1982, 09-30 Permit: 82A-8932 ResidencePLAN NUMBER
APPLIC,I T' ON /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
Nj \ \b-7 ARC, cT
LEGAL DESCRIPTION - SEE ATTACHED
LOT
BLOCK SUBDIVISION
OWNER
3.
ADDRESS
(Lb tcai✓
PHONE
C,— ice,
PARCEL NUMBER /S
t sgo- >` 7
CONTRACTOR
4 >'e■C
' ADDRESS
DESIGNER
5. ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
/NEW ❑ ALT.
AiJ BLD. ❑ PLMB.
ZI P
Actual Set Backs in Feet
Q w North 'South
PHONE
ZIP
PHONE
ZIP
TO
❑ AD'N.
❑ MECH.
❑ RPL.
❑ M.H.
❑ MVE.
❑ POOL
❑ OTHER
East ""-e. Wes
Size of Parcel
l i tG uC(9_
Type Const.
ni
Occupancy
Valuation
Main Floor
Area of Decks
Upper Floors
DESCRIBE WORK
8. t N G `E Ann
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
c-c
WATER
SEWER
No. Baths
Zone Classification
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Garage Area
Finished Basement
No. Tories
CERTIFICATE
of EXEMPTION
Enum. Dist.
Ownership
Public ❑ Private Lu'
No. ,Rooms
Req'd.
Location (Area)
(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 INSPECTIO
DATE OF APPLICATION CHZ.2- S37.j SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Heald
nning
Fire Marshall
Co engine.
Utilities y-41-"Y
9/.0
Oz-
Plans Examiner
C,VV ri LS
SEPA Checklist
Bu,Lt din cy=echroiclan
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Storage
FEES COLLECTED
Single $
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$
PERMIT NUMBER
S ZA 3a
02* *24600
*246006
A *000
857,2
09 -22 -82
z 6479.
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED
8 2
P E R M I T"Nt'' 2 Z 2 4 6 i),[1-2u-2
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