1982, 12-15 Permit: 82B-1969 ResidencePLAN NUMBER
3041-
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
STRE9T'ADmRESS
1.
LOT
2. -?
Gl
OWry�R
3 fV is �'� :S'(�'
MAILING ADDRESS. •i 1'
CONTR CT R
I v i, AEG
SUBDIVISION
BLOCK
Cif
'PARCEL NO. I it) r5,.t
4.
PHONE
PHONE
ADDRESS
LICENSE EXPIRES
ZIP
PHONE ,c^
LEGAL DESCRIPTION:
Actual Set Back in Feet to:
North 4- i South S 2' East c..3 0 I West
ZIP
DESIGNER
5.
P5-161 /64-)1 A \
ADI SSi 1/N1
6.
CHANGE OF USE FROM
TO
PHONE
7Oj
ZIP
Size of Parcel
Zone asst i lion
Residential 12'
.x Commercial ❑
Ty1. f,on t. Occupancy Spnn red
,fj) I
El Yes o ❑Req'd.
NewConst. Valuation J �R4nodeled Valuation Total Bldg. Floor Area
'72,- f,.
Main Floor Upper Floors
Cover Deck
Garage /Storage
Greenhouse
Uncv. Deck
Fin. Basement
Unfin. Basement
TYPE 2(pEW ❑ ALT. ❑ AD' N.
7• OF
WORK BLD. ❑ PLMB. ❑ MECH.
❑ RPL. ❑ MVE.
❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Floors
1
Certifi. of Exempt.
or Variance
No. Fin.,gooms
Required Yes❑ No/
Received Yes ❑ No❑
8 DESI iFr 9RK
VALUATION
9.
SOL RCE
UTILITIES
11>-r 163 0 9 CA WP/fER
PUBLIC
PRIVATE ❑
GAS
ELECTRIC
CJ
Shorelines /Flood Hazard
Yes NotApplic. ❑
No. Dwel1 lings
Number
Plans Required
Received
SEWAGE/
SEPTIC Ai
SEWER ❑
Ownership
Public ❑ Private
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 REVER } SIDE FOR REQUIRED INSPECTIONS
SIGNATURE OF
OWNER OR AGENT -
_r1
APPLICATION
DATE
SPECIAL APPROVA - PECIA CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
PRELIM. FINAL DATE—
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL
PERMIT NUMBER
► 7e,
u2* *26&00
*264.006
A *0.00
165,92
12 -06 -82
6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE4s;UEc ,- 8 2
PERMtTtN0.6. 9 z * 2 6 4, 0 0 tLdTAL
N
5 c rttot
4-(
2r‘
9
>4.4AItt
75—