1983, 09-01 Permit 83A-8457 MHArrLI.:A I ICON/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
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LOT BLOCK UBin ; VISION
2. b F(t 4 oft L.- . - G—rc
q,„NJ, PM s
MAILINGADDRE S
CONTR• TOR
4. ADDRESS
•
DESIGNER
ADDRESS
CHANGE OF USE FROM
LICENSE EXPIRES
PHONE
2v7
ZIP
PHONE
ZIP
TO
TYPE NEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
7. OF ❑ BLD. ❑ PLMB. I: MECH. M.H. 0 POOL O OTHER
WORK
DESCRIBEoK
B.
SOURCE
F
UTILLIITIES
9.
VALUATION
ELECTRIC
PUBLICS SEPT!TAGG.
PRIVATE ❑ SEWER ❑
PARCEL NO.
LEGAL DESCRIPTI N:
Actual Set Backs in Feet to: }+ XIt, rm
North South w !(t East
•v-�
Size of Parcel
Type Co. t.
New Const. Valuation
West
Zone Cllassif tion
IC1^vAA`r
Sprinklered
❑Yes ❑No ❑Req'd.
Residential '.
Commercial ❑
Remodeled Valuation
Main Floor Upper Floors
No. Baths
Certifi. of Exempt.
or Variance
Uncv. Deck
No. Floors
Shorelines/Flood Hazard
Yes❑ Not Applic. 0
Ownership
Public 0 Private
Garage/Storage
Fin. Basement
No. Fin. Rooms
Total Bldg. Floor Area
Required Yes❑ No❑
Received Yes❑ Nofl
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
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 NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Greenhouse
Unfin. Basement
No. Dwellings
Plans Required 0
Received ❑
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
SD.
PERMIT NUMBER
07* *50.00
8456
09-01-83
6479,
O.
O
C3
W
—a
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
09-01-85 845.7z
DATE ISSUED
*5O.00a1-2
PERMIT NO. TOTAL