1982, 09-30 Permit: 82A-8933 Residence(PLAN 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
1.
LOT
2. E6'
13, togs trcz.�
SUBDIVISION
BLOCK
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL NUMBER /S
OWNER
3. i'■i/`)i.
ADDRESS
. 12-1V "� T
CONTRACTOR
4.
ADDRESS
DESIGNER
5. ADDRESS
PHONE
ZIP
Actual Set Backs in Feet
North A (South
PHONE
Size of Parcel
V 7X 5
ZIP
East IWestigI
Zone Classification
Type Const. Occupancy
Sprinklered
❑Yes ❑NO ❑ Req'd.
PHONE
Valuation
eAce
ZI P
Main Floor I Upper Floors
g --
Building Area in Sq. Ft.
a52
Garage Area
Storage
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
L9NEW ❑ ALT.
I'J BLD. ❑ PLMB.
TO
Area of Decks
elCD
Finished Basement
Unfin. Basement
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
No. Baths
No. Stories
No. Rooms
No. of Dwellings
DESCRIBE WORK
8. f, CIAIrVA.Lr ,�i,Q/.'�13� �c
CERTIFICATE
of EXEMPTION
Enum. Dist. I Location (Area)
Req'd.
Rec'd.
Not ¢eq'd.
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
SEWER
C• 'mac i.��C l✓..,,
Ownership
Public ❑ Private IN
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 INSPECTI b
DATE OF APPLICATION
SIGNATURE OF APPLICANT"—
SPECIAL APPROVALS
' NAME DATE
Healy(
PI ning
Fire Marshall
CS(.IEngi
�(u LJJ
Utilities
Plans Examiner
Oifv irlc.6
SEPA Checklist
Idchcia
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
FEES COLLECTED
Single $
Building '` ef;�
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMBER
02* *24E.00
*246006
A *C00
857.02
09- 22'' -82
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
019n30-12 89 3.3z *246.00 aF
DATE ISSUED
PERMIT NO.
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