1983, 06-30 Permit 83A-6008 AdditionSTREET ADDRESS
�.
LOT
2.
BLOCK
rirrLm,M 1 IVIV/F'LRMIT
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
SUBDIVISION
OWNER
3 At-- ATtA.L_,4
MAILING ADDRESS
tz. 'T /
CONTRACTOR
NC312 fki r tj 2('\ t--tbc'rc-{7
ADDRESS
e. aok
DESIGNER
5.
ADDRESS
PHONE
LICENSE EXPIRES
PHONE
E5(
ZIP
PHONE
ZIP
Tel
PHONE
6.
CHANGE OF USE FROM
TO
ZIP
PARCEL NO.
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North 'South
Size of Parcel
Type Const. Occupancy
Nee Const. Valuation
S1 72- 4-
Main Floor
Cover Deck
East I West t t� j
Residential V
Commercial ❑
Zone Classification
�4f2. t
Sprinklered
❑Yes ❑No ❑Req'd.
Remode ed Valuation
Upper Floors
Total Bldg. Floor Area
ZiC.
Garage/Storage l Greenhouse
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE ❑ NEW ❑ ALT. (AD'N. ❑ RPL. ❑ MVE.
7. OF
WORK VBLD. ❑ PLMB. ❑ MECH. CIM.H. ❑ POOL
DESCRIBE WORK
8. Pt 0 (- i Y : ,� .712d LOCI fi'V1 `
VALUATION SOURCE
9' OF UTILITIES
GAS
❑ OTHER
No. Baths
Certifi. of Exempt.
or Variance
No. Floors
No. Fin. Rooms
No. Dwellings
I ELECTRIC I WATER
PUBLIC ❑
PRIVATE ❑
SEWAGE
SEPTIC II
SEWER ❑
Required Yes❑ Nod
Received Yes❑ Nor)
Shorelines/Flood Hazard
Yes Not Applic.X5 f
Ownership
Public ❑ Private 11(
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
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-
ority to violate or cancel the provisions of any other state or local law regulating construction or the performance
construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
SIGNATURE OF - 7APPLICATION
OWNER OR AGEN-
SPECIAL APPROVALS
PRELIM. FINAL t DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
ICtO
1-Apre.S4te YNt ri- VItittArdctq U a .4
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Number
Plans Required
Received V
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL
PERMIT NUMBER
b> - OIVej
Uc*
*E 800
*f 800
000 8
6007f
06-3C-83
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE IS(]ED l (,f ) 6 0 0. 8 oz
PERMIT NO.
*68.00°l
TOTAL