1983, 05-11 Permit 83A-3827 AdditionPLAN NUMBER
Cf
APPLICATION/PERMIT
SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
' NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
PERMIT NUMBER
8 A ;. 2-1
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS
1. 17 y91, 0
LOT BLOCK SUBDIVISION
Ir:Z-N C\fn \ Li 1319(1'
3 OW R 0 611 J ! PHONE PFjl *,/
MAILING ADDRESS
C NTRAC O
�t i, I 051
4. ADDRESS
r Iv 111 ►�' ;1Al 'ol %
DESIGNER
5.
VV�Z
LICENSE EXPIRES
PAO"
PHONE
PARCEL NO. it, .y i O 1 1
LEGAL DESCRIPTION:
Actual Set Backs in Feet to:
North 4, 7 I South
Size of Parcel
IQG'x�
ns . Ociupanc
[East I West 1
ne Classification Residential
Commercia ❑
Sprinklered
❑Yes ❑No ❑Reg'd.
New Const. Valuation Remode ed Valuation
Total Bldg. Floor Area
ADDRESS
CHANGE OF USE FROM
6.
ZIP
TO
TYPE ❑ NW ❑ ALT. r AD' N. ❑ RPL. ❑ MVE.
7 OF WORK BLD. ❑ PLMB. 0 MECH. 0 M.H. ❑ POOL ID OTHER
DESCRIBE WQRK
8.
VALUATION
9.
SOURCE
F
UTILITIES
ELECTRIC
Main Floor
Upper Floors
Garage/Storage
Fin. Basement
No. Fin. Rooms
Cover Deck
No. Baths
Certifi. of Exempt.
or Variance
Uncv. Deck
No. Floors
Shorellnes/Flood Hazard
Yes Not Applic.❑
Ownership
Public 0 Private 0
Greenhouse
Required Yes❑ No❑
Received Yes❑ No❑
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 visions of any other state or local law regulating construction or the performance
of construction. SE - /REVERSE 5,115E FOR REQUIR • INSPE • NS
SIGNATURE OF
OWNER OR AtEN
DPPLICATION/�/
DATE L/
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
SPE• IAL CONDITIONS: t5' REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Unfln. Basement
No. Dwellings
Number
Plans Required 0
Received ❑
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $
rfr
02* *54,00
ik54.006
A *0.00
374.2�
05--(:6-83
2 6479. •
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED
053
PERMIT NO.
TOTAL
382.7 V ;,..(* I000.
ILT
STEEL
BUILDINGS, INC.
N. 10111 Newport Highway • Spokane, WA 99218 • (509) 487-7090
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Pro, 560