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HomeMy WebLinkAbout1983, 05-09 Permit: 83A-3883 ResidencePLAN NUMBER APPLICATION/PERMIT Z� SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY /f NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 �E ADDRESS � LJ 2. LQ�T BLOf;K 3 APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES PARCEL NO. r Su DIVISION LEGAL DESCRIPTION: PHON PHONE CON . CT �} LICENSE EXPIRES PHONE 4. ADDRESS �r ZIP DESIGNER PHONE 5. ADDRESS ZIP Actual Set Backs in Feet to: North South East West I� Sicel �j I`T �" Fin. Basement Zone Classif'cati n Residential P1 Commercial C list. Ty�OoNN Occu rxy M Sprinklered ❑Yes ❑No ❑Req'd. New Const. Valuation �o &??Z-1 Remodeled Valuation Total Bldg. Floor Area Main Flo9L Upper Floors IGaragelstorage j No. Dwellings Greenhouse CHANGE OF USE FROM TO Cover Deck Uncv. Deck Fin. Basement Unfin. Basement 6. ©© No. Baths No. Floors No. Fin. Rooms No. Dwellings TYPE Z NEW ❑ ALT. ❑ AWN. ❑ RPL. ❑ MVE. 7. OF ❑ OTHER LD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL Certifi.ofExempt. Required Yes El No❑ Number WORK or Variance Received Yes❑ No❑ DES RRequired 1 P az Plans e 8. & Yes0ShorelinesNot A ic. 0 Received VALUATTION SOURCE OF AS I ELECTRIC WATER PUBLIC SEWAGE SEPTIC ❑ Ownership / FEES COLLECTED 9• UTILITIES PRIVATE❑ SEWER/ Public ❑ Private F7 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 �r` ) work will be complied with whether specified herein or not. The granting of a permit does not presume to give au- Building thority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. SEE REVERSE SIM FOR REQUIRED INSPECTION Plumbing SIGNATURE OF APPLICATI fNIA/AICA no Ar_PtdT ° DATE Mach. SPECIAL APP PRELIM. Env. Health Planning Fire Prevent. Utilities ALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) — ,ATE -r LIC , /Nj C,(•7 IZ&4 0 Z_ p(::�' SEPA Plans',` PERMIT IS NONTRANSFERABLE Exam. `° '' PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED Building IN 180 DAYS Tech. Plan Check SEPA Modular/ MFG. Home Other (Specify) TOTAL $ I WHEN MACHINE VALIDATED IN TH THIS BECOMES A PERMIT. PERMIT NUMBER 2* 37 G C 379,1 C, DATE"F61 EDl 0 —8 3 PERMIT 4. 8, 3 oz * 3 / 0. 0 0 �OIFAL Ll 1! � 37 ON w