1982, 09-13 Permit: 82A-8173 FixturesPLAN NUMBER
APPLICATION /PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456 -3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
i LC.7
LO BLOCK
OWN R
3. ��
4.
ADDRESS
CONTRACTOR
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DRESS �,
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SUCUI V ISION
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LEGAL DESCRIPTION - SEE ATTACHED
PHONE
ZIP
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
HONE
41-7
PHONE
ZI P
TO
ErNEW ❑ ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
❑ BLD. ( PLMB. ❑ MECH. ❑ M.H. ❑ POOL
❑ OTHER
9.
DESCRIBE WORK
VALUATION SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
PARCEL NUMBER /S
Actual Set Backs in Feet
North South
Size of Parcel
Type Const.
Valuation
Main Floor
Occupancy
Upper Floors
Area of Decks
No. Baths
No. Stories
CERTIFICATE
of EXEMPTION
Enum. Dist.
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Storage
Unfin. Basement
Location (Area)
Ownership
Public ❑ Private ❑
USE CODE
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 authority 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
DATE OF APPLICATION
SIGNATURE OF APPLICANT
c
LI"
SPECIAL APPROVALS
NAME DATE
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SPECIAL CONDITIONS:
SEPA Checklist
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
No. of Dwellings
FEES COLLECTED
Single $
Building —7
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
t 74
PERM'T NUMBER
03* *37.00
*37.00
A *0.00 8
817.2°
09 -13 -82
z 6.479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0'9 -13 -82
DATE ISSUED
(
817,32
PERMIT NO.
*37.00aI-
TOTAL