HomeMy WebLinkAbout1983, 06-15 Permit 83A-5275 ResidencePLAN NUMBER
OSe
APPLICATION/PERMIT
,'OKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
PERMIT NUMBER
8.3A 5:2 5"
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1. 1N3D►Ar i4
LOT
2.
BLOCK SUBDIVISION
OWNER
3 'D �, trN'r�CLPit-15��s
MAILING ADDRESS
.9,7r X 6 .12)Gk 35
CONTRACTOR
4. SAKG
ADDRESS
�A
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
PHONE
LICENSE EXPIRES
PHONE
"(156"
ZIP
PHONE
ZIP
PHONE
ZIP
TO
7 TYPEy EW ❑ ALT. 0 AD`N. ❑ RPL. ❑ MVE. ❑OTHER
WORK r' BLD. ❑ PLMB. 0 MECH. ❑ M.H. ❑ POOL
PARCEL NO.
0154 — t01'1
LEGAL DESCRIPTION:,gti-cA'a�,.�A �A +�k •t?T. Lyir
P.5L-lc. ri ice) . ' c 82 : 'a""' F \t.1(.45 r
Actual Set Backs in Feet to:
North .554 South
Size of Parcel
Type Const. Occupancy
R:31m yl
ewConst. Valuation
44a 5
Main Floor
Cover Deck
No. Baths
.7-
East (o'
West Coil
Zone Classification
AGS.-4t3
Sprinklered
❑Yes ❑No ❑Req'd.
Remodeled Valuation
Upper Floors
Uncv. Deck
Garage/Storage
Fin. Basement
Residential
Commercial 0
Total Bldg. Floor Area
Greenhouse
Unfin. Basement
No. Floors
CertifI. of Exempt.
or Variance
Required
Received
No. Fin. Rooms
fj
Yes❑ Nol
Yes❑ No0
DESCRIBE WORK Shorelines/Flood Hazard
8. 6fAvV‘tLu
VALUATION SOURCE
9 UTILITIES
GAS
ELECTRIC
WATER
PUBLIC ❑
PRIVATE 0
SEWAGE
SEPTIC
SEWER ❑
Yes❑ Not Applic. ❑
Ownership /
Public ❑ Private it3
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 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 rum^
APPLICATION
DATE 5,-1..5) \.%3
SPECIAL APPROVALS
PRELIM. FOAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
9f r
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
No. Dwellings
Number
Plans Required (4";
Received ICY
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
co
TOTAL $ yt
0 2 * *3 1 1.0 0
*31 1.008
A *0.00 8
527.4
0.6— 1 5-83
2 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEQS UEb1 5 8
cr
PERMIT2. 7, 5 z 3 ,1 l Q' QOOJhAL