1983, 08-02 Permit 83A-7246 MH2.
L
HrrL1c.;A I ION/PERMIT
SPOKANE COUNTY — DEPARTMENT OF BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRES, HARD TO MAKE 3 COPIES
STREET ADDRESS
E - 119� M1%� I 9
LOT
BLOCK
SU.011 IO 5 pk t5i 4444
OVVN R 3. c_ �r' V614 �5j
MAILING ADDRESS
•
CONTT
4. ADDRESS
DESIGNER
J. ADDRESS
CHANGE OF USE FROM
5
LICENSE EXPIRES
PHONE
PHONE
ZIP
PHONE
ZIP
TO
PARCEL NO. 02 544 — 042_
LEGAL DESCRIPTION:
Actual Set Backs in Feet to: 11set•t 51 <NJ
( 9
North South East
Size of Parcel
Type
Occupancy
Z
New Const. Valuation
West
Zone Classification
Residential
Commercial ❑
Sprinklered
❑Yes ONo ❑ Reg 'd.
Remode ed Valuation
Main Floor Upper Floors Garage/Storage
Total Bldg. Floor Area
Greenhouse
Cover Deck
Uncv. Deck
Fin. Basement
Unf In. Basement
TYPE .eNEW ❑ ALT. D AD'N. ❑ 5Pt. ❑ MVE.
7. OF ❑ BLD. ❑ PLMB. D MECH. .PJ M.H. ❑ POOL ❑OTHER
WORK
DESCITBE WORK
8.
VALUATION SODURCEAS
9. UTIF
LITIES
ELECTRIC
WATE
PUB ICRQ'
PRIVATE ❑
SEWAG
SEPTIC
SEWER ❑
No. Baths
Certifi. of Exempt.
or Variance
No. Floors
Shorelines/Flood Hazard
Yes Not Applic. ❑
Ownership
Public ❑ Private ❑
No. Fin. Rooms
No. Dwellings
Required Yes No❑ Number
Received Yes ❑ Nol ;
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 7-2 ' - r3
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 Cl
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
50
Other (Specify)
TOTAL $ 2-(-)
PERMIT NUMBER
f�' -7Z4
07* *50.00
*50.006
A *0.00 0
724,5B
08-02-83
2 6479.
d
IL)
W
-J
L
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
S in
DATEn'ISSUED' 2 — 8 3
PERMIT NQ.' it * Q O O TOT
A- L