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1983, 02-24 Permit 83A-1059 MHri_,.' iwrviocn II l ArrL1t;A I ION/PERMIT SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675 STREET ADDRESS 1. LOT 2. -37 OWNER 3. 4' ADDRESS 5' ADDRESS APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES EL • 11420 1•Akt.)S ► c..� MAILING ADDRESS • 164 ' •0 M I:-WS i= I E 4---p CONTRACTOR 5..exa AJC c, iCi ✓Vls"- DESIGNER CHANGE OF USE FROM PHONE `;37 LICENSE EXPIRES PHONE ZIP PHONE PHONE 7. TYPE `O NEW 0 ALT. El AD' N. 0 RPL. 0 MVE. OF ❑ BLD. 0 PLMB. 0 MECH. 1 "M.H. 0 POOL ❑ OTHER WORK DESCRIBE WORK 8. Pszt, VALUATION fret% SOURCE F UTILITIES GAS ELECTRIC WATER PUBLIC ❑ PRIVATE ❑ SEWA SEPTIC SEWER ❑ PARCEL NO. ©A544 LEGAL DESCRIPTION: Actual Set Backs in Feet to: �K t T VV cs North South East West Zone Classification Size of Parcel Typerffst. Occupancy X IQ Const. Valuation I A- err') Certifi. of Exempt. or Variance Residential 4 Commercial ❑ Spr nklered ❑Yes ❑No ❑Req'd. Remode ed Valuation Upper Floors No. Floors Shorelines/Flood Hazard Yes Not Applic. Ownership / Public ❑ Private IH Garage/Storage TotalcAdgiar Area Greenhouse 1 Unfin. Basement No. Fln. Rooms No. Dwellings Yes❑ No Yes ❑ No Required Received 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 REO }RED 1 PECTIONS SIGNATURE OF /J APPLICATIO OWNER OR AGENT '� _• • t DATE SPECIAL APPROVALS PRELIM. FINAL DATE Env. Health Planning Fire Prevent. Engineer Utilities SEPA Plans Bwm. Building Tech. SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) 9-4-2/iy/gte PERMIT IS NONTRANSFERABLE PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED IN 180 DAYS Number Requ red ❑ tv Received ❑ FEES COLLECTED Building Plumbing Mech. Plan Check SEPA Modular/ �r MFG. Home Other (Specify) TOTAL $ PERMIT NUMBER i3.3A -10E-✓°1 07* *50.00 *50008 A *0,00 0 10582 02-14-83 6479, WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. —14-53 105.9z HATE ISS02UED PERMIT NO. TOTAL *5O.00°H