1982, 12-01 Permit: 82B-1537 InsertPLAN 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 4 COPIES
JOB...aDDRE S'7 0 OS 'r]' ^ ucl._,
BL
CK SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
OW R P NE
3. h S L h cL!y -!oi? J (A1 jE IGVf� 42ts -4574
ADDRESS 1 ZIP
E AL
. I-1dos ILL Gc -
CONTRACTOR P ION E
4. fl `{-� NCI SOU W/51V
4
ADDRESS
' -
DESIGNER w
PHONE
5' ADDRESS
PARCEL NUMBER /S
Required Set Backs in Feet
North 'South
Size of Parcel
Type Const.
Occupancy
Valuation
East (West
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
ZIP
DWL Area I Basement Area
Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
CJ NEW
TO
Split Entry
Split Level
Rancher
❑ BLD.
❑ ALT. ❑ P,$ N. ❑ RPL. ❑ MVE.
❑ PLMB. ��MECH: ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Rec'd.
Not Req'd.
DESCRIBE WORK
s �5J EJ j lid J `(SEIF.(2r- P -. sa X
VALUATION Source GAS ELECTRIC
of
9. Utilities
WATER
SEWER
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 st e or local law regulating construction or the
performance of construction.
)DATE -/ -I G - by SIG
SPECIAL APPROVALS
DEPT. REQ'D. RECD.
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE 1?-4/612-OFFICIAL 1?-4/612-OFFICIAL APPROVED ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL $711f)�v
nU
PERMIT NUMBER
DATE .241 --
O4* *20.00
*2000,
A *000
15362
1 201 —82
6.479.
WHEN MACHINE VALIDATED IN THIS SPAC
TH I S f rIjtI EIS A r,ki M I T.
1 5,375 *2O,OO,aPi
DATE REMARKS
RECORD OF INSPECTIONS
T
Final Inspection
INSPECTED BY