1983, 05-02 Permit 83A-3515 AdditionPLAN NUMBER
APPLICAT'ON_/PERMIT
SPOKANE COUNTY - DEPART":TENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
LOT
2.
BLOCK
SUBDIVISION
OWNER
3
MAILING ADDRESS
t 3 JCS.,.; C.00I-)L4i1
4. ADDRESS
CONTRACTOR
a"#1Mr~
n� 0.01,6
DESIGNER
5.
ADDRESS
PHONE
LICENSE EXPIRES
CHANGE OF USE FROM
•
PHONE
CV2g.
ZIP
PHONE
ZIP
PHONE
ZIP
TO
TYPE ❑ EW ❑ ALT. 03 AD' N. ❑ RPL. 0 MVE.
7 OF ❑OTHER
WORK �' BLD. 0 PLMB. ❑ MECH. 0 M.H. ❑ POOL
North
PARCEL NO.
1 Q,^�,�� 1 l OC(
LEGAL DESCRIPTION:
Actual Set Backs In Feet to:
/ 7 / 'South
Size of Parcel
71C L(oC� Ail??12.ok
Ty,Const. Occupancy
N
NewConst. Valuation
Main Floor
�attz
East
West
Zone Classification
Residential IYI
Commercial ❑
Spr nklered
❑Yes ❑No ❑Req'd.
Remode ed Valuation
Upper Floors
Garage/Storage
Cover Deck
Uncv. Deck
No. Baths
Certif I. of Exempt.
or Variance
No. Floors
S. DSCRIBE WORK C,
VALUATION
9.
SOOURCE
F
UTILITIES
GAS
•
ELECTRIC
WATER
PUBLIC 0
PRIVATE 0
SEWAGE/
SEPTIC fsr
SEWER ❑
Total Bldg. Floor Area
Greenhouse
Fin. Basement
No. Fin. Rooms
Required Yes❑ NoPf
Received Yes❑ Nof]
Shorelines/Flood Hazard
Yes NotApplic. ❑
Ownership
Public 0 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
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au-
thority 10 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
SIGNATURE OF
OWNER OR AGENT
yt�Q/t
APPLICATION
DATE
SPECIAL APPRO5YALS
Env. Health
PRELIM. FINAL DOTE
(
f a !Ei!O 1
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SP • • AL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Unfln. Basement
No. Dwellings
Number
Required
Received
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
64?•el°
TOTAL $ 6`'3'
PERMITNUMBER
- 9_ 5
0
8.00
68.00
6 06
02* *68.00
*68.006
A *0,00
351,42
05-0283
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUkt ' 0 L' u 3'
35 L 5
PERMIT NO.
*68,0''0.2-F-1.
TOTAL