1982, 09-30 Permit: 82A-8935 ResidencePLAN 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 I I CC
Acz ._ L.T.
LOT
2.
BLOCK SUBDIVISION
LEGAL DESCRIPTION - SEE ATTACHED
boa
PARCEL NUMBER /S
OWNER
3. IJCC�c.` COS ' r2.t.t.G —CCO►v
ADDRESS
tC(Zil
PHONE
ZIP
ZIy
4.
CONTRACTOR
ADDRESS
DESIGNER
ADDRESS
CHANGE OF USE FROM
6.
TYPE
7. OF
WORK
TO
atiEw ❑ ALT. ❑ AD'N.
BLD. ❑ PLMB. ❑ MECH.
❑ RPL.
❑ M.H.
PHONE
ZIP
PHONE
ZIP
❑ MVE.
❑ POOL
❑ OTHER
Actual Set Backs in Feet
North ,./a.i 'South
Size of Parcel
ti lx C96 AVM-CA
Typ Const. Occupancy
V uation
NIC) 34=, gar
Main Floor
Area of Decks
DESCRIBE WORK
8. .t'vG Lt.- ( iDE■Y.�
VALUATION
9.
SOURCE
OF
UTILITIES
GAS
ELECTRIC
WATER
Upper
East 30 West
Zone Classification
S) (Nimr`V
Sprinklered
❑Yes ❑No ❑ Req'd.
Building Area in Sq. Ft.
Floors Garage Area
Storage
Finished Basemen
No. Baths
•
No. Stories
i
CERTIFICATE
of EXEMPTION
Enum. Dist.
SEWER
"&EST lC..,
Ownership
Public ❑ Private
Nooms
Unfin. Basement
No. of Dwellings
Req'd. Rec'd.
Location (Area)
SE 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
SIGNATURE OF APPLICANT
SPECIAL APPROVALS
NAME DATE
Fire Marshall
Plans Examiner
tti E
SEPA Checklist
Building nician
S'J'7 z`[Jj
SPECIAL CONDITIONS:
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Not Yeq'd.
FEES COLLECTED
Single
Building
Plumbing
Mech.
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
PERMIT NUMB °R
E'z r e° 35
02*
A
857.32
09 -22 -82
6.479.
*24600
*246006
*0.00
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
0'9 ='y3` Q 8.2
DATE ISSUED
89 3,(52 * 246.00 °r
PERMIT NO.
Loll Bloc_
be c1d
lk A
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011
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