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1983, 09-15 Permit: 83A-9065 ResidencePLAN NUMBER APPLICATION/PERMIT • ;SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY n NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 U APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES STREET ADDRESS PARCEL NO. 1. r. l � � �33541- 1:�-©l LO,T BLOCK I su�sp IVISION LEGAL DESCRIPTION: 2• 1 I � M�01L0IAe> 0 r OWrfG� —IS 1 PHONE MAILING AD RUS Actual Set Backs in Feet to: SPECIAL APPROVALS SPECIAL CO DITIONS: (SEE REVERSE SIDE FOR NOTICE) PRELIM. FINAL DATE Env. Health Planning Fire Prevent. Engineer p '113 Utilities S SEPA �& Plans PERMIT IS NONTRANSFERABLE Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED B�Itlkng I A I N 180 DAYS Plan Check SEPA Modular/ MFG. Home Other (Specify) PERMIT NUMBER b&5' ij 0 TOTAL $ ==x I WHEN MACHINE VALIDATED IN THIS SPACE, THIS (�BECOMES APERMIT. L DATEYSSUEC` — PERMITNO. U' z * 3 8. 0 0 I AL North —.7 ISouth East West e ---- CON T I LICENSE EXPIRES PHONE Si f rcel X Zone blas 'ficat' n ' 5 Residentia lel Commercial ❑ 4. - ADDRESS ZIP Type Constu Spr❑kl red ❑Yes ❑Req'd. DESIGNER PHONE New Const. Valuation I Remodeled Valuation Total Bldg. Floor Area 5. ADDRESS ZIP Mai F oor_ Gara Storage Greenhouse a 1upperFloors CHANGE OF USE FROM TO Cover Deck Uncy. k in. Basement__ asseement Un asegent s TYPE W ❑ ALT. ❑ AD' N. ❑ RPL. ❑ MVE. No. Baths No. Floors No. Fin. Dams No. Dwellings %. 5" OF 11 OTHER WORK BLD. ❑ PLMB. ❑ MECH. ❑ M.H. El POOL Certifi. of Exempt. Required Yes❑ No❑ Number or Variance Received Yes ❑ No ❑ 8 DES RIBEWORK lal �� �V Shorelines/ Flood Hazard Plans Required Yes❑ NotApplic. ❑ Received VALUATION I SOURCE AS ELECTRIC PUBLIER SEPT SEPTIC Ownership FEES COLLECTED 9• UTILITIES PRIVAT ❑ 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 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 SUN FORJWAVIELED IN CTIONS Plumbing SIGNATURE OF OWNER OR AGEN/Z' DATEAPPLICATI Mach. SPECIAL APPROVALS SPECIAL CO DITIONS: (SEE REVERSE SIDE FOR NOTICE) PRELIM. FINAL DATE Env. Health Planning Fire Prevent. Engineer p '113 Utilities S SEPA �& Plans PERMIT IS NONTRANSFERABLE Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED B�Itlkng I A I N 180 DAYS Plan Check SEPA Modular/ MFG. Home Other (Specify) PERMIT NUMBER b&5' ij 0 TOTAL $ ==x I WHEN MACHINE VALIDATED IN THIS SPACE, THIS (�BECOMES APERMIT. L DATEYSSUEC` — PERMITNO. U' z * 3 8. 0 0 I AL Ab Zc, N 00