1982, 12-08 Permit 82B-1764 Demo ResidencePLAN NUMBE9
APPLICATION/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
STRE
LOT
2.
OWNER
3
ADDRESS
f�(1,;s j titi-'yt
BLOCK
SUBDIVISION
M!{>ILING ADDRESS
/IAN M
CON
4. ADDRESS
tAr 1,)
TOR
CIckyditce IAA:11Iva
PHONE
et 2-fr - SS`n�7
LICENSE EXPIRES
DESIGNER
PHONE
PHONE
ZIP
PHONE
PARCEL NO./ ` 5q y _ Q 2 L
LEGAL DESCRIPTION: the,
/J(
'Pry.`i icy '''etc-C )III, LT6c,, ^+=vhlcy-J
Actual Set Backs in Feet to: 4.1
North 'South :. C, ( East (j I west
Size of Parcel Zone Classification
X(L, '
Sprinkiered
Dyes ❑No ❑Req'd.
Residential l21
Commercial ❑
New Const. Valuation
Remode ed Valuation
Total Bldg. Floor Area
260
ADDRESS
CHANGE OF USE FROM
6.
ZIP
TO
7 TYPE 0 �NNEW 0 ALT. 0 AD'N. 0 RPL. 0 MVE. C�OTHER
WORK ❑"BLD. 0 PLMB. 0 MECH. 0 M.H. CIPOOL
DESCRIBE WORK
8. 6c7I
VALU
9.
TION
0a
SOURCE
F
UTILITIES
LAND(, I otJ
GAS
Main Floor
Cover Deck
No. Baths
Upper Floors Garage/Storage
Uncv. Deck Fin. Basement
No. Floors No. Fin. Rooms
Greenhouse
Unfin. Basement
No. Dwellings
Certifi. of Exempt.
or Variance
ELECTRIC
WATER
PUBLIC ❑
PRIVATE 0
SEWAGE
SEPTIC 0
SEWER 0
IRequired
Received
Shorelines/Flood Hazard
Yes Not Appllc. ❑
Ownership
Public 0 Private r.
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 MO,ry>I �tntl�NTLr'f
OWNER OR AGENT
SPECIAL APPROVALS
PRELIM. FINAL DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
A._ DATE
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
Yes❑ No❑
Yes0 No0
Number
Plans Required ❑
Received ❑
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $ 2- _"
PERIVi1T NUi/13ER
02* *20.00
*20,008
E1 *0,00 2
1763g
12-08-82
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
•
DATE liSt2E15 0 8
82
PERMIT NO. 6. 4
d
z
*2O.00aJ
TOTAL
s