1982, 11-29 Permit 82B-1401 Demo Residence, GaragePLAN NUMBER
y
APPLICATION/PERMIT
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
STREET ADDRESS
1. - I2 ev— r�Z,f6,.'2j. -r--N
LOT LOCK SUBVISION
2. I6 11/12 B1r j
6, `��
.GVJNER PHONE
3. -,I_:"j rdirt51.1.(7JSr.(- /)- I(o2
MAILING ADDRESS
r-0 .0-0x 4 --,-y✓J
CONTRN'cffiv LICENSE EXPIRES
4 ADDRESS
�� t�/
DESIGNER
DESIGNER
5.
ADDRESS
CHANGE OF USE FROM
6.
PHONE
ZIP
PHONE
ZIP
PHONE
ZIP
TO
TYPE ❑ NEW ❑ ALT. ❑ AD'N. D RPL. ❑ MVE. THER
7. OF O'O
WORK I'LD. ❑ PLMB. ❑ MECH. ElM.H. ❑ POOL
DESCRIBE WORK
fp O'N10L 1 110(J
VALUATION
9.
SOURCE
OF
UTILITIES
AS
ELECTRIC
`��
PARCEL NO.
LEGAL DESCRIPTION:
Actual Set Backs In Feet to:
North I South
Size of Parcel
Type •nst
East I West
Zo eClassification Residential
C, z I 1 (� Commercial ❑
Occupa `y Sprinklered
(
❑Yes ❑No ❑Req'd.
NewConst. Valuation
/ (CL)`°
Remodeled Valuation Total Bldg. Floor Area
Main Floor Upper Floors
000
Cover Deck Uncv. Deck
No. Baths No. Floors
Garag
/Storage
Fin. Basement
No. Fin. Rooms
Greenhouse
Unfin. Basement
No. Dwellings
Certlfi. of Exempt.
or Variance
Required Yes❑ No0
lReceived Yes CI No0
Shorelines/Flood Hazard
Yes Not Apollo.
WAT R
PUBLIC 0
PRIVATE ❑
SEWA E Ownership
SEPTIC E SEWER CIPublic 0 Private 0
I hereby certify that I have read and examined this appl cation 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 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
SIGNATURE OF
OWNER OR AGENT
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
APPLICATION
DATE
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTIC
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS 9 �j I /� r�
DATE IiSIED 2— 8 2 PERMITk D, 1 z * 2 O. U 0 '(iOtAL
Number
Plans Required 0
Received 0
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $ •
PERMIT NUMBER
1z I+ol
0-
V
W
J
LL
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.