1983, 03-17 Permit: 83A-1945 ResidencePLAN NUMBER APPL ICAT ION /PERMIT PERMITNUMBER
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
1_
2.
3.
4
EM&A,
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
PARCEL NO.
6 CHANGE OF USE FROM
v 1-4 V L/ , c.=
- , mss-
PHO E �
---
PHONE
Fin. Basement
_L-�_�
�� � �
fl
IN K IZIP
No. Baths No.
Actual Set Backs in Feet to:
North South -3Q East West
CTOR ,
L%
� r/I,C.J.
LICENSE EXPIRES
PHONE
Size of Parcel
X
Zone lassification
0 Q crm ,
Residential 9
Commercial C
aE
7 �
ZIP
G
Ty
Doc
pancy
Sprinklered
Dyes ❑No ❑Req'd.
GN R IPRONE
2
Required
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
R SS
ZIP
Miain EIA_n o6r
I Upper Floors
Garage/)a St r
Greenhouse
6 CHANGE OF USE FROM
TO
Cover Deck
uncv. DeCK
Fin. Basement
unfi�erent
No. Baths No.
Floors
No. Fin. RoomsNo.
Dwellings
TYPE El NEW ❑ALT. 11 AD'N. El RPL. ❑ MVE.
7. OF ❑ OTHER
WORK ❑ BLD. ❑ PLMB. ❑ MECH. ❑ M. H. ❑ POOL
Certifi. of Exempt.
Required
Yes❑ No❑
Numbar
or Variance
Received
Yes❑ No❑
DESCRIB WORK.
8. f C� 2
Shorelines/ Flood Hazard
Yes❑ Not Applic. ❑
Plans Required
Received
VAAJATION
SOURCE
OF
G S
ELECTRIC
PUBLICWATER
GE
SESEWAPTIC
Ownership
FEES COLLECTED
9
UTILITIES
PRIVATE ElSEWER
❑
public ❑Private
Z;1t
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
—T«O
Building
work will be compiled 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 SIDE FOR REQUIRED INSPECTIONS
Plumbing
SIGNATURE OF APPLICATIO
OWNER OR AGENT DATE
Mach.
SPECIAL APPROVAts SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTIC )
PRELIM. FINAL DATE
L/v°
Plan Check
Env. Health
'
-01 Fi LP1 (7Z�-[J
3/6,
4
3`
SEPA
Planning
L223
i46Q�tNYy
9
Modular/
MFG. Home
Fire
Prevent.
Engineer
Other (Specify)
Utilities
TOTAL $
SEPA
WHEN MACHINE VALIDATED IN
Plans
PERMIT IS NONTRANSFERABLE
THIS BECOMES A PERMIT.
Exam.
Buildin
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
Tech. g IN 180 DAYS((�� Q
II? DATEIAE—DI 7— u 3 PERMITlI� 4,5 5 * 4 0 6, 0 0.1`AL
0
135,
w
YG .7j f 6 't
IU
I
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