1982, 02-25 Permit: 82A-1283 Fire Damage RepairPLAN 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
LOT BLOCK SIJADIVISION
3.
4.
LEGAL DESCRIPTION - SEE ATTACHED
OWNER
MR++ J i1'J 70
AD ESS
. B col A 1-141
CONTRACTOR
ADDRESS
DESIGNER
ADDRESS
PARCEL NUMBER /S ^+ I./
r5
Actual Set Backs in Feet
'South East IWest
PHONE
Size of Parcel
Zon Classification Li 6
ZIP
Type Const.
V yI
Occupancy 1 Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE
Valuation
Building Area in Sq. Ft.
ZIP
Main Floor
Upper Floors 1 Garage Area
Storage
CHANGE OF USE FROM
6.
TO
Area of Decks
Finished Basement
Unfin. Basement
TYPE
7. OF
WORK
❑ NEW ErIALT. ❑ AD N. ❑ RPL. ❑ MVE.
1"BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not
DES RIBE WORK e
8. l;}� i�'/kq r"3/1/4(r--- VALUATION SOURC GAS ELE IC
5co OF
9, , UTILITIES
Enum. Dist. I Location (Area)
WATER
SEWER
Ownership SE CODE
Public ❑ Private
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 onstruction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICATION ^ S - SIGNATURE OF APPLIC
SPECIAL APPROVALS
NAME DATE
Env l Health
Planning
Fire Marshall
Co. Engineer
Utilities
Pla Examiner
SEPA Checklist
Bard ++�T,etFiPtf ci a n
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$ �
PERMIT NUMBER
02* *4700
*4700 rri
*47,006
R *000 8
1282.5
02-25-82
5 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
07.'25' =82
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED
128.3 z *4'7.0.0 aI-2
PERMIT NO. TOTAL