL $ WHEN MACHINE VALIDATED IN TH THIS BECOMES A PERMIT. PERMITNUMBER 4 E, DATEYsSuEol 5- 8 3 PERMIT N 6' 3 z* 3 5 0, O O TOTAL I " | ^ ----'---__ NO