1983, 05-04 Permit 83A-3652 MHPLAN NUMBEK
PERMIT NUMBER
MrrL It.:a I IVIV / lLKIVl I I
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
1.
STREET A j re UBDLV ION
meq.c.ric.A.40A.,)v
2. 20 LOT BLOCK PI 1.1 C vim✓rr Pi 0 1.-6 4- 1 6',
PHONE PHONE
97b — 593:'
4' ADDRESS
CONTRACT
OWNER
fo►J NI 16 E- g+-L-
LING I ADDRESS
OR •
4-3
LICENSE EXPIRES
DESIGNER
5.
ADDRESS
CHANGE OF USE FROM
6.
ZIP
PHONE
ZIP
PHONE
ZIP
TO
TYPE . NEW ❑ ALT. ❑ AD'N. ❑ R L. ❑ MVE.
% OF OTHER
WORK ❑ BLD. ❑ PLMB. ❑ MECH.H. 0 POOL ❑
PARCEL NO.
09 - &4.24
LEGAL DESCRIPTION:
Actual Set Backs in Feet to: e".74.I
North l
Size of Parcel
South [East 1 West
Zone Classi ication
lr-
Residential g
Commercial ❑
Sprinklered
❑Yes ❑No ❑Req'd.
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor Area
Main Floor Upper Floors Garage/Storage
Greenhouse
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basement
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certifi. of Exempt.
or Variance
Required Yes❑ No❑
Received Yes❑ No❑
Number
DE CRIBE WORK
8. 0.0K-"'- I ({61--2c 7c7
VALUATION SOURCE GAS ELECTRIC WATER
9 • UTILITIES PUBLIC
PRIVATE ❑
SEWAGE/
SEPTIC :at
SEWER 0
Shorelines/ Flood Hazard
Yes NotApplic. ❑
Ownership
Public 0 Private
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 provi_ s of any other state or local law regulating construction or the performance
of construction. SEE REVERSE d1 OR REQUIRE 'INSPEC IONS
SIGNATURE OF
OWNER OR AGENT
APPLICATION,/��
DATE
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Plans Required ❑
Received 0
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
07* *50.00
*50.006
A *000 5
36512
05-04-83
2 6479
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEVSSuFDO 4 - 8 3
PERMIT]. 5, 2. z * 5 O. 0 0 04AL