HomeMy WebLinkAbout1983, 10-06 Permit 83B-0000 Hay CoverPLAN NUMBER APPLIOA y ION/PERMIT
SPOKANE COUNTY — DEPAR) nfiENT OF BUILDING & SAFETY
l% NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 458-3675
STREETADDRESS
LOT BLOCK
2.
OWNER
3.
gaA' R12
APPLICANT: COMPLETE NUMBERED SPACES -PRESS HARD TO MAKE 3 COPIES
PARCEL NO. 018 1Q
sueoivlsioN P ON PHONE LEGALDESCRIPTION:W.
5410r- 6. I I c
ko y cr, I� ,1351 r
I I ZIP Actual Set Backs Infest to: _
' llvv
North ISOuth jEast
I West C,—
T ",rZ'/, �, ^
�'I l�.�l/ f/W
LICENSE EXPIRES
E?IN
e Parcel / Z ^e Iassllicgt�P
l
4.
fe7
f' ,merclel
❑
A RESS
P
pe
�
Oxu ncy
Sprinkiered
Oyes ONo OReq'd.
DESIGNER
PHONE
w Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
5.
ADDRESS
ZIP
ain Floor Upper
F
Garage/Sto�ag�
Greenhouse
CHANGEOFUSE FROM
TO
ver Deck Unw.
Deck
Fin. Basement
Untln. Basement
6.
-
-
-
. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
TYPE N W O ALT. O AD' N. O RPL. O MVE.
7 OF 0 OTHERrtiil
�D.
WORK O PLMB. O MECH. O M.H. ❑ POOL
of Exempt.
Required
YesO No❑
Number
varianoe
Received
YNO No0
6 DE BE W RK GCJ %
Shorellnes/FloodHazard
Plans Required�(YesO
Not Applic.11
RecelyVALUATIO
9•
SOOUFCE
GAS
ELECTRIC
PUBLICO
SEEP IACDwnerohip
FEES COLLECTED
UTILITIES
PRIVATE❑
SEWERublic
O Private
I hereby certify that 1 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-
Building
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction. SEE RWIME SIDE FOR JgQUIRED INSPECTIONS
Plumbing
SIGNATURE OF APPLICATION/Q
OWNER OR AGENT DATE
Mach.
SPECIALAPPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE
Plan Check
Env. Health
N
SEPA
Planning
Modular/
Fire
MFG. Home
Prevent.
Engineer
Other (Specify)
Utilities
SEPA
Plans
Exam.
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
TOTAL $
PERMITNUMBER
g�3tj— 0 o0
U2^ FSY00
tt00�
0 0 ".
WHEN MACHINE VALIDATED IN THIS SPACI
THIS BECOMES A PERMIT.
10W06t83' 0'z
DATE ISSUED - PERMIT NO.
*89,002,0
TOTAL
:I -
U.1 W
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