1983, 11-23 Permit: 83B-1960 ResidencePLAN NUMBER - APPL ICAT ION /PERMIT
SPOKk COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 4311-367a
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. F. 1172-5 37 k V3354fi- i l5
,+
LOT
BLOCK
I SUBDIVISION
No. Dwellings
TYPE yaNEW El ALT. 11 AWN. El RPL. ❑ MVE.
LEGAL DESCRIPTION:
2.
I a
1 -3
^ n i Lom e-
Fi QST- A001 o!V
WORK
or Variance
Received Yes❑ No❑
DESCRIBEWORK
OWNER
Plans Required El8.
PHONE
PHONE
Received ❑
VALUATION
SOURCE
GAS
3.
a
SEWAGE
❑
2IF-
FEES COLLECTED
9
LI
UTILITIES
MAILING AD RESS
Ire/tom q -rq�(C&
SEWE
ZIP
ua t Backs in Feet to:
North (0,?l South 3L#)
East 1'' West
�31
00
Building 370-X
CONTRACTOR
LICENSE EXPIRES
PHONE
of construction. SEE REVERM WE F R OUIRED INSPECTIONS
Size of ParcelZone
t
Classification
Residential
OWNER OR AGE DATE
Mach.
Dl�n !`hnnL
SPECIAL APPROVALS
{�
7`f',/3 /� W
Commercial ❑
4.
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
V 14
123
Dyes ❑No
❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
�
`i` i
5.
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
`i
1 4
---
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unf in. Basement
6.
1
—
I —
7
,+
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
TYPE yaNEW El ALT. 11 AWN. El RPL. ❑ MVE.
Z
7. OF El OTHER
�D• ElPLMB. ❑ MECH. ElM.H. ❑POOL
Certifi. of Exempt.
Required Yes❑ No El
Number
WORK
or Variance
Received Yes❑ No❑
DESCRIBEWORK
Shorelines/ Flood Hazard
Plans Required El8.
9 5i IGNC — Ac-
Yes❑ NotApplic. ❑
Received ❑
VALUATION
SOURCE
GAS
ELECTRIC
WATER
PUBLIC C1SEPTIC
SEWAGE
❑
Ownership
FEES COLLECTED
9
LI
UTILITIES
PRIVATE ❑
SEWE
Public ❑ Private ❑
1 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
00
Building 370-X
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 rovis)ons of any other state or local law regulating construction or the performance
of construction. SEE REVERM WE F R OUIRED INSPECTIONS
Plumbing
SIGNATURE OF APPLICATION !/ ,.
OWNER OR AGE DATE
Mach.
Dl�n !`hnnL
SPECIAL APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Env. Health
N�
Planning
Pians
Exam.
Building
Tech.
ON Mpe
(00 t R1 W
Z)e- WF,IZ
A
-'�(PA)� LI
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
SEPA
Modular/
MFG.Home
Other (Specify)
TOTAL $ -Irx
WHEN MACHINE VALIDAT
THIS BECOMES A PERMIT.
DATE IlSlilm 2 3 - 8 3
PERMIT NUMBER
193e:, - Ictc.,
PERMIT 109 6. 0 � * 3 7 U O 0T8T�L
(� k -i
i'
Pl,,u 145-1
14
F7
s 61 fi
& Na
'-
72-,
4i*VE